Clinical Study Concerning the Relationship between Community-Acquired Pneumonia and Viral Infection in Northern Thailand
Clinical Study Concerning the Relationship between Community-Acquired Pneumonia and Viral Infection in Northern Thailand
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DOI：
10.2169/internalmedicine.50.4738
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发表时间：
2011-01-01
影响因子：
1.2
通讯作者：
Watanabe, Hiroshi
中科院分区：
文献类型：
--
作者：
Hara, Koyu;Yahara, Koji;Watanabe, Hiroshi
目的 在泰国，与社区获得性肺炎 (CAP) 相关的病原体已在细菌病原体中进行了广泛研究，但尚未在病毒病原体中进行研究。为了阐明病毒病原体与CAP的关联，我们对CAP患者的病毒和细菌病原体进行了全面的研究。方法我们入组了2006年至2008年泰国清迈Nakornping医院住院的119名CAP患者。对肺炎的严重程度进行了分类，并估计了死亡的危险因素。从血液和痰标本中确定细菌和真菌病原体，并使用 7 种呼吸道病毒特异性引物，通过 RT-PCR 从鼻咽标本中鉴定病毒病原体。 结果 总体而言，29 名患者感染了 HIV，90 名患者未感染 HIV。 HIV感染者中最常分离出的微生物病原体是：4种肺炎克雷伯菌、4种结核分枝杆菌和3种流感嗜血杆菌。在非 HIV 感染患者中，主要微生物病原体为：6 株铜绿假单胞菌、5 株流感嗜血杆菌和 4 株肺炎克雷伯菌。至于CAP的病毒病原体，从2名HIV感染者和5名非HIV感染者中鉴定出流感病毒。此外，在非 HIV 感染患者中各 2 名患者中检测到人鼻病毒 (HRV) 和呼吸道合胞病毒 (RSV)。 结论 我们的研究表明，在泰国北部的 CAP 患者中，最常见的病毒是流感病毒 (5%)，其次是 HRV (2%) 和 RSV (2%)。潜在的慢性阻塞性肺疾病（COPD）似乎与疾病的严重程度相关。
Objective The etiological agents associated with community-acquired pneumonia (CAP) in Thailand have been studied extensively in bacterial pathogens, but not in viral pathogens. To clarify the association of viral pathogens with CAP, we conducted a comprehensive study of viral and bacterial pathogens in patients with CAP.Methods We enrolled 119 hospitalized patients with CAP in Nakornping Hospital, Chiang Mai, Thailand between 2006 and 2008. The severity of pneumonia was classified and the risk factors for death were estimated. Bacterial and fungal pathogens were determined from specimens taken from blood and sputum, and viral pathogens were identified from nasopharyngeal specimens by RT-PCR using primers specific for 7 respiratory viruses.Results Overall, 29 patients were HIV-infected and 90 patients were non-HIV-infected. The microbial pathogens most commonly isolated among HIV-infected patients were: 4 Klebsiella pneumoniae, 4 Mycobacterium tuberculosis and 3 Haemophilus influenzae. Among non-HIV infected patients, predominant microbial pathogens were: 6 Pseudomonas aeruginosa, 5 Haemophilus influenzae and 4 Klebsiella pneumoniae. As for viral pathogens for CAP, influenza virus was identified from 2 HIV-infected patients and 5 non-HIV infected patients. In addition, human rhinovirus (HRV) and respiratory syncytial virus (RSV) were identified from 2 patients each among non-HIV-infected patients.Conclusion Our study demonstrates that the most common viral agent was influenza virus (5%), followed by HRV (2%) and RSV (2%) among CAP patients in northern Thailand. The underlying chronic obstructive pulmonary disease (COPD) seems to be correlated with the severity of illness.