| Objective:The etiology of CAP patients was analyzed in Department of respiration of the First Affiliated Hospital of China Medical University from September 2016 to July 2017.It could provide theoretical basis for clinicians' initial experience treatment,achieve the goal of rational application of antibiotics,improve treatment effect,reduce hospitalization cycle and save medical resources.Methods:hospitalized cases of CAP patients were collected in Department of respiration of the First Affiliated Hospital of China Medical University from September 2016 to July 2017.The nasal swabs,sputum and urine specimens were collected for patients within 48 hours of admission.Sputum culture,blood culture,PCR detection,urine antigen detection and serological antibody test were used for etiological detection,including bacteria,mycoplasma,chlamydia,Legionella pneumophila,and common respiratory viruses.The results were recorded and the etiology of the disease was analyzed in terms of age,sex,clinical manifestation and imaging.Result: Blood culture was performed in 10 of 54 patients with CAP,the positive rate of bacteria was 0/10.There were 17 cases with sputum culture,the positive rate of bacterial was 2/17,of which the 1/17 was Streptococcus pneumoniae and the 1/17 was Haemophilus influenzae.There were 31 cases with sputum PCR detection,the positive rate of PCR was 9/31,including mycoplasma(7/31)and Legionella pneumophila(2/31);PCR detection of 54 rows of nasal swabs,virus detection rate of PCR were 20/54,the detection rate of Mycoplasma were 5/54,the detection rate of Chlamydia were 1/54.In serological detection,the positive rate of Mycoplasma1:640Ig M was 10/54.The detection rate of Flu A/Flu B-Ag antigen in nasal swab was0/54.The detection rate of Legionella pneumophila antigen was 1/54,and the detection rate of Streptococcus pneumoniae urinary antigen was 0/54.There were 33patients(54%)with positive results.The pathogens included virus(20,37.04%),atypical pathogens(18,33.33%),Mycoplasma mixed infection(11,20.37%),bacteria(2,3.7%).There was no statistically significant difference in the detection rate of pathogens in the sex distribution,in the distribution of different age groups,and in the low-and middle-high-risk patients with CRUB-65 score.In the results of virus detection,most of case(8 cases,14.81%)were infected with Influenza Virus A.The age distribution of virus infection is commonly seen in middle-aged and elderly patients.Compared with young people,there is statistical significance between them.Most of them were ground glass shadow in 9 cases(45%),followed by interlobular septal thickening in 7 cases(35%).In the detection results of atypical pathogens,the most common pathogens were Single mycoplasma infection(10,18.52%),Mycoplasma infections were mainly concentrated among adolescents and young people,and were statistically significant compared with those in the middle and old age groups.There were only 2 patients(3.7%)with bacterial infection,included Streptococcus(1,1.85%),Haemophilus influenzae mixed with influenza A infection(1,1.85%).The atypical pathogens mixed with virus infection(6,11.11%)were the highest Among the mixed infection.In Single Mycoplasma infection,single virus infection,and Mycoplasma combined with virus infection,there was no statistical difference between the three groups in the symptoms,signs and laboratory tests.Conclusion:In this group,Most of the cases were found by virus and atypical pathogens,the second was mixed infection,and the detection of bacteria was the most rare.Among the patients with positive viral detection,A single influenza virus A was common.The main infection group was middle-aged and elderly.In atypical pathogen infection,mycoplasma was most common,and the main infection population was adolescents and young people.Atypical pathogens mixed with virus infection was common in the mixed infection. |
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