Prout S, Potgieter P D, Forder A A, Moodie J W, Matthews J
S Afr Med J. 1983 Sep 17;64(12):443-6.
Of 81 adult patients with community-acquired pneumonia, bacterial infections were found in 37%, mycoplasma and viral infections in 21%, and tuberculosis in 6%; no pathogen could be identified in 46% of cases. More than one agent was identified in 12% of patients. Streptococcus pneumoniae, the most common pathogen, was found in 63%, Haemophilus influenzae in 26,7%, Staphylococcus aureus in 6,7%, and other Gram-negative organisms in 10% of patients with proven bacterial pneumonia. Most clinical and radiographic features were of little value in differentiating between different aetiological agents, but Gram-stained sputum gave a valuable early guide to therapy in 60% of cases of proven bacterial pneumonia. Blood culture was positive in 13,6% of cases. All the organisms conformed to their usual sensitivity patterns. Since Strept. pneumoniae is the predominant pathogen, penicillin should be the drug of choice in the immediate 'blind' treatment of community-acquired pneumonia.
在81例成人社区获得性肺炎患者中，37%发现有细菌感染，21%为支原体和病毒感染，6%为肺结核；46%的病例未发现病原体。12%的患者发现不止一种病原体。最常见的病原体肺炎链球菌在确诊为细菌性肺炎的患者中占63%，流感嗜血杆菌占26.7%，金黄色葡萄球菌占6.7%，其他革兰氏阴性菌占10%。大多数临床和影像学特征在区分不同病原体方面价值不大，但革兰氏染色痰液在60%确诊为细菌性肺炎的病例中为治疗提供了有价值的早期指导。血培养阳性率为13.6%。所有病原体的药敏模式均符合其通常情况。由于肺炎链球菌是主要病原体，青霉素应作为社区获得性肺炎立即“盲目”治疗的首选药物。
