Klinik für Pneumologie, Medizinische Hochschule Hannover, Carl Neuberg Str 1, D-30625 Hannover, Germany.
Thorax. 2012 Jan;67(1):71-9. doi: 10.1136/thx.2009.129502. Epub 2010 Aug 20.
It is difficult to determine the impact of community-acquired pneumonia (CAP) in Europe, because precise data are scarce. Mortality attributable to CAP varies widely between European countries and with the site of patient management. This review analysed the clinical and economic burden, aetiology and resistance patterns of CAP in European adults. All primary articles reporting studies in Europe published from January 1990 to December 2007 addressing the clinical and economic burden of CAP in adults were included. A total of 2606 records were used to identify primary studies. CAP incidence varied by country, age and gender, and was higher in individuals aged ≥65 years and in men. Streptococcus pneumoniae was the most common agent isolated. Mortality varied from <1% to 48% and was associated with advanced age, co-morbid conditions and CAP severity. Antibiotic resistance was seen in all pathogens associated with CAP. There was an increase in antibiotic-resistant strains, but resistance was not related to mortality. CAP was associated with high rates of hospitalisation and length of hospital stay. The review showed that the clinical and economic burden of CAP in Europe is high. CAP has considerable long-term effects on quality of life, and long-term prognosis is worse in patients with pneumococcal pneumonia.
在欧洲，由于缺乏准确的数据，很难确定社区获得性肺炎（CAP）的影响。CAP 所致死亡率在欧洲各国之间以及患者管理地点之间差异很大。这篇综述分析了欧洲成年人中 CAP 的临床和经济负担、病因和耐药模式。所有纳入的研究都报告了欧洲的成年人 CAP 的临床和经济负担，发表时间为 1990 年 1 月至 2007 年 12 月。共使用 2606 条记录来确定主要研究。CAP 的发病率因国家、年龄和性别而异，≥65 岁的人群和男性中发病率更高。肺炎链球菌是最常见的分离病原体。死亡率从<1%到 48%不等，与高龄、合并症和 CAP 严重程度有关。所有与 CAP 相关的病原体均存在抗生素耐药性。虽然抗生素耐药菌株有所增加，但耐药性与死亡率无关。CAP 与高住院率和住院时间有关。综述表明，欧洲 CAP 的临床和经济负担很高。CAP 对生活质量有很大的影响，且肺炎链球菌肺炎患者的长期预后更差。
