Community acquired pneumonia in north eastern Australia--a hospital based study of aboriginal and non-aboriginal patients.

BACKGROUND: Although the most important organism causing community acquired pneumonia continues to be Streptococcus pneumoniae, the frequency of other pathogens varies considerably across the world.

AIMS: To look for the causes of community acquired pneumonia (CAP) in north east Australia. To examine the differences between Aboriginal and non-Aboriginal subjects with emphasis on prevalence, risk factors, causative organisms and prognosis.

METHODS: The records of 200 consecutive patients admitted to Cairns Hospital during 1992 with a diagnosis of pneumonia were studied.

RESULTS: Aboriginal patients made up half the numbers admitted, but only 13% of the population. More Aboriginal adults died than non-Aboriginal adults, but no child died. Heavy alcohol use, chronic lung disease and diabetes mellitus were the commonest risk factors for Aborigines (alcohol, chronic lung disease and cancer for non-Aboriginal subjects). S. pneumoniae, followed by Haemophilus influenzae were the most common pathogens found. Both were sensitive to amoxycillin. The yield of definite pathogens was low. Staphylococcal and melioidosis pneumonia were confined to Aboriginal patients. Chlamydia, legionella and Mycoplasma pneumoniae were not identified.