与社区获得性肺炎中多微生物感染相关的风险因素和结果
Catia Cillóniz1, Davide Calabretta2, Andrea Palomeque3
1Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain; Faculty of Health Sciences, University Continental, Huancayo, Peru.
住院成人的多微生物肺炎与更糟糕的结果和更高的30天死亡率有关. 识别诸如多层肺炎之类的风险因素对于管理这种严重形式的社区性肺炎至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
- 临床微生物学 临床微生物学
背景情况:
- 多微生物肺炎与住院患者的疾病严重程度增加有关.
- 了解多微生物社区性肺炎 (CAP) 的患病率和风险因素对于有效的患者管理至关重要.
- 这项研究研究了成年CAP患者的临床特征,结果和死亡率预测因素.
研究的目的:
- 在住院成人CAP患者中确定多微生物肺炎的患病率.
- 确定与多微生物肺炎相关的临床特征和危险因素.
- 评估多微生物感染对住院和30天死亡率的影响.
主要方法:
- 对来自5114名成人CAP患者的前性收集数据进行了回顾性分析.
- 在1703名患者中确定的病因,在这个子组中14%的患者中确定了多微生物感染.
- 用多变量分析来确定多微生物病因和30天死亡率的独立风险因素.
主要成果:
- 在14%的CAP患者中发现了具有明确病因的多微生物感染,在病房中比ICU患者更常见.
- 常见的多微生物组合包括肺炎性链球菌与呼吸道病毒,流感性血球菌或金黄色葡萄球菌.
- 多微生物病因与不适当的初始抗微生物治疗,住院,30天和1年死亡率较高有关.
- 多层肺炎是危险因素,而发烧与多微生物病因风险较低有关.
- 多微生物感染独立预测了30天死亡率的更高风险.
结论:
- 在住院的CAP患者中,多微生物感染与较差的结果有关,特别是在患有并发病的老年人中.
- 多微生物感染是成年CAP中30天死亡率的独立风险因素.
- 在评估多微生物CAP的风险时,应考虑诸如多层肺炎等临床因素.
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