University College London.
Clin Med (Lond). 2012 Dec;12(6):538-43. doi: 10.7861/clinmedicine.12-6-538.
Community-acquired pneumonia (CAP) is one of the most common acute infections requiring admission to hospital. The main causative pathogens of CAP are Streptococcus pneumoniae, influenza A, Mycoplasma pneumoniae and Chlamydophila pneumoniae, and the dominant risk factors are age, smoking and comorbidities. The incidence of CAP and its common complications, such as the requirement for intensive care and complicated parapneumonic effusions, are increasing, making it essential for all physicians to have a good understanding of the management of CAP. Although the diagnosis and treatment of CAP is straightforward in most cases, it can be more complex, and recent data indicate that the mortality of CAP in the UK is surprisingly high. In the future, routine use of biomarkers to improve risk stratification and tailor management to individual patients could improve outcomes, and there is some evidence that modulation of CAP-associated inflammation could also be beneficial. Both research into host-microbial interactions in the lung and clinical trials of different management and preventative treatments are urgently needed to combat the increasing morbidity and mortality associated with CAP.
社区获得性肺炎（CAP）是最常见的需要住院治疗的急性感染之一。CAP 的主要病原体包括肺炎链球菌、甲型流感病毒、肺炎支原体和肺炎衣原体，主要危险因素是年龄、吸烟和合并症。CAP 的发病率及其常见并发症（如需要重症监护和复杂的肺炎旁胸腔积液）正在增加，因此所有医生都必须很好地了解 CAP 的管理。尽管在大多数情况下，CAP 的诊断和治疗都很简单，但也可能更复杂，最近的数据表明，英国 CAP 的死亡率出人意料地高。在未来，常规使用生物标志物来改善风险分层，并根据个体患者的情况调整治疗方案，可能会改善预后，而且有一些证据表明，调节 CAP 相关炎症也可能有益。为了应对与 CAP 相关的发病率和死亡率的增加，迫切需要研究肺部宿主-微生物相互作用以及不同管理和预防治疗的临床试验。
