Le Bel Josselin, Pinot Juliette, Alfaiate Toni, Ecollan Marie, Cussac Fanny, Pecqueur Raphaël, Revel Marie-Pierre, Vartanian Cyrille, Varon Emmanuelle, Theilacker Christian, Duval Xavier, Partouche Henri, Laouénan Cédric, Gilberg Serge
Université Paris Cité, Department of general practice, Paris, France, Paris, France.
Université Paris Cité, IAME, INSERM, Paris, France.
NPJ Prim Care Respir Med. 2025 Jan 4;35(1):1. doi: 10.1038/s41533-024-00405-7.
Streptococcus pneumoniae (SP) remains an important cause of community acquired pneumonia (CAP). We aimed to describe the prevalence and characteristics of outpatients with radiologically confirmed pneumococcal CAP. Between November 2017 and December 2019, a French network of general practitioners enrolled CAP-suspected adults, with ≥1 clinical signs of infection and ≥1 signs of pulmonary localization in an observational study. Pneumococcal CAP was defined by the combination of a chest X-ray (CXR) compatible with CAP and SP detection by any of four microbiological tests (blood culture, sputum culture, pneumococcal urinary antigen test [BinaxNow®] and serotype-specific multiplex urinary antigen detection test [Pfizer Inc®]. To identify other pathogens, next to cultures, nasopharyngeal multiplex PCR was performed. Three hundred and forty-eight patients were included, of whom 144 had a positive CXR, 135/144 (93.8%) had not received antibiotics prior to inclusion, 21/144 (14.6%) had ≥1 positive microbiological test for SP, and 66/144 (45.8%) were negative for all four microbiological tests and were considered as non-pneumococcal CAP. Pneumococcal serotypes were identified for 12 patients. This study assessing the prevalence of SP among CAP outpatients using comprehensive microbiologic testing shows that SP is still the most frequently identified microorganism.
肺炎链球菌（SP）仍然是社区获得性肺炎（CAP）的重要病因。我们旨在描述经放射学确诊的肺炎球菌性CAP门诊患者的患病率和特征。在2017年11月至2019年12月期间，一个法国全科医生网络在一项观察性研究中纳入了疑似CAP的成年人，这些患者具有≥1种感染临床体征和≥1种肺部定位体征。肺炎球菌性CAP的定义为胸部X线（CXR）符合CAP表现且通过四种微生物学检测方法中的任何一种检测到SP（血培养、痰培养、肺炎球菌尿抗原检测[BinaxNow®]和血清型特异性多重尿抗原检测[Pfizer Inc®]）。为了识别其他病原体，除培养外，还进行了鼻咽部多重PCR检测。共纳入348例患者，其中144例CXR阳性，135/144（93.8%）在纳入前未接受过抗生素治疗，21/144（14.6%）的SP微生物学检测≥1项呈阳性，66/144（45.8%）的四项微生物学检测均为阴性，被视为非肺炎球菌性CAP。对12例患者进行了肺炎球菌血清型鉴定。这项使用综合微生物学检测评估CAP门诊患者中SP患病率的研究表明，SP仍然是最常鉴定出的微生物。
