合肥地区社区获得性肺炎154例病原学调查

Pathogenic study of 154 patients with community acquired pneumonia in Hefei city

目的了解合肥地区本院CAP患者病原体分布,分析各种病原体的构成。方法对2005年1月～2007年3月间本院154例CAP患者进行病原体检测,病原体确定诊断阳性判断标准：合格标本培养出病原体;间隔2～4周,非典型病原体抗体滴度呈现大于或等于4倍增高。应用PCR分别扩增肺炎支原体16SrRNA,肺炎衣原体主要外膜蛋白基因和军团菌主要外膜蛋白porin基因。结果154例标本进行了细菌培养和血清学检测和DNA检测,其中肺炎链球菌是最为常见的病原菌,占23.8%,流感嗜血杆菌占5.2%,化脓链球菌占5.2%,肺炎克雷伯菌和不动杆菌各占1.9%;在非典型病原体中,肺炎支原体占13.6%,肺炎衣原体占1.9%,嗜肺军团菌占0.6%。其中,单一病原体感染占57.1%,二重病原体混合感染占15.6%,三重占2.6%,混合感染病原体中肺炎支原体最为多见占52.4%。结论合肥地区本院CAP病原体最为常见的是肺炎链球菌,非典型病原体中以肺炎支原体最为多见,混合感染中以肺炎支原体最为多见,占52.4%。

Aim To study the distribution and composition of pathogens of the patients with community acquired pneumonia in Hefei city,China.Methods Bacterial cultrure,serological and DNA amplification were carried out simultaneously to each sample collected from patients in the first people hospital from January,2005 to March,2007.All patients must be followed with the positive results of bacterial culture and the antibody diter of atypical pathogen was no less than 4 times in 2 to 4 weeks.The 16 SrRNA of Mycoplasma pneumoniae,the major outer membrane protein gene of Clamydia pneumoniae and the major outer membrane protein porin gene of Legionella pneumoniae were amplificated by PCR.Results Specific pathogens were identified in 154 patients.Among them 39 cases with streptococcus spp infections.Hemophilus influenzae 8 cases,Streptococcus pyogenes 8 cases,Klebsiella pneumoniae and Acinetobacter respectively;Among atypical pathogens,Mycoplasma pneumoniae 21cases,Clamydia pneumoniae 1 case and Legionella pneumoniae 2 cases.Among these patients,88 cases were single pathogen infections,24 cases double pathogens infections and 4 cases three pathogens infections.The Mycoplasma pneumoniae was the most extensively,about 52.4%.Conclusion Streptococcus pneunomiae is the most common pathogen of CAP patients in Hefei city.Mycoplasma pneumoniae is the most common among the atypical pathogens and mix infections.