【摘要】 目的 研究社区获得性肺炎患者病原微生物分布情况。方法 选择2017年1月至2018年1月在本院急诊科治疗的确诊为社区获得性肺炎(CAP)的患者257例,采用自行设计的调查表研究患者基本资料,收集患者痰标本和血液标本进行微生物检测。结果 入选患者中年龄≥60岁者比例明显高于18～44岁及45～59岁患者。年龄≥60岁的患者中高血压、冠心病、糖尿病、COPD、肾功能不全、入院前抗生素使用、BMI≤18.5,CURB-65≥2的比例明显高于18～44岁及45～59岁患者。嗜肺军团菌(11.28%)是患者最常见的病原体,其次为流感病毒(10.51%)。其余检出病原体为铜绿假单胞菌(9.34%)、大肠埃希菌(8.95%)、金黄色葡萄球菌(8.56%)、支原体(5.84%)、鲍曼不动杆菌(5.06%)、肺炎衣原体(5.06%)、阴沟肠杆菌(2.72%)、克雷伯杆菌(2.72%)、肺炎链球菌(2.72%),嗜麦芽假单胞菌(2.33%)、产气肠杆菌(1.17%)、流感嗜血杆菌(0.78%)、溶血链球菌(0.39%)。≥60岁患者中嗜肺军团菌、流感病毒、铜绿假单胞菌、大肠埃希菌、鲍曼不动杆菌感染的比例明显高于18～44岁及45～59岁患者。结论 CAP主要发病于60岁以上的患者,糖尿病、高血压、肾功能不全等合并症可能是CAP的危险因素。嗜肺军团菌、流感病毒、大肠埃希菌、铜绿假单胞菌、支原体、鲍曼不动杆菌等是CAP的主要病原微生物。更多还原

【Abstract】 Objective To explore the distribution of pathogenic microbes in patients with community-acquired pneumonia(CAP). Methods 257 patients with CAP diagnosed in the emergency department of our hospital from January 2017 to January 2018 were enrolled. The self-designed questionnaire was used to collect the basic data of patients, and specimens of patient sputum and blood were collected for microbiological examination. Results The ratio of patients aged ≥60 years was significantly higher than those aged 18-44 years and 45-59 years. In age ≥60 group, the ratios of hypertension, coronary heart disease, diabetes, COPD, renal insufficiency, antibiotic use before admission, BMI≤18.5 and CURB-65≥2 were significantly higher than those aged 18-44 years and 45-59 years respectively. Legionella pneumophila(11.28%) was the most common pathogen, followed by influenza virus(10.51%), Pseudomonas aeruginosa(9.34%), Escherichia coli(8.95%), Staphylococcus aureus(8.56%), Mycoplasma(5.84%), Acinetobacter baumannii(5.06%), Chlamydia pneumoniae(5.06%), Enterobacter cloacae(2.72%), Klebsiella(2.72%), Streptococcus pneumoniae(2.72%), Pseudomonas maltophilia(2.33%), Enterobacter aerogenes(1.17%), Haemophilus influenzae(0.78%) and Streptococcus hemolyticus(0.39%). The rates of Legionella pneumophila, influenza virus, Pseudomonas aeruginosa, Escherichia coli and Acinetobacter baumannii infection in patients ≥60 years were significantly higher than in those aged 18-44 and 45-59 years respectively. Conclusion The incidence of CAP is higher in elderly patients aged ≥60 years. Complications such as diabetes, hypertension and renal insufficiency are potentially the risk factors of CAP. Legionella pneumophila, influenza virus and Escherichia coli are the main pathogens of CAP.更多还原