重症社区获得性肺炎的诊治

Diagnosis and Treatment of Severe Community-Acquired Pneumonia

重症CAP是一组具有 特征性的临床疾病,病人常需进入ICU治疗。重症CAP的最常见病原体有肺炎链球菌、军团菌、革兰阴性菌、流感嗜血菌和金黄色葡萄球菌等。诊断CAP时应尽量明确其病原体以选用有效的抗菌药物。如经验性应用抗菌药物,应注意针对引起重症CAP的最常见病原体。重症CAP病人如合并呼吸衰竭时,常需要进行机械通气治疗。

Severe CAP is a distinct clini- cal entity requiring ICU management. The most common organisms responsible for se-vere CAP are Streptococcus pneunomiae, Le-gionella pneumoph, gram - negative bacilli, Haemophilus influenzae and Staphylococcus aureus. It is important in establishing the pathogens of CAP and allowing for the initiation of effective antimicrobial therapy. Empiric therapy should cover the most common organisms of severe CAP. Patients with severe CAP developing respiratory failure usually require mechanical ventilation.