Multiple pathogens in adult patients admitted with community-acquired pneumonia: A one year prospective study of 346 consecutive patients
Multiple pathogens in adult patients admitted with community-acquired pneumonia: A one year prospective study of 346 consecutive patients
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DOI：
10.1136/thx.51.2.179
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发表时间：
1996-02-01
期刊：
影响因子：
10
通讯作者：
Porath, A
中科院分区：
文献类型：
--
作者：
Lieberman, D;Schlaeffer, F;Porath, A
背景 - 本研究的目的是评估入院成人患者社区获得性肺炎的病因。方法 - 对以色列南部一所大学附属地区医院收治的患有社区获得性肺炎的连续 346 名平均 (SD) 49.3 (19.5) 岁（范围 17-94）成人患者（54% 男性）进行为期一年的前瞻性研究。从 308 名患者 (89%) 中获取恢复期血清样本。社区获得性肺炎的病原学诊断基于血培养阳性和/或肺炎链球菌、流感嗜血杆菌、卡他莫拉菌、呼吸道病毒、伯内蒂克克斯体、肺炎支原体、肺炎衣原体和军团菌抗体滴度的显着变化。 结果 - 279 名患者（80.6%）确定了社区获得性肺炎的病因。病原体分布如下：肺炎链球菌，148例（42.8%）；肺炎支原体，101（29.2%）；肺炎衣原体，62（17.9%）；军团菌，56 (16.2%)；呼吸道病毒，35 种（10.1%）；伯内氏 C , 20 (5.8%);流感嗜血杆菌 19 (5.5%)；及其他原因，21例（6.0%）。在 55 岁以上的患者中，肺炎衣原体是第二常见的病原体 (25.5%)。在 133 名患者 (38.4%) 中发现了一种以上病原体。结论 - 以色列社区获得性肺炎的病原体与世界其他地区描述的不同。在许多患者中发现了不止一种致病因子。对于所有这些患者，治疗应包括大环内酯类抗生素，至少在疾病的第一阶段。
Background - The purpose of this study was to assess the causes of community-acquired pneumonia in adult patients admitted to hospital.Methods - A prospective study was performed on 346 consecutive adult patients (54% men) of mean (SD) 49.3 (19.5) years (range 17-94) admitted to a university affiliated regional hospital in southern Israel with community-acquired pneumonia over a period of one year. Convalescent serum samples were obtained from 308 patients (89%). The aetiological diagnosis for community-acquired pneumonia was based on positive blood cultures and/or significant changes in antibody titres to Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, respiratory viruses, Coxiella burnetti, Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella sp.Results - The aetiology of community-acquired pneumonia was identified in 279 patients (80.6%). The distribution of causal agents was as follows: S pneumoniae, 148 patients (42.8%); M pneumoniae, 101 (29.2%); C pneumoniae, 62 (17.9%); Legionella sp, 56 (16.2%); respiratory viruses, 35 (10.1%); C burnetii, 20 (5.8%); H influenzae 19 (5.5%); and other causes, 21 patients (6.0%). In patients above the age of 55 years C pneumoniae was the second most frequent aetiological agent (25.5%). In 133 patients (38.4%) more than one causal agent was found.Conclusions - The causal agents for community-acquired pneumonia in Israel are different from those described in other parts of the world. In many of the patients more than one causal agent was found. In all these patients treatment should include a macrolide antibiotic, at least in the first stage of their illness.