Bansal S, Kashyap S, Pal L S, Goel A
Department of Medicine, Indira Gandhi Medical College and Hospital, Shimla, India.
Indian J Chest Dis Allied Sci. 2004 Jan-Mar;46(1):17-22.
Community acquired pneumonia (CAP) is a common clinical problem. The present study was designed to evaluate the clinical and bacteriological profile of CAP in Shimla.
Seventy patients with community acquired pneumonia were enrolled in this study. In all the patients blood culture, sputum culture, pleural fluid culture (if available) and serological studies for the detection of Mycoplasma pneumoniae specific IgM antibodies by enzyme linked immunosorbent assay (ELISA) were done.
Of the 70 patients, 53 (75.6%) had an identifiable atiology with 12 patients having evidence of mixed infection. No organisms could be isolated in 17 patients inspite of using serological methods for Mycoplasma pneumoniae, invasive procedures like bronchoscopic aspirations in addition to the conventional methods like sputum culture, blood culture and pleural fluid culture. The most frequent pathogen was Streptococcus pneumoniae (n = 19; 35.8%) followed by Klebsiella pneumoniae (n = 12; 22%), Staphylococcus aureus in (n=9; 17%), Mycoplasma pneumoniae (n = 8; 15%), Escherichia Coli (n = 6; 11%), beta-haemolytic streptococci (n = 4; 7.5%) and other Gram-negative bacilli (n = 5, 9%).
Age smoking and under lying co-morbid conditions specially chronic obstructive pulmonary disease (COPD) were significantly associated with the development of CAP (p < 0.01).
社区获得性肺炎（CAP）是一个常见的临床问题。本研究旨在评估西姆拉地区社区获得性肺炎的临床和细菌学特征。
本研究纳入了70例社区获得性肺炎患者。对所有患者进行了血培养、痰培养、胸腔积液培养（若有），并通过酶联免疫吸附测定（ELISA）进行血清学研究以检测肺炎支原体特异性IgM抗体。
70例患者中，53例（75.6%）有明确的病因，12例有混合感染的证据。尽管使用了检测肺炎支原体的血清学方法、除痰培养、血培养和胸腔积液培养等传统方法外还采用了支气管镜吸取等侵入性操作，但仍有17例患者未分离出病原体。最常见的病原体是肺炎链球菌（n = 19；35.8%），其次是肺炎克雷伯菌（n = 12；22%）、金黄色葡萄球菌（n = 9；17%）、肺炎支原体（n = 8；15%）、大肠杆菌（n = 6；11%）、β溶血性链球菌（n = 4；7.5%）和其他革兰阴性杆菌（n = 5；9%）。
年龄、吸烟和潜在的合并症，特别是慢性阻塞性肺疾病（COPD）与社区获得性肺炎的发生显著相关（p < 0.01）。
