The Etiology Study on Severe Community-Acquired Pneumonia in Adults in Emergency Department_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

LiuZhen ¹ , LiuQimeng ² , ZhaoLi ¹ , YangJiankun ¹ , LiJing ¹ ,  YeHuan ²

1. Emergency Department, Fuxing Hospital, Capital Medical University, Beijing, 100038, China;
2. ;

Corresponding author：

YeHuan, Email: yedahuan@yeah.net

Keywords：

Severe community-acquired pneumonia; Emergency department; Aetiology

DOI：

10.7507/1671-6205.2015011

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the etiologic feature and prognosis of adult patients with severe community-acquired pneumonia (SCAP). Methods According to the guideline on the diagnosis and treatment of community-acquired pneumonia in 2006, 105 patients with SCAP were included in the study. The proportion of pathogens (including multiple resistant bacteria) and mortality rate were recorded. Appropriate statistical methods were selected and all data were analyzed by using SPSS Version 18.0 computerized program. Results The predominant pathogen with SCAP was Pseudomonas aeruginosa, followed by Klebsiella pneumoniae, Staphylococcus aureus, and Legionella pneumophila. In death cases, Klebsiella pneumoniae was the most common pathogen, followed by Staphylococcus aureus. It was showed in the drug sensitivity test that most pathogens were drug-sensitive strains. The patients with tumor had higher risks to get infected with Gram-negative bacillus. Conclusions The etiology of patients with SCAP in our emergency department is given priority to Gram-negative bacillus and sensitive strains, of which Pseudomonas aeruginosa and Klebsiella pneumoniae are predominant. As for the Gram-positive cocci, Staphylococcus aureus is the most common pathogen. Legionella pneumophila is the most common pathogen in atypical pathogens, which only account for a small proportion of the aetiology of SCAP. Patients with Klebsiella pneumoniae and Staphylococcus aureus infections are associated with poor prognosis.

Citation： LiuZhen, LiuQimeng, ZhaoLi, YangJiankun, LiJing, YeHuan. The Etiology Study on Severe Community-Acquired Pneumonia in Adults in Emergency Department. Chinese Journal of Respiratory and Critical Care Medicine, 2015, 14(1): 42-47. doi: 10.7507/1671-6205.2015011 Copy

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7.	Matsushima T, Miyashita N, File TM Jr. Etiology and management of community-acquired pneumonia in Asia. Curr Opin Infect Dis, 2002, 15:157-162.
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10.	孙志泉.高龄社区获得性肺炎的细菌学及药敏分析.临床肺科杂志, 2013, 18:1796-1797.
11.	朱仲生, 姜春玲, 张卫星, 等. 52例重症社区获得性肺炎病原体及药物敏感性分析.中国社会医学杂志, 2006, 23:169-170.
12.	Brown RB. Legionella pneumonia:the spectrum continues to expand. Chest, 2004, 125:1979-1980.
13.	Boukadida J, Salem N, Hannachi N, et al. Genotypic exploration of a hospital neonatal outbreak due to Klebsiella pneumonia producing extended-spectrum-betalactamase. Arch Pediatr, 2002, 9:463-468.
14.	Fine MJ, Auhle TE, Yealy DM, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia.N Engl J Med, 1997, 336:243-250.
15.	李佩章, 陈艳华, 陆一平, 等.肿瘤患者医院感染的病原菌分布及耐药性分析.中华医院感染学杂志, 2008, 12:1764-1766.

1. 查日田.重症社区获得性肺炎评价的研究进展.临床肺科杂志, 2012, 17:2266-2268.
2. Houck PM, Bratzler DW, Nsa W, et al. Timing of antibiotic administration and outcomes for Medicare patients hospitalized with community-acquired pneumonia. Arch Intern Med, 2004, 164:637-644.
3. 中华医学会呼吸病学分会.社区获得性肺炎诊断及治疗方案.中华结核和呼吸杂志, 2006, 29:651-655.
4. 葛均波, 徐永健, 主编.内科学.北京:人民卫生出版社, 2013, 9.
5. Schaaf B, Kruse J, Rupp J, et al. Sepsis severity predicts outcome in community-acquired pneumococcal pneumonia. Eur Respir J, 2007, 30:517-524.
6. 刘又宁, 陈民钧, 赵铁梅, 等.中国城市成人社区获得性肺炎665例病原学多中心调查.中华结核和呼吸杂志, 2006, 29:3-8.
7. Matsushima T, Miyashita N, File TM Jr. Etiology and management of community-acquired pneumonia in Asia. Curr Opin Infect Dis, 2002, 15:157-162.
8. 林榜素, 庄剑平, 胡容, 等.高龄社区获得性肺炎的细菌学及其耐药性研究.中国全科医学, 2012, 15:1523-1525.
9. 刘又宁, 曹彬, 王辉, 等.中国九城市成人医院获得性肺炎微生物学与临床特点调查.中华结核和呼吸杂志, 2012, 35:739-746.
10. 孙志泉.高龄社区获得性肺炎的细菌学及药敏分析.临床肺科杂志, 2013, 18:1796-1797.
11. 朱仲生, 姜春玲, 张卫星, 等. 52例重症社区获得性肺炎病原体及药物敏感性分析.中国社会医学杂志, 2006, 23:169-170.
12. Brown RB. Legionella pneumonia:the spectrum continues to expand. Chest, 2004, 125:1979-1980.
13. Boukadida J, Salem N, Hannachi N, et al. Genotypic exploration of a hospital neonatal outbreak due to Klebsiella pneumonia producing extended-spectrum-betalactamase. Arch Pediatr, 2002, 9:463-468.
14. Fine MJ, Auhle TE, Yealy DM, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia.N Engl J Med, 1997, 336:243-250.
15. 李佩章, 陈艳华, 陆一平, 等.肿瘤患者医院感染的病原菌分布及耐药性分析.中华医院感染学杂志, 2008, 12:1764-1766.

Chinese Journal of Respiratory and Critical Care Medicine

The Etiology Study on Severe Community-Acquired Pneumonia in Adults in Emergency Department

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