Community-acquired pneumonia of mixed etiology:: prevalence, clinical characteristics, and outcome
Community-acquired pneumonia of mixed etiology:: prevalence, clinical characteristics, and outcome
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DOI：
10.1007/s10096-005-1346-2
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发表时间：
2005-06-01
影响因子：
4.5
通讯作者：
Martin-Hidalgo, A
中科院分区：
文献类型：
--
作者：
Gutiérrez, F;Masiá, M;Martin-Hidalgo, A
混合病原学的社区获得性肺炎(CAP)在文献中得到越来越多的重视，但其临床意义仍不清楚。这项分析的目的是描述混合病因的CAP的患病率、临床特征和转归。数据来自一项对连续两年的CAP患者进行的前瞻性研究，在这些患者中进行了广泛的微生物检查。使用预先定义的严格标准来确定病因学。共纳入493名患者。单种病原体222例(45%)，两种或两种以上病原体28例(5.7%)。在所有年龄段以及在医院和门诊接受治疗的患者中都可以看到混合感染。最常见的病原体组合是一种细菌+一种“非典型”生物(28.6%)和两种细菌生物(28.6%)。与单一微生物肺炎患者相比，混合性肺炎患者更有可能有基础疾病(%比45%，p=0.04)和痴呆(25%比10%，p=0.02)。混合性肺炎患者一系列明确的并发症发生率较高(39.3%vs.18.6%；OR=2.84；p=0.02)。混合病原学的社区获得性肺炎并不常见。混合型肺炎患者更有可能有潜在的医疗条件，他们的病程可能更严重。
Community-acquired pneumonia (CAP) of mixed etiology has increasingly been appreciated in the literature, but its clinical significance remains unknown. The aim of this analysis was to describe the prevalence, clinical characteristics, and outcome of CAP of mixed etiology. Data were obtained from a 2-year prospective study of consecutive patients with CAP in whom an extensive microbiological workup was performed. Predefined strict criteria were used to establish the etiology. A total of 493 patients were included. A single pathogen was detected in 222 (45%) cases and two or more pathogens in 28 (5.7%) cases. Mixed infections were seen across all age groups and in patients treated both in hospital and as outpatients. The most frequent combinations of pathogens were those of a bacterium plus an "atypical" organism (28.6%) and of two bacterial organisms (28.6%). Compared with patients with monomicrobial pneumonia, patients with mixed pneumonia were more likely to have underlying conditions (64% vs. 45%, p=0.04) and dementia (25% vs. 10%, p=0.02). The incidence of a defined series of complications was higher in patients with mixed pneumonia (39.3% vs. 18.6%; OR=2.84; p=0.02). Community-acquired pneumonia of mixed etiology is uncommon. Patients with mixed pneumonia are more likely to have underlying medical conditions, and they may have a more severe course of disease.