Almirall Jordi, Cabré Mateu, Clavé Pere
Servei de Cures Intensives, Hospital de Mataró, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Barcelona, Spain.
Nestle Nutr Inst Workshop Ser. 2012;72:67-76. doi: 10.1159/000339989. Epub 2012 Sep 24.
The incidence and prevalence of aspiration pneumonia (AP) are poorly defined. They increase in direct relation with age and underlying diseases. The pathogenesis of AP presumes the contribution of risk factors that alter swallowing function and predispose to the oropharyngeal bacterial colonization. The microbial etiology of AP involves Staphylococcus aureus, Haemophilus influenzae and Streptococcus pneumoniae for community-acquired AP and Gram-negative aerobic bacilli in nosocomial pneumonia. It is worth bearing in mind the relative unimportance of anaerobic bacteria in AP. When we choose the empirical antibiotic treatment, we have to consider some pathogens identified in oropharyngeal flora. Empirical treatment with antianaerobics should only be used in certain patients. According to some known risks factors, the prevention of AP should include measures in order to avoid it.
吸入性肺炎（AP）的发病率和患病率尚无明确定义。它们与年龄和基础疾病呈直接正相关。AP的发病机制推测是由改变吞咽功能并易导致口咽部细菌定植的危险因素所致。AP的微生物病因在社区获得性AP中包括金黄色葡萄球菌、流感嗜血杆菌和肺炎链球菌，在医院获得性肺炎中则为革兰氏阴性需氧杆菌。值得注意的是，厌氧菌在AP中的相对重要性较低。在选择经验性抗生素治疗时，必须考虑口咽部菌群中已确定的一些病原体。仅在某些患者中使用抗厌氧菌的经验性治疗。根据一些已知的危险因素，AP的预防应包括采取措施以避免其发生。
