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急性社区获得性下呼吸道感染的致病特征与临床特点

Pathogenic features and clinical characteristics of acute community-acquired lower respiratory tract infections.

作者信息

Li Na, Yan Xixin, Lu Zhiwei, You Xiaonan, Yang Shengfen

机构信息

Na Li, Department of Infectious Diseases, The First Department of Pulmonary and Critical Care Medicine, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Respiratory Critical Care Medicine, Hebei Institute of Respiratory Diseases, Shijiazhuang 050000, Hebei, China.

Xixin Yan, The First Department of Pulmonary and Critical Care Medicine, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Respiratory Critical Care Medicine, Hebei Institute of Respiratory Diseases, Shijiazhuang 050000, Hebei, China.

出版信息

Pak J Med Sci. 2024 Aug;40(7):1355-1360. doi: 10.12669/pjms.40.7.7899.

DOI:10.12669/pjms.40.7.7899
PMID:39092033
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11255800/
Abstract

OBJECTIVE

To investigate the pathogen distribution and clinical characteristics of acute community-acquired lower respiratory tract infections (CALRTIs).

METHODS

This was a retrospective study. The clinical data of 218 patients with CALRTIs admitted to Baoding No.1 Central Hospital from December 2021 to December 2022 were retrospectively collected and were divided into two groups according to the results of polymerase chain reaction(PCR) testing using a nasopharyngeal swab: streptococcus pneumoniae positive group(observation group) and non-streptococcus pneumoniae positive group(control group). Clinical symptoms, blood gas analysis indicators were compared between the two groups.

RESULTS

Haemophilus influenzae and Staphylococcus aureus, as well as virus and atypical pathogen infection, were the predominant pathogenic bacteria in both groups. No statistically significant differences were observed in the positive rates of sputum smear, sputum culture, respiratory virus detection and atypical pathogen detection between the two groups(P>0.05). However, the control group had a higher detection rate of gram-positive bacteria, gram-negative bacteria and Legionella pneumophila in sputum smears than the observation group, with a statistically significant difference(P<0.05). One death occurred in each group, with no significant difference in mortality and six in each group left the hospital or were transferred due to deterioration, with no significant difference in improved discharge rates.

CONCLUSION

Acute community-acquired lower respiratory tract infections(CALRTIs) take bacteria, viruses and atypical pathogens as its leading pathogenic bacteria. In the treatment of patients with acute CALRTIs, early pathogenic examination should be performed to assist in guiding antibiotic therapy for rapid control, early recovery and ameliorated clinical outcomes.

摘要

目的

探讨急性社区获得性下呼吸道感染(CALRTIs)的病原体分布及临床特征。

方法

本研究为回顾性研究。回顾性收集2021年12月至2022年12月在保定市第一中心医院住院的218例CALRTIs患者的临床资料,并根据鼻咽拭子聚合酶链反应(PCR)检测结果分为两组:肺炎链球菌阳性组(观察组)和非肺炎链球菌阳性组(对照组)。比较两组的临床症状、血气分析指标。

结果

两组主要病原菌均为流感嗜血杆菌、金黄色葡萄球菌以及病毒和非典型病原体感染。两组痰涂片、痰培养、呼吸道病毒检测及非典型病原体检测阳性率比较,差异无统计学意义(P>0.05)。然而,对照组痰涂片革兰阳性菌、革兰阴性菌及嗜肺军团菌检出率高于观察组,差异有统计学意义(P<0.05)。两组各死亡1例,死亡率差异无统计学意义;两组各有6例因病情恶化出院或转院,好转出院率差异无统计学意义。

结论

急性社区获得性下呼吸道感染(CALRTIs)以细菌、病毒及非典型病原体为主要病原菌。在急性CALRTIs患者的治疗中,应尽早进行病原学检查,以协助指导抗生素治疗,实现快速控制、早期康复并改善临床结局。