Clinical Characteristics And Etiological Analysis Of Community-acquired Pneumonia

Objective:To explore the clinical characteristics and etiology of community-acquired pneumonia(C AP),and combine the results of drug sensitivity culture to provide evidence for early empirical drug use.Methods:A total of 344 patients with C AP admitted to the Department of Respiratory Medicine in our hospital from July 1,2015 to June 31,2017 were selected to collect clinical data including general conditions(age,sex,occupation,onset season,underlying disease),and clinical manifestations(Fever,cough,sputum,etc.),imaging(chest and chest C T),laboratory tests(peripheral white blood cell count,sputum culture,blood culture,serum IgM antibody,etc.),and use of antibiotics outside the hospital.Statistical characteristics and?2 test were used to analyze the clinical features and etiology.Results:1.A total of 344 patients with CAP were collected,aged from 14 to 91 years old,with an average age of 56±19.6 years.The ratio between males and females was 1.26:1.Incidence season takes winter and spring as the main clinical manifestations of cough,sputum,and fever.Occupation is mostly retirees and farmers.2.There were 324 cases of pathogen detection in 344 patients,accounting for 94.2%.104 of the pathogens tested positive,the positive rate was 32.1%.Of the patients with positive pathogen detection,90(86.5%)were infected with a single pathogen and 14(13.5%)were infected with two or more pathogens.The top three pathogens were 34 cases of mycoplasma,12 cases of Streptococcus pneumoniae,and 11 cases of K lebsiella pneumoniae.Mycoplasma pneumoniae was more common in CAP patients without underlying diseases and without antibiotics.The incidence rate was significantly higher than those with basic diseases and antibiotics before admission(P<0.05),and the detection rate of middle-aged and young patients(age<60 years).Significantly higher than the elderly group(X~2=19.261,P<0.01).The detection rate of Gram-positive bacteria in patients without a history of antibiotic treatment was higher than that in patients with a history of antibiotic treatment(X~2=4.142,P<0.05).The detection rate of gram-negative bacteria in the basic disease group was higher than that in the non-basal disease group(X~2=4.838,P<0.05).3.The susceptibility test results of quail culture showed that the resistance rates of Streptococcus pneumoniae to erythromycin,azithromycin,and levofloxacin were all over50%.Klebsiella pneumoniae contained compound antibiotics and aminoglycosides containing?-lactamase inhibitors.Classes,imipenem,and meropenem have low resistance rates.Acinetobacter baumannii has a high res istance rate to multiple levofloxacin,piperacillin and ceftazidime.Conclusions:1.Mycoplasma pneumoniae is the most common pathogen of CAP,and Streptococcus pneumoniae is still an important pathogen of C AP.2.Gram-negative bacterial infections have a n increasing trend in CAP.3.Early empirical therapy should be based on the patient's condition,age,underlying disease,and history of antibiotic treatment.Select drugs that cover potential pathogens.4.To timely and standardize the etiological detection of sputum samples and formulate effective and reasonable individualized treatment plans based on drug sensitivity results,which is of significance for the rational use of antibiotics and avoiding the abuse of antibiotics.