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成人社区获得性肺炎:一项单中心回顾性研究。

Community-Acquired Pneumonia in Adults: A Mono-Center Retrospective Study.

作者信息

Khorvash Farzin, Hakamifard Atousa, Esmaeili Sharif Ali, Mahmoudzadeh Zali Mahdieh, Motamedi Narges, Ghiasi Farzin, Esmaeili Sharif Masoud, Esmaeili Farah, Adibi Atousa

机构信息

Infectious Diseases and Tropical Medicine Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Occupational Therapy, University of Rehabilitation and Social Sciences, Tehran, Iran.

出版信息

Tanaffos. 2024 Jan;23(1):11-29.

Abstract

BACKGROUND

Adult community-acquired pneumonia is the most common cause of hospitalization and a leading cause of death. Identification of microorganisms causing community-acquired pneumonia.

MATERIALS AND METHODS

A cross-sectional design was used. Information on adults hospitalized due to pneumonia in the cold seasons of 2018 and 2019 was collected. Results of microbiologic tests, other than serology and urinary antigen, were reviewed.

RESULTS

205 patients had eligible criteria. The mean age was 52.4 and 62% were male. Microorganisms were identified in 117 (57%) patients. The most common etiologic agents were Influenza H1N1 2009 (n=39, 33.4%), Tuberculosis (n=21, 17.9%), Non-Albicans Candida Yeast (n=9, 7.8%), Methicillin Resistant Staphylococcus Epidermis (n=7, 6%) and Klebsiella Pneumonia (n=5, 4.3%). Streptococcus Pneumoniae had the 6 rank (n=3, 2.6%). A higher body mass index was associated with superimposed infections. 10 of 18 (56%) patients who died in hospital, got definite microbiologic diagnoses. The maximum mortality was due to staphylococci, with methicillin-resistant strains of (n=2, 66%) and (n=2, 29%).

CONCLUSION

H1N1 2009 was the first cause. Tuberculosis with rising incidence could cause acute pneumonia. Pneumococcal incidence had declined. Community-acquired staphylococcal pneumonia is the most dangerous; hence, specific protocol-based treatments should be applied promptly. Community-acquired and Tuberculosis must be included in differential diagnosis of the disease. Antibiotics need to be individualized in managing the obese patients. A special focus on the epidemiology of virulence factors of is needed as it is common, severe, and lethal.

摘要

背景

成人社区获得性肺炎是住院的最常见原因,也是主要死因。确定引起社区获得性肺炎的微生物。

材料与方法

采用横断面设计。收集了2018年和2019年寒冷季节因肺炎住院的成人信息。回顾了除血清学和尿抗原检测之外的微生物检测结果。

结果

205例患者符合入选标准。平均年龄为52.4岁,62%为男性。117例(57%)患者检测出微生物。最常见的病原体为2009年甲型H1N1流感(n = 39,33.4%)、结核(n = 21,17.9%)、非白色念珠菌(n = 9,7.8%)、耐甲氧西林表皮葡萄球菌(n = 7,6%)和肺炎克雷伯菌(n = 5,4.3%)。肺炎链球菌排第6位(n = 3,2.6%)。较高的体重指数与合并感染有关。18例(56%)住院死亡患者中,10例得到了明确的微生物学诊断。最高死亡率归因于葡萄球菌,耐甲氧西林菌株占(n = 2,66%)和(n = 2,29%)。

结论

2009年甲型H1N1流感是首要病因。发病率上升的结核可导致急性肺炎。肺炎球菌发病率有所下降。社区获得性葡萄球菌肺炎最为危险;因此,应及时采用基于特定方案的治疗方法。疾病的鉴别诊断必须包括社区获得性肺炎和结核。治疗肥胖患者时抗生素需要个体化。由于其常见、严重且致命,需要特别关注其毒力因子的流行病学。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3cb/11655007/5c363e7ffd7c/Tanaffos-23-11-g001.jpg

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