Community acquired pneumonia - a prospective UK study
Community acquired pneumonia - a prospective UK study
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DOI：
10.1136/adc.83.5.408
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发表时间：
2000-11-01
影响因子：
5.2
通讯作者：
Cant, A
中科院分区：
文献类型：
--
作者：
Drummond, P;Clark, J;Cant, A
背景 - 英国关于儿科社区获得性肺炎 (PCAP) 的数据很少。目的 - 调查英格兰东北部 PCAP 的病因和最有用的诊断测试。方法 - 对诊断为 PCAP 的住院患者进行前瞻性研究。结果 - 从 60% (81/136) 的病例中分离出病原体，并认为 51% (70/136) 的病例是其肺炎的明确或可能原因。 50 例 (37%) 感染病毒（65% 呼吸道合胞病毒），19 例 (14%) 感染细菌（7% A 组链球菌，4% 肺炎链球菌），有 1 例混合感染。在进行血清抗肺炎球菌溶血素抗体检测的亚组（51 名患者）中，6% 有肺炎球菌感染的证据，且全部年龄均在 2 岁以下。最佳诊断率是配对血清学（34%，31/87），其次是病毒免疫荧光（33%，32/98）。结论——病毒感染占诊断病例的71%。 A组链球菌是最常见的细菌感染原，肺炎支原体和肺炎链球菌的发病率均较低。肺炎球菌肺炎是 2 岁以下儿童肺炎最常见的细菌原因，但年龄较大的儿童则不然。炎症标志物和胸部 X 光特征无法区分病毒性肺炎和细菌性肺炎；血清学和病毒免疫荧光是最有用的诊断测试。
Background-There are few data on paediatric community acquired pneumonia (PCAP) in the UK.Aims-To investigate the aetiology and most useful diagnostic tests for PCAP in the north east of England.Methods-A prospective study of hospital admissions with a diagnosis of PCAP.Results-A pathogen was isolated from 60% (81/136) of cases, and considered a definite or probable cause of their pneumonia in 51% (70/136). Fifty (37%) had a virus implicated (65% respiratory syncytial virus) and 19 (14%) a bacterium (7% group A streptococcus, 4% Streptococcus pneumoniae), with one mixed infection. Of a subgroup (51 patients) in whom serum antipneumolysin antibody testing was performed, 6% had evidence of pneumococcal infection, and all were under 2 years old. The best diagnostic yield was from paired serology (34%, 31/87), followed by viral immunofluorescence (33%, 32/98).Conclusion-Viral infection accounted for 71% of the cases diagnosed. Group A streptococcus was the most common bacterial infective agent, with a low incidence of both Mycoplasma pneumoniae and S pneumoniae. Pneumococcal pneumonia was the most common bacterial cause of pneumonia in children under 2 years but not in older children. Inflammatory markers and chest x ray features did not differentiate viral from bacterial pneumonia; serology and viral immunofluorescence were the most useful diagnostic tests.