Wang Xinxin, Zhang Haihua, Zhang Tao, Pan Lei, Dong Ke, Yang Ming, Ma Ruina, Li Yujuan
Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China.
Department of Laboratory, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China.
Infect Drug Resist. 2020 Jun 8;13:1607-1617. doi: 10.2147/IDR.S251564. eCollection 2020.
The etiology and distribution of community-acquired pneumonia (CAP) vary periodically and geographically. The clinical evaluation of CAP among patients with cancers remains unknown.
This retrospective hospital-based study on adult CAP was conducted in Tang Du Hospital, China, from September 2018 to August 2019. The demographic characteristics, clinical manifestations and laboratory data were extracted from medical records and compared between CAP patients with and without cancers. Univariable and multivariable logistic regression methods were used to explore risk factors associated with CAP patients with and without cancers.
Data from 149 CAP patients with cancers and 268 CAP patients without cancers were analyzed. Patients without cancers were more likely to show fever, cough and yellow sputum, higher level of neutrophil count than the cancer patients. ( 14.77% vs 9.33%, p = 0.093) and ( 16.11% vs 11.57%, p = 0.189) were among the most commonly encountered pathogens in both the groups. (P. 26.50% vs 11.41%, p < 0.001), ( 8.21% vs 1.34%, p = 0.003), and filamentous fungi (10.82% vs 4.7%, p = 0.033) were predominant in CAP patients without cancers. ( 22.15% vs 14.18%, p = 0.038) and (MRS 23.49 vs 15.68, p = 0.049) were more prevalent for CAP cancer patients. Certain pathogens were increasing in a cold season. In patients without cancers, MRS, and were associated with central nervous system (CNS) disease, connective tissue disease, bronchiectasis, respectively. In addition, healthy adults were likely to be infected with showing fever.
CAP patients with cancers had atypical clinical manifestations and showed no distinct increase in inflammatory markers. The predominant pathogens differed as well as similar between the CAP patients with and without cancers. Certain pathogens follow a seasonal pattern. CNS disease, connective tissue disease and bronchiectasis were associated with the predominant pathogens in patients without cancers.
社区获得性肺炎（CAP）的病因和分布随时间和地域周期性变化。癌症患者中CAP的临床评估尚不清楚。
本项基于医院的成人CAP回顾性研究于2018年9月至2019年8月在中国唐都医院进行。从病历中提取人口统计学特征、临床表现和实验室数据，并在有癌症和无癌症的CAP患者之间进行比较。采用单变量和多变量逻辑回归方法探讨有癌症和无癌症的CAP患者的危险因素。
分析了149例有癌症的CAP患者和268例无癌症的CAP患者的数据。无癌症患者比癌症患者更易出现发热、咳嗽和黄痰，中性粒细胞计数水平更高。（14.77%对9.33%，p = 0.093）和（16.11%对11.57%，p = 0.189）是两组中最常见的病原体。（肺炎克雷伯菌26.50%对11.41%，p < 0.001）、（金黄色葡萄球菌8.21%对1.34%，p = 0.003）和丝状真菌（10.82%对4.7%，p = 0.033）在无癌症CAP患者中占主导。（耐甲氧西林金黄色葡萄球菌22.15%对14.18%，p = 0.038）和（MRS 23.49对15.68，p = 0.049）在有癌症的CAP患者中更普遍。某些病原体在寒冷季节增加。在无癌症患者中，耐甲氧西林金黄色葡萄球菌、肺炎克雷伯菌和铜绿假单胞菌分别与中枢神经系统（CNS）疾病、结缔组织病、支气管扩张有关。此外，健康成年人感染肺炎克雷伯菌时可能出现发热。
有癌症的CAP患者临床表现不典型，炎症标志物无明显升高。有癌症和无癌症CAP患者的主要病原体既有差异又有相似之处。某些病原体呈季节性规律。中枢神经系统疾病、结缔组织病和支气管扩张与无癌症患者的主要病原体有关。
