西澳大利亚急诊科诊断的肺炎细菌学
The bacteriology of pneumonia diagnosed in Western Australian emergency departments.
作者信息
Ingarfield S L, Celenza A, Jacobs I G, Riley T V
机构信息
Discipline of Emergency Medicine, School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Western Australia, Australia.
出版信息
Epidemiol Infect. 2007 Nov;135(8):1376-83. doi: 10.1017/S0950268807007844. Epub 2007 Feb 5.
We used Western Australian emergency department data linked to hospital morbidity, death and microbiology data to describe the bacteriology of pneumonia according to age. The 'atypical' organisms and viruses were not assessed. A total of 6908 patients over a 3-year period were given an emergency department diagnosis of pneumonia, 76.9% were admitted and 6.3% died in hospital. Blood was cultured from 52.9% of patients with 6.4% growing potential pathogens. Streptococcus pneumoniae was the most common organism isolated and accounted for 92% of pathogens in those aged <15 years. Isolation of Enterobacteriaceae species tended to increase with age and accounted for around 25% of isolates from the elderly. Sputum was cultured from 25.3% of patients and bacteria were isolated from 30.3% of samples, commonly Haemophilus influenzae and S. pneumoniae. Isolates from sputum showed no distinct trend across age groups. These patterns question the value of routine blood and sputum cultures and have implications for empiric therapy for the elderly.
我们利用西澳大利亚急诊科的数据，这些数据与医院发病率、死亡率及微生物学数据相关联，以按年龄描述肺炎的细菌学情况。未对“非典型”病原体和病毒进行评估。在三年期间，共有6908例患者在急诊科被诊断为肺炎，76.9%的患者入院治疗，6.3%的患者在医院死亡。52.9%的患者进行了血培养，其中6.4%培养出潜在病原体。肺炎链球菌是最常分离出的病原体，在15岁以下患者中占病原体的92%。肠杆菌科细菌的分离率随年龄增长而趋于增加，在老年人中约占分离菌株的25%。25.3%的患者进行了痰培养，30.3%的样本分离出细菌，常见的是流感嗜血杆菌和肺炎链球菌。痰培养分离出的病原体在各年龄组中无明显趋势。这些模式对常规血培养和痰培养的价值提出了质疑，并对老年人的经验性治疗有影响。
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