社区获得性和卫生保健相关金黄色葡萄球菌肺炎的特征和当地危险因素,Scientific Reports

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社区获得性和卫生保健相关金黄色葡萄球菌肺炎的特征和当地危险因素
Scientific Reports ( IF 3.8 ) Pub Date : 2022-11-04 , DOI: 10.1038/s41598-022-23246-1
Li-Na Lee , Wen-Ru Chou , Jann-Yuan Wang , Yen-Liang Kuo , Chi-Yueh Chang , Yi-Chien Lee , Shao-Hsien Tung , Wen-Ching Tsao , Ke-Yun Chao , Wei-Lun Liu

本研究旨在确定金黄色葡萄球菌( S. aureus )引起的社区获得性 (CAP) 和医疗保健相关性肺炎 (HCAP) 的特征、危险因素和死亡率。我们检索了 2.6 年内经血液或胸腔积液培养诊断为金黄色葡萄球菌CAP 或 HCAP 的成人，并与经血液或呼吸道培养或尿液抗原诊断为肺炎链球菌（S. pneumoniae ）CAP 或 HCAP 的成人进行比较。我们发现 18 例 CAP 患者和 9 例因金黄色葡萄球菌引起的 HCAP （女性 33%，66.6 ± 12.4 岁），以及 48 例 CAP 患者和 15 例因肺炎链球菌引起的 HCAP（女性 41%，69.5 ± 17.5 岁）。糖尿病（52% vs. 24%，p = 0.019），血液透析（11% vs. 0%，p = 0.046），皮肤病变（44% vs. 0%，p < 0.001），空洞结节（37% vs. 0.001） . 1.6%，p < 0.001）和胸腔积液（48% 对 18%，p = 0.007）在葡萄球菌组比肺炎球菌组更常见。3例葡萄球菌肺炎患者出现急性心肌梗死。肺炎严重程度指数（139 ± 52 对比 109 ± 43，p = 0.005）和 30 天死亡率（41% 对比 9.5%，p = 0.001) 在葡萄球菌组中更高。多变量分析显示基础疾病（尤其是癌症和肝硬化）、风险等级 4/5、心态改变、休克和双侧肺炎是 30 天死亡率的危险因素。

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Characteristics and local risk factors of community-acquired and health-care-associated Staphylococcus aureus pneumonia

This study aims at identifying characteristics, risk factors and mortality of community-acquired (CAP) and health-care-associated pneumonia (HCAP) by Staphylococcus aureus (S. aureus). We retrieved adults with S. aureus CAP or HCAP diagnosed by blood or pleural effusion culture in 2.6 years, and compared with those of Streptococcus pneumoniae (S. pneumoniae) CAP or HCAP diagnosed by blood or respiratory culture, or urine antigen. We found 18 patients with CAP and 9 HCAP due to S. aureus (female 33%, 66.6 ± 12.4 years-old), and 48 patients with CAP and 15 HCAP due to S pneumoniae (female 41%, 69.5 ± 17.5 years). Diabetes mellitus (52% vs. 24%, p = 0.019), hemodialysis (11% vs. 0%, p = 0.046), skin lesions (44% vs. 0%, p < 0.001), cavitary nodules (37% vs. 1.6%, p < 0.001) and pleural effusions (48% vs. 18%, p = 0.007) were more common in staphylococcal than pneumococcal group. Three patients with staphylococcal pneumonia had acute myocardial infarction. Pneumonia severity index (139 ± 52 vs. 109 ± 43, p = 0.005) and 30-day mortality (41% vs. 9.5%, p = 0.001) were higher in staphylococcal group. Multivariate analysis showed underlying disease (especially cancer and cirrhosis), risk class 4/5, altered mentality, shock and bilateral pneumonia were risk factors for 30-day mortality.

更新日期：2022-11-04

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