NEW AND EMERGING ETIOLOGIES FOR COMMUNITY-ACQUIRED PNEUMONIA WITH IMPLICATIONS FOR THERAPY - A PROSPECTIVE MULTICENTER STUDY OF 359 CASES
NEW AND EMERGING ETIOLOGIES FOR COMMUNITY-ACQUIRED PNEUMONIA WITH IMPLICATIONS FOR THERAPY - A PROSPECTIVE MULTICENTER STUDY OF 359 CASES
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DOI：
10.1097/00005792-199009000-00004
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发表时间：
1990-09-01
期刊：
影响因子：
1.6
通讯作者：
VICKERS, RM
中科院分区：
文献类型：
--
作者：
FANG, GD;FINE, M;VICKERS, RM
肺炎导致每年超过500，000名成年人住院，并在美国列为第六大死亡原因（1，2）。尽管在诊断技术和治疗方面取得了进展，但肺炎的管理仍然具有挑战性，因为在多达49%的病例中，确切的病因仍不确定（表1）。此外，新的病原体被认为是社区获得性肺炎的原因。鉴于诊断可能性范围广泛，管理变得更加复杂，因为通常一开始就需要经验性治疗，而精确的病原学诊断需要实验室检测结果，而这些结果可能无法立即获得。我们的具体目标是提供当今社会社区获得性肺炎的微生物病因频率的最新信息，以便合理制定最新的诊断和管理方法。由于许多新发现的或新认识的药物需要与用于更传统病原体的治疗不同的治疗，因此这些信息在经验性抗生素治疗的选择中是相关的。因此，我们进行了一项为期1年的前瞻性多中心研究，患者因肺炎而入住私人社区、大学和退伍军人管理局医院。入组研究的患者常规使用更新的专业实验室方法以及既定的肺炎诊断方法。
Pneumonia results in more than 500,000 hospital admissions annually in adults and ranks as the sixth leading cause of death in the United States (1, 2). Despite progress in diagnostic techniques and treatments, management of pneumonia remains challenging, because the precise etiology re-mains uncertain in as many as 49% of cases (Table 1). Moreover, new agents have been implicated as causes of community-acquired pneumonia. Given the broad spectrum of diagnostic possibilities, management has become more complex, as empiric therapy is usually required at the outset and precise etiologic diagnosis requires results of laboratory tests, which may not be immediately available. Our specific goal was to provide current information on the frequency of microbial etiologies for community-acquired pneumonia in the modern-day era such that an updated approach to diagnosis and management could be rationally formulated. Since many of the newly discovered or newly appreciated agents require therapy different from that used for the more traditional pathogens, this information would be pertinent in selection of empiric antibiotic therapy. We, therefore, conducted a 1-year prospective multicenter study of patients admitted for pneumonia to a private community, a university, and a Veterans Administration hospital. Newer specialized laboratory methods as well as estab-lished methods for diagnosis of pneumonia were routinely used for patients entered into the study.