moniae in 3 (2%), Staphylococcus aureus in 3 (2%), gramnegative enterobacteria in 5 (4%), Moraxella catarrhalis in 2 (2%), and viruses in 4 (3%). The yields from laboratory tests were 48% for paired serology, 20% from adequate sputum sample, and 3% from blood culture. Conclusion: Our study shows that a large percentage of mild CAP cases are admitted to hospitals in Kuwait. Atypical pathogens have a signifi cant role in the etiology of CAP. There is overtreatment of CAP with a combination

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... nt consisting mainly of third-generation chephalosporins and macrolides. Introduction There are several studies from Europe and North America that describe the microbial etiology of community-acquired pneumonia (CAP) [1-3] . Despite extensive diagnostic testing in these studies, the responsible pathogen was not identifi ed in as many as 50% of patients. In a recent retrospective study, which was the fi rst in Kuwait [4] , we found that the microbial etiology of CAP in Kuwait was identifi ed in only 14% of the patients. The retrospective nature of this study and the lack of routine Abstract Objectives: The aim of this study is to determine the microbial etiology and severity of community-acquired pneumonia (CAP) in Kuwait. Subjects and Methods: The severity of consecutive adult CAP cases admitted to 3 hospitals over a 1-year period was classifi ed according to the Pneumonia Outcome Research Team (PORT) severity index. The microbial etiology was determined using standard methods for bacteria and serological tests for atypical and viral pathogens. Results: The study population was 124 of the 135 admissions; 63 female, 61 male; mean age 41.3 8 18 years. The severity class distribution was: class I 31%, class II 37%, class III 17%, class IV 13%, and class V 2%. Etiological agents were identifi ed from 44 patients (35%), with one pathogen in 31 (25%), two in 9 (7%), and three or more in 4 (3%). The most common pathogens identifi ed were: Mycoplasma pneumoniae in 14 patients (11%), Legionella pneumophila in 10 (8%), Chlamydia pneumoniae in 8 (6%), infl uenza B virus in 8 (6%), infl uenza A virus in 5 (4%), Haemophilus infl uenzae in 4 (3%), Streptococcus pneu-