82例社区获得性肺炎病原体调查分析

Pathogens analysis of 82 community-acquired pneumonia

目的调查社区获得性肺炎（CAP）的病原体分布，为本社区CAP的经验性治疗提供依据。方法收集2006年1月～2008年1月CAP患者共82例，分别留取呼吸道分泌物进行细菌培养，应用常规方法分离鉴定细菌，同时检测患者急性期和恢复期肺炎支原体、肺炎衣原体、嗜肺军团菌血清抗体。结果82例CAP患者48例（58．5％）病原学检查阳性。检出肺炎支原体14例；肺炎衣原体5例；嗜肺军团菌3例。分离出流感嗜血杆菌15例；肺炎链球菌10例；卡他莫拉菌5例；肺炎克雷伯杆菌2例；金黄色葡萄球菌2例。14例为混合感染。结论流感嗜血杆菌和肺炎链球菌仍是CAP的主要致病菌。非典型病原体在CAP中占有重要地位，且多为混合感染。

Aim To investigate the pathogens of community-acquired pneumonia（CAP） ,and to provide therapy evidence community-acquired pneumonia for drug resistance of isolated bacteria. Methods A prospective study was performed on 82 adult patients with CAP from January 2006 to January 2008. Sputum samples were collected for culture. Bacteria were isolated and identifiedby by using conventional methods. Antibodies of the paired serum samples to mycoplasma pneumonia, chlamydia pneumonia, and legionella pneumophila were detected. Results The etiology of CAP was identified in 48 patients. The distribution of casual agents was as follows ： haemophilus influenzae 15, streptococcus pneumoniae 10, moraxelle eatarrhalis 5, klebsiella pneumoniae 2, staphylococcus aureus 2, mycoplasma pneumonia 14,chlamydia pneumoniae 5, legionella pneumophila 3. In 14 patients more than one causal agent were found. Conclusions Haemophilus influenzae and streptococcus pneumoniae were the most common bacteria for CAP. Adult CAP was caused by atypical pathogens and the rate of mixed infection was high.