Incidence and characteristics of viral community-acquired pneumonia in adults
Incidence and characteristics of viral community-acquired pneumonia in adults
复制标题
DOI：
10.1136/thx.2006.075077
复制
发表时间：
2008-01-01
期刊：
影响因子：
10
通讯作者：
Murdoch, D. R.
中科院分区：
文献类型：
--
作者：
Jennings, L. C.;Anderson, T. P.;Murdoch, D. R.
背景：在成人中，社区获得性肺炎（CAP）的病毒病因特征不明确。本研究的目的是通过使用广泛的病毒诊断测试阵列，并比较病毒性肺炎与肺炎球菌pneumococcus pneumonia.Methods的特点，以确定成人CAP的病毒病因学：成人入院基督城医院超过1年的时间与CAP被列入研究。微生物学检测方法包括血液和痰培养，肺炎链球菌和嗜肺军团菌的尿抗原检测，配对血清中的抗体检测和鼻咽拭子中的呼吸道病毒的检测，免疫荧光，培养和PCR.Results：304例CAP，病毒诊断88（29%），鼻病毒和流感A是最常见的。在49例（16%）患者中检测到两种或两种以上病原体，其中45例为病毒和细菌混合感染。尽管有几个变量与某些病因独立相关，但没有可靠的病毒性肺炎临床预测因子。肌痛的存在与任何呼吸道病毒引起的肺炎（OR 3.62，95% CI 1.29至10.12）和流感肺炎（OR 190.72，95% CI 3.68至9891.91）相关。鼻病毒/肺炎球菌混合感染与严重的疾病。结论：病毒相关的CAP是常见的成人。涉及细菌和病毒病原体的多种微生物感染是常见的，并可能与重症肺炎有关。
Background: In adults, viral causes of community-acquired pneumonia (CAP) are poorly characterised. The aims of this study were to characterise the viral aetiology of CAP in adults by using an extensive array of viral diagnostic tests and to compare the characteristics of viral pneumonia with those of pneumococcal pneumonia.Methods: Adults admitted to Christchurch Hospital over a 1-year period with CAP were included in the study. Microbiological testing methods included blood and sputum cultures, urinary antigen testing for Streptococcus pneumoniae and Legionella pneumophila, antibody detection in paired sera and detection of respiratory viruses in nasopharyngeal swabs by immunofluorescence, culture and PCR.Results: Of 304 patients with CAP, a viral diagnosis was made in 88 (29%), with rhinoviruses and influenza A being the most common. Two or more pathogens were detected in 49 (16%) patients, 45 of whom had mixed viral and bacterial infections. There were no reliable clinical predictors of viral pneumonia, although several variables were independently associated with some aetiologies. The presence of myalgia was associated with pneumonia caused by any respiratory virus (OR 3.62, 95% CI 1.29 to 10.12) and influenza pneumonia (OR 190.72, 95% CI 3.68 to 9891.91). Mixed rhinovirus/pneumococcal infection was associated with severe disease.Conclusions: Virus-associated CAP is common in adults. Polymicrobial infections involving bacterial and viral pathogens are frequent and may be associated with severe pneumonia.