铜陵地区社区获得性肺炎病原学调查

Etiology of Community-acquired Pneumonia in Tongling

目的研究铜陵地区社区获得性肺炎（CAP）病原体的分布规律。方法对2006年1月～2008年12月铜陵地区260例CAP患者留取的痰标本进行细菌培养，采用血清学方法检测非典型病原体。结果在260例CAP患者中，检测到病原体147株，其中24．2％（63例）痰培养阳性，53．1％（78株）检测到非典型病原体；肺炎支原体是最常见的病原体，检出52株，占35．4％，其次为肺炎衣原体26株，占17．7％，6．5％（17例）患者存在混合感染，肺炎支原体和肺炎衣原体混合感染最常见；20株肺炎链球菌对青霉素的不敏感率为0，仅1例中敏，敏感率为95．0％，对红霉素的不敏感率为50．0％。结论非典型病原体尤其是肺炎支原体感染在CAP占据重要地位，肺炎链球菌、肺炎克雷伯菌是铜陵地区CAP常见的致病细菌。

OBJECTIVE To investigate the pathogenic causes of community-acquired pneumonia （CAP） in adult patients in Tongling. METHODS A prospective study was performed on 260 consecutive adult patients with CAP in Tongling city during last three years. Bacteria culture of sputum and serological tests in paired serum samples were detected. RESULTS Of 260 patients with etiological evaluation, 128 （49.2%） patients had an identifiable etiology, 63 （24. 2%） had positive outcome from sputum cultured, atypical pathogens were detected from 75 （28.8%）patients. Pathogens identified in 128 patients were： Mycoplasma pneumoniae （35. 4%）, Chlamydia pneumoniae （17.7%） and Streptococcus pneumoniae （13. 6%）. 6. 5% All patients had mixed infection. The resistance rate of S. pneumoniae to penicillin and erythromycin was 5 and 50%, respectively. CONCLUSIONS Atypical pathogens have important role in CAP,of which M. pneumoniae is the most common pathogen. S. pneumoniae and K. pneumoniae are the commonly encountered bacteria for CAP in Tongling.