Causative agent distribution and antibiotic therapy assessment among adult patients with community acquired pneumonia in Chinese urban population.
Causative agent distribution and antibiotic therapy assessment among adult patients with community acquired pneumonia in Chinese urban population.
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DOI：
10.1186/1471-2334-9-31
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发表时间：
2009-03-18
影响因子：
3.7
通讯作者：
Hou X
中科院分区：
文献类型：
--
作者：
Liu Y;Chen M;Zhao T;Wang H;Wang R;Cai B;Cao B;Sun T;Hu Y;Xiu Q;Zhou X;Ding X;Yang L;Zhuo J;Tang Y;Zhang K;Liang D;Lv X;Li S;Liu Y;Yu Y;Wei Z;Ying K;Zhao F;Chen P;Hou X
对社区获得性肺炎 (CAP) 主要微生物模式的了解构成了经验性抗菌治疗初步决策的基础，因此在 2003 年至 2004 年期间对中国成年城市人口的 CAP 进行了一项前瞻性研究。招募合格的患者，并通过痰和/或血培养以及抗体血清转化测试来筛查细菌、非典型和病毒病原体。还评估了抗生素治疗和患者结果。在 324/610（53.1%）名患者中发现非病毒病原体，其中肺炎支原体最为常见（126/610，20.7%）。在 62/195 (31.8%) 携带细菌病原体的患者中鉴定出非典型病原体。在 184 名随机选择的患者中，有 35 名（19%）发现了呼吸道病毒，其中腺病毒最为常见（16/184，8.7%）。肺炎链球菌对青霉素和阿奇霉素的不敏感性分别为22.2%（耐药（R）：3.2%，中间（I）：19.0%）和79.4%（R：79.4%，I：0%）。在查明致病病原体并记录抗生素治疗的患者（312 名）中，单独使用 β-内酰胺类抗生素以及联合使用 β-内酰胺类抗生素和大环内酯类药物或氟喹诺酮类药物的临床治愈率分别为 63.7%（79/124）和 67%（126/188）。对于肺炎支原体和/或肺炎衣原体混合感染的患者，使用针对非典型病原体的治疗方案（例如β-内酰胺加大环内酯或氟喹诺酮）比单独使用β-内酰胺有更高的治愈率（75.8% vs. 42.9%，p = 0.045）。在中国成人CAP患者中，肺炎支原体最为常见，且多见非典型病原体的混合感染。与其他地区报告的数据相比，肺炎链球菌的大环内酯类耐药率较高，青霉素耐药率较低。
Knowledge of predominant microbial patterns in community-acquired pneumonia (CAP) constitutes the basis for initial decisions about empirical antimicrobial treatment, so a prospective study was performed during 2003–2004 among CAP of adult Chinese urban populations. Qualified patients were enrolled and screened for bacterial, atypical, and viral pathogens by sputum and/or blood culturing, and by antibody seroconversion test. Antibiotic treatment and patient outcome were also assessed. Non-viral pathogens were found in 324/610 (53.1%) patients among whom M. pneumoniae was the most prevalent (126/610, 20.7%). Atypical pathogens were identified in 62/195 (31.8%) patients carrying bacterial pathogens. Respiratory viruses were identified in 35 (19%) of 184 randomly selected patients with adenovirus being the most common (16/184, 8.7%). The nonsusceptibility of S. pneumoniae to penicillin and azithromycin was 22.2% (Resistance (R): 3.2%, Intermediate (I): 19.0%) and 79.4% (R: 79.4%, I: 0%), respectively. Of patients (312) from whom causative pathogens were identified and antibiotic treatments were recorded, clinical cure rate with β-lactam antibiotics alone and with combination of a β-lactam plus a macrolide or with fluoroquinolones was 63.7% (79/124) and 67%(126/188), respectively. For patients having mixed M. pneumoniae and/or C. pneumoniae infections, a better cure rate was observed with regimens that are active against atypical pathogens (e.g. a β-lactam plus a macrolide, or a fluoroquinolone) than with β-lactam alone (75.8% vs. 42.9%, p = 0.045). In Chinese adult CAP patients, M. pneumoniae was the most prevalent with mixed infections containing atypical pathogens being frequently observed. With S. pneumoniae, the prevalence of macrolide resistance was high and penicillin resistance low compared with data reported in other regions.
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DOI：
10.1007/s10096-006-0146-7
发表时间：
2006-06-01
影响因子：
4.5
作者：
Huang, H. H.;Zhang, Y. Y.;Wang, F.
通讯作者：
Wang, F.
影响因子：
6.4
作者：
KAUPPINEN, MT;HERVA, E;SYRJALA, H
通讯作者：
SYRJALA, H
影响因子：
105.7
作者：
Mills, GD;Oehley, MR;Arrol, B
通讯作者：
Arrol, B
影响因子：
9.6
作者：
Moola, S;Hagberg, L;Staley, H
通讯作者：
Staley, H
影响因子：
3.1
作者：
COLLIER, AM;CLYDE, WA
通讯作者：
CLYDE, WA