Liu Hui, Xiao Xin-cai, Lu Jian-yun, Chen Zong-qiu, Luo Lei, Yang Zhi-cong
Division of Infectious Disease, Guangzhou Center for Disease Control and Prevention, Guang zhou 510440, China.
Division of Infectious Disease, Guangzhou Center for Disease Control and Prevention, Guang zhou 510440, China. Email:
Zhonghua Yu Fang Yi Xue Za Zhi. 2013 Dec;47(12):1089-94.
To investigate the epidemic characteristics and pathogenic spectrum of community acquired pneumonia (CAP) in Guangzhou from 2009 to 2012.
14 major comprehensive hospitals were selected from 11 districts as sentinel hospitals for CAP cases surveillance, including 18 982 223 in total during the 4 years. The characteristics of pathogenic spectrum of CAP were stratified and analyzed by year, age and season.
18 982 223 cases were included in the surveillance from year 2009 to 2012, in which 56 618 cases were CAP. The number of CAP cases increased from 8677 in year 2009 to 19 947 in year 2012 in Guangzhou; while the percentage of visits for CAP raised from 0.22% (8677/3 893 800) to 0.41% (19 947/4 839 766). The difference showed statistical significance (χ(2) = 2693.00, P < 0.05). Among the hospitalized CAP cases, 66.05% (10 954/16 585) were aged ≤ 5 years old or > 66 years old. The percentage of cases infected by a single pathogen was 88.11% (14 613/16 585), while co-infected cases accounted for 4.17% (691/16 585). Bacteria accounted for the largest proportion of 65.25% (10 821/16 585) as a single pathogen, followed by mycoplasma 13.54% (2245/16 585), virus 9.01% (1494/16 585) and chlamydia 0.32% (53/16 585). The proportion of virus infection was increasing from 4.74% to 11.64%. The difference showed statistical significance (χ(2) = 135.32, P < 0.05). Bacteria infection was the leading causes for CAP cases in all age groups; however the percentage increased with the increasing of ages. The rate of bacterial infection was increased from 48.35% (2993/6191) among children aged ≤ 5 years old to 81.31% (3873/4763) among adults aged over 65 years (χ(2) = 1632.00, P < 0.05). The rate of atypical pathogens (mycoplasma, chlamydia) for children ( ≤ 15 years old) (25.99%, 1805/6945) was higher than that for adults aged ≥ 16 years old (5.12%, 494/9640) (χ(2) = 2.11, P < 0.05). The effect from season on the pathogenic spectrum was not observed.433 hospitalized CAP cases were dead from 2009 to 2012. Case fatality rate was highest among people aged over 65 years old (4.70%, 224/4763) and lowest among children aged between 6 to 15 years old (0.27%, 2/754).
The incidence of community acquired pneumonia was rising in Guangzhou from 2009 to 2012. Bacteria was the dominant pathogen. Children and old people were the high-risk population of community acquired pneumonia; while co-infection was still at low level.
调查2009年至2012年广州社区获得性肺炎（CAP）的流行特征及病原谱。
从11个区选取14家大型综合医院作为CAP病例监测哨点医院，4年共纳入18982223例。按年份、年龄和季节对CAP病原谱特征进行分层分析。
2009年至2012年共纳入监测病例18982223例，其中CAP病例56618例。广州CAP病例数从2009年的8677例增至2012年的19947例；CAP就诊比例从0.22%（8677/3893800）升至0.41%（19947/4839766）。差异有统计学意义（χ(2)=2693.00，P<0.05）。住院CAP病例中，66.05%（10954/16585）年龄≤5岁或>66岁。单一病原体感染病例占88.11%（14613/16585），合并感染病例占4.17%（691/16585）。单一病原体中细菌占比最大，为65.25%（10821/16585），其次是支原体13.54%（2245/16585）、病毒9.01%（1494/16585）和衣原体0.32%（53/16585）。病毒感染比例从4.74%升至11.64%。差异有统计学意义（χ(2)=135.32，P<0.05）。各年龄组中细菌感染均为CAP主要病因；但随年龄增长占比增加。≤5岁儿童细菌感染率从48.35%（2993/6191）升至65岁以上成人的81.31%（3873/4763）（χ(2)=1632.00，P<0.05）。儿童（≤15岁）非典型病原体（支原体、衣原体）感染率（25.99%，1805/6945）高于≥16岁成人（5.12%，494/9640）（χ(2)=2.11，P<0.05）。未观察到季节对病原谱的影响。2009年至2012年433例住院CAP病例死亡。65岁以上人群病死率最高（4.70%，224/4763），6至15岁儿童最低（0.27%，2/754）。
2009年至2012年广州社区获得性肺炎发病率上升。细菌是主要病原体。儿童和老年人是社区获得性肺炎高危人群；合并感染水平仍较低。
