Jokinen C, Heiskanen L, Juvonen H, Kallinen S, Kleemola M, Koskela M, Leinonen M, Rönnberg P R, Saikku P, Stén M, Tarkiainen A, Tukiainen H, Pyörälä K, Mäkelä P H
Department of Medicine, Kuopio University Hospital, Kuopio, Finland.
Clin Infect Dis. 2001 Apr 15;32(8):1141-54. doi: 10.1086/319746. Epub 2001 Mar 23.
To determine the etiology of community-acquired pneumonia in the adult population of a defined area, specific antibody responses in paired serum samples, levels of circulating pneumococcal immune complexes in serum samples, and pneumococcal antigen in urine were measured. Samples (304 paired serum samples and 300 acute urine samples) were obtained from 345 patients > or =15 years old with community-acquired, radiologically confirmed pneumonia, which comprised all cases in the population of 4 municipalities in eastern Finland during 1 year. Specific infecting organisms were identified in 183 patients (including 49 with mixed infection), as follows: Streptococcus pneumoniae, 125 patients; Haemophilus influenzae, 12; Moraxella catarrhalis, 8; chlamydiae, 37 (of which, Chlamydia pneumoniae, 30); Mycoplasma pneumoniae, 30; and virus species, 27. The proportion of patients with pneumococcal infections increased and of those with Mycoplasma infections decreased with age, but for each age group, the etiologic profile was similar among inpatients and among outpatients. S. pneumoniae was the most important etiologic agent. The annual incidence of pneumococcal pneumonia per 1000 inhabitants aged > or =60 years was 8.0.
为确定某特定区域成年人群社区获得性肺炎的病因，对配对血清样本中的特异性抗体反应、血清样本中循环肺炎球菌免疫复合物水平以及尿液中的肺炎球菌抗原进行了检测。样本（304份配对血清样本和300份急性尿液样本）取自345例年龄≥15岁的社区获得性肺炎患者，这些患者的肺炎经放射学确诊，涵盖了芬兰东部4个直辖市1年内该人群中的所有病例。在183例患者（包括49例混合感染患者）中鉴定出了特定的感染病原体，具体如下：肺炎链球菌，125例；流感嗜血杆菌，12例；卡他莫拉菌，8例；衣原体，37例（其中肺炎衣原体30例）；肺炎支原体，30例；病毒种类，27例。肺炎球菌感染患者的比例随年龄增长而增加，支原体感染患者的比例随年龄增长而下降，但在每个年龄组中，住院患者和门诊患者的病因学特征相似。肺炎链球菌是最重要的病原体。每1000名年龄≥60岁居民中肺炎球菌肺炎的年发病率为8.0。
