86例老年社区获得性肺炎住院患者病原学调查  

Etiology survey in elderly hospitalized patients with community acquired pneumonia

作　　者：李素引[1] 阎锡新[2] 齐顺祥[3] 张菊香[1] 

机构地区：[1]河北省衡水市哈励逊国际和平医院呼吸内科,053000 [2]河北医科大学第二医院呼吸内科河北省呼吸病研究所,河北石家庄050000 [3]河北省疾病预防控制中心病毒所,河北石家庄050000

出　　处：《中国误诊学杂志》2011年第30期7327-7328,共2页Chinese Journal of Misdiagnostics

摘　　要：目的了解老年社区获得性肺炎(CAP)住院患者的病原学特点,并分析其临床特征。方法收集住院的老年CAP患者86例、非老年CAP患者69例,取合格痰标本行多重PCR检测,同时进行痰培养检测。结果 PCR检测发现老年社区获得性肺炎患者病原菌以肺炎链球菌检出率最高,占33.7%,病毒以甲型流感病毒检出率最高,占19.8%;痰培养以铜绿假单胞菌检出率最高,占9.3%;病原体混合感染占43%。老年CAP患者发热患者占20.9(18/86)%,伴消化道症状、低氧、肺部啰音的患者分别占62.8%(54/86)、34.9%(30/86)、73.3%(63/86),与非老年组比较差异有统计学意义。结论肺炎链球菌是老年CAP最常见的致病菌;病毒在老年CAP中占据重要地位;混合感染不容忽视;老年CAP临床症状不典型。Objective To investigate the etiology of community-acquired pneumonia[CAP）in elderly hospitalized patients,and to analyze the clinical characteristics. Methods A study was performed on 86 elderly inpatients and 69 non-elderly inpatients with CAP from November 2008 to August 2009 ,Sputum samples in all patients in acute phase were collected for multiplex PCR detection and for bacteria culture. Results In elderly patients, multiplex PCR detection indicate that Streptococcus pneumoniae, the most common pathogen, was isolated in 29 cases （ 33.7% ） , and Influenza A virus,the most common virus was isolated in 17 cases （19.8%） ;Sputum cultures indicate that Pseudomonas aeruginosa（ 8/86,9.3 % ） was the most isolate. Mixed infection were found in 37 （43 % ） patients. In elderly patients, 18 （ 20.9 % ） cases with fever, 54 cases （ 62.8 % ） with gastrointestinal symptoms, 30 （ 34.9% ） cases with hypoxia, 63 （73.3 % ） cases with rale, compared with non-elderly group, the difference was statistically significant （ P〈 0.05）. Conclusions Streptococcus pneumoniae is the major bacteria in the elderly patients with CAP;Viruses have high status in the elderly patients with CAP;Mixed infection should not be ignored;The clinical symptoms of CAP in the elderly are atypical

关 键 词：肺炎/微生物学 

分 类 号：R563.1[医药卫生—呼吸系统]