Molina Jesús, González-Gamarra Amelia, Ginel Leovigildo, Peláez Mª Encarnación, Juez Juan Luis, Artuñedo Antonio, Aldana Gonzalo, Quesada Enriqueta, Cabré Joan Josep, Gómez Antonio, Linares Manuel, Marín Maria Teresa, Yolanda Sanchez Pilar, Núñez Leonor, Gonzálvez Jaime, Mascarós Enrique, López Javier, Cano Agustina, Herrero José, Carmen Serra María, Cimas Enrique, Pedrol Marta, Alfaro Juan Vicente, Martinón-Torres Federico, Cifuentes Isabel, Méndez Cristina, Ocaña Daniel
Primary Health Care Center Francia, Fuenlabrada, 28943 Madrid, Spain.
Primary Health Care Center Goya, 28009 Madrid, Spain.
Microorganisms. 2021 Feb 28;9(3):508. doi: 10.3390/microorganisms9030508.
The real burden of community-acquired pneumonia (CAP) in non-hospitalized patients is largely unknown. This is a 3-year prospective, observational study of ambulatory CAP in adults, conducted in 24 Spanish primary care centers between 2016-2019. Sociodemographic and clinical variables of patients with radiographically confirmed CAP were collected. Pneumococcal etiology was assessed using the Binax Now test. Patients were followed up for 10 ± 3 days. A total of 456 CAP patients were included in the study. Mean age was 56.6 (±17.5) years, 53.5% were female, and 53.9% had ≥1 comorbidity. Average incidence of CAP was 1.2-3.5 cases per 1000 persons per year. Eighteen patients (3.9%) were classified as pneumococcal CAP. Cough was present in 88.1% of patients at diagnosis and fever in 70.8%. Increased pulmonary density (63.3%) and alveolar infiltrates with air bronchogram (16.6%) were the most common radiographic findings. After 14.6 ± 6.0 days (95% CI = 13.9-15.3), 65.4% of patients had recovered. Hospitalization rate was 2.8%. The most frequently prescribed antibiotics were quinolones (58.7%) and β-lactams (31.1%). In conclusion, one-third of CAP patients did not fully recover after two weeks of empiric antibiotic therapy and 2.8% required hospitalization, highlighting the significant burden associated with non-hospitalized CAP in Spain.
非住院患者社区获得性肺炎（CAP）的实际负担在很大程度上尚不清楚。这是一项对成人门诊CAP进行的为期3年的前瞻性观察研究，于2016年至2019年在西班牙24个初级保健中心开展。收集了影像学确诊的CAP患者的社会人口统计学和临床变量。使用Binax Now检测评估肺炎球菌病因。对患者进行了10±3天的随访。该研究共纳入456例CAP患者。平均年龄为56.6（±17.5）岁，53.5%为女性，53.9%有≥1种合并症。CAP的平均发病率为每年每1000人1.2 - 3.5例。18例患者（3.9%）被归类为肺炎球菌性CAP。诊断时88.1%的患者有咳嗽，70.8%的患者有发热。肺部密度增加（63.3%）和伴有空气支气管征的肺泡浸润（16.6%）是最常见的影像学表现。在14.6±6.0天（95%CI = 13.9 - 15.3）后，65.4%的患者康复。住院率为2.8%。最常开具的抗生素是喹诺酮类（58.7%）和β-内酰胺类（31.1%）。总之，三分之一的CAP患者在经验性抗生素治疗两周后未完全康复，2.8%的患者需要住院治疗，这凸显了西班牙非住院CAP所带来的重大负担。
