在社区获得的肺炎中病毒病因的频率
Zain Ahmad Khan1, Akbar Shoukat Ali1, Imran Ahmed2
1Section of Pulmonary and Critical Care, Department of Medicine, Aga Khan University, Karachi.
概括
呼吸系统病毒是巴基斯坦社区获得性肺炎 (CAP) 的重要原因. 细菌和共感染与CAP患者的较高死亡率有关.
科学领域:
- 传染性疾病 传染性疾病
- 呼吸系统医学 呼吸系统医学
- 临床微生物学 临床微生物学
背景情况:
- 社区获得性肺炎 (CAP) 的管理依赖于确定其原因.
- 巴基斯坦CAP病毒病因学研究有限.
- 了解病毒患病率对于有效的治疗策略至关重要.
研究的目的:
- 为了确定巴基斯坦CAP患者病毒病因的频率.
- 分析与病毒CAP相关的临床特征.
- 评估病因学对CAP患者预后的影响.
主要方法:
- 在阿迦汗大学医院 (March 2022-February 2023) 的CAP患者的医疗记录的回顾性审查.
- 纳入标准:入院后48小时内进行微生物学测试;排除:免疫受损患者.
- 计算病毒和细菌病因频率,分析临床特征和预后因素.
主要成果:
- 在166名患者中,有115人 (69.3%) 发现了致病微生物.
- 病毒病因占主导地位:83个 (72.1%) 仅仅是病毒,18个 (15.6%) 仅仅是细菌,14个 (12.2%) 共同感染.
- 流感A是最常见的病毒 (47.4%);金黄色葡萄球菌是最常见的细菌 (56.3%).
- 细菌和病毒-细菌联合感染在未幸存者中更为频繁 (38.1%与16.6%,p=0.034).
- 死亡率预测因素包括CURB-65分数,白细胞病,高CRP,高甲酸和机械通风.
- 机械通风独立增加了死亡风险 (OR 43.407).
- 总体死亡率为12.7% (21/166),病毒-细菌联合感染组的死亡率最高 (28.6%) (p=0.046).
结论:
- 呼吸道病毒是巴基斯坦CAP的重要原因之一.
- 细菌感染,单独或与病毒共感染,与死亡率的增加有关.
- 迅速诊断和管理病毒和细菌CAP对于改善患者的治疗结果至关重要.
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