四川地区成人支原体肺炎临床分析

目的了解四川地区社区成人获得性肺炎中支原体肺炎的分布及临床和治疗转归情况,为经验治疗提供依据。方法对四川地区273例≥15岁的社区获得性肺炎患者取急性期合格痰标本做细菌培养,同时用血清学方法检测肺炎支原体。结果273例患者中50例确定为支原体肺炎,其中33例为单纯的肺炎支原体感染,17例合并其它细菌感染。肺炎支原体感染与性别无关,多见于50岁以下尤其是30岁以下的年轻患者。肺炎支原体所致的肺炎与一般的细菌性肺炎相比,临床表现和实验室检查相似,但以干咳为主,肺部体征少。按照社区获得性肺炎指南,提示经验性单用新氟喹诺酮或β内酰胺抗生素 大环内酯或新氟喹诺酮治疗社区获得性肺炎疗效较好。结论四川地区支原体肺炎在社区获得性肺炎中占18.32%,为常见病原菌之一。经验治疗抗菌药物的选择,应覆盖非典型病原体。

Clinical analysis of adult community-acquired pneumonia in Sichuan

Objective To investigate the epidemiology,clinical presentation and therapy of mycoplasma pneumoniae in community-acquired pneumonia(CAP) in Sichuan Province.Methods 273 adult patients with CAP from 10 hospitals in Sichuan Province were enrolled in the study.Bacterial culture from respiratory tract exudates and serological tests from paired serum samples for mycoplasma pneumoniae were detected.Results Among the 50 cases of mycoplasma pneumonia identified from the 273 patients,17 were accompanied with bacterial infections and 33 were single mycoplasma-infected pneumonia.There was no correlation regarding the mycoplasma pneumonia between male and female.Mycoplasma pneumonia infection was more frequently seen among patients aged below 50 years,especially below 30 years.No significant difference was noted in terms of symptoms,signs and laboratory tests between general bacteria-infected pneumonia and mycoplasma-infected pneumonia.The main typical features for mycoplasma pneumonia were dry cough and slight pulmonary signs.Conclusion Mycoplasma pneumonia accounts for 18.32% of community-acquired pneumonia and it is thereupon regarded as one of the major pathogens.Antibiotic treatment for CAP patients should cover atypical pathogens.