北京某医院成人社区获得性肺炎的病原学分析

Etiological analysis of adult community acquired pneumonia in a hospital in Beijing

目的了解北京某医院成人社区获得性肺炎(community acquired pneumonia,CAP)的病原学分布及特点,为CAP经验性治疗提供依据及参考。方法回顾性分析2016年10月1日～2017年10月31日北京市某三级医院425例CAP病人的病原学分布特点。结果 425例CAP病人,253例病原学检测阳性,阳性率59. 5%,其中142例检出支原体,阳性率33. 4%; 125例细菌检测阳性,阳性率29. 4%,其中肺炎链球菌65例,阳性率15. 3%,流感嗜血杆菌46例,阳性率10. 8%; 104例病毒检测阳性,阳性率24. 5%,其中检出甲型流感25例,阳性率5. 9%,副流感病毒18例,阳性率4. 2%,病原体混合感染检出93例,阳性率21. 9%,以支原体混合细菌感染及细菌混合感染为主。各类病原体中以支原体、肺炎链球菌、流感嗜血杆菌多见。结论支原体为北京某院CAP病人感染的首位病原体,肺炎链球菌、流感嗜血杆菌次之,甲型流感病毒为首位病毒病原,初步揭示了该院CAP病原学分类特点,为经验性治疗CAP提供病原学依据及参考。

Objective To investigate the etiological distribution and characteristics of adult community acquired pneumonia( CAP) in a hospital in Beijing,and to provide evidence and reference for CAP empirical treatment. Methods The etiological distribution of 425 CAP patients in a tertiary hospital of Beijing from Oct. 1,2016 to Oct. 31,2017 was analyzed retrospectively. Results Among 425 CAP patients,253 cases were positive,with a positive rate of 59. 5%,of which 142 cases of Mycoplasma were detected,the positive rate being 33. 4%. A total of 125 cases were positive,with a positive rate of 29. 4%,of which 65 cases of Streptococcus pneumoniae were positive,the positive rate being 15. 3%;46 cases of Haemophilus influenzae were positive,the positive rate being 10. 8%. A toal of 104 virus detections were positive,with a positive rate of 24. 5%,among which 25 cases of influenza A were detected,the positive rate being 5. 9%;18 cases of parainfluenza virus were detected,the positive rate being4. 2%;and 93 cases of mixed infection of pathogens were detected,the positive rate being 21. 9%,which were mainly mixed bacterial infection of Mycoplasma and mixed bacterial infection. Among all kinds of pathogens,Mycoplasma,Streptococcus pneumoniae and Haemophilus influenzae were common. Conclusion Mycoplasma is the first pathogen of CAP infection in a hospital in Beijing,followed by Streptococcus pneumoniae,Haemophilus influenzae. The influenza A virus is the first viral pathogen. It has preliminarily revealed the classification of CAP pathogens in our hospital and provided the basis and reference for the pathogeny treatment of CAP.