Williams R M
Pacific Coast Primary Care, Daly City, California 94015, USA.
Lippincotts Prim Care Pract. 1998 Nov-Dec;2(6):625-33.
Streptococcus pneumoniae community-acquired pneumonia (CAP) results in 40,000 deaths each year (Atkinson, 1997), making it the leading cause of death secondary to infection. Of these deaths, 50% could be prevented with the use of the pneumococcal vaccine. Developed 20 years ago, only 28% of patients 65 years and older receive the vaccine despite a prevention rate of invasive pneumococcal infections of 56-81% in immunocompetent adults. The overall cost for treating patients with CAP is more than $23 billion per year. More than $3.5 billion was spent on Medicare patients alone. Immunizing identified high-risk patients for CAP can improve morbidity and mortality rates for this group and ultimately reduce the amount of health care dollars spent on this preventable disease. Guidelines for identifying high-risk groups, a description of the vaccine, vaccination recommendations, and the signs and symptoms of CAP are discussed.
肺炎链球菌社区获得性肺炎（CAP）每年导致40000人死亡（阿特金森，1997年），使其成为继发感染的主要死亡原因。在这些死亡病例中，使用肺炎球菌疫苗可预防50%。该疫苗于20年前研发，尽管其对免疫功能正常的成年人侵袭性肺炎球菌感染的预防率为56%-81%，但65岁及以上的患者中只有28%接种了该疫苗。每年治疗CAP患者的总费用超过230亿美元。仅医疗保险患者就花费了超过35亿美元。为确诊的CAP高危患者接种疫苗可改善该群体的发病率和死亡率，并最终减少用于这种可预防疾病的医疗费用。本文讨论了识别高危群体的指南、疫苗描述、接种建议以及CAP的体征和症状。
