社区获得性肺炎确诊患者中结核病的患病率

Tinku Joseph, V. Dharmadhikari, Ajit Kulkarni
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摘要

目的:了解社区获得性肺炎(CAP)住院患者中肺结核的比例。方法:前瞻性研究了连续2年在三级保健中心确诊为社区获得性肺炎(CAP)的患者。对痰和血培养样本进行了系统的调查。一部分患者进行尿抗原检查和血清血清学检查。结果:按照BTS CAP指南纳入疑似CAP患者104例作为研究组,其中痰AFB涂片阳性21例(20.19%)。18例(17.30%)患者痰革兰氏染色阳性,但各自培养未见任何生长。其中革兰氏染色阳性65例(62.50%),细菌病原学培养阳性。痰、血培养阳性病例中最常见的CAP病原菌为肺炎链球菌(19/65),其次为肺炎克雷伯菌(17/65)、金黄色葡萄球菌(13/65)、铜绿假单胞菌(8/65)、大肠杆菌(4/65)、不动杆菌(3/65)。结论:结核病是结核病流行地区CAP发病的主要原因之一。我们的诊断指数可以帮助临床医生立即从CAP中识别肺结核病例,并开始适当的隔离和最佳治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prevalence of Tuberculosis among Community Acquired Pneumonia Diagnosed Patients
Aim: To evaluate the proportion of pulmonary TB among patients hospitalized with suspected communityacquired pneumonia (CAP). Methods: Consecutive patients diagnosed with community acquired pneumonia (CAP) admitted to a tertiary care centre over a 2 year period was studied prospectively. Systematic investigation of samples of sputum and blood cultures was performed. A subset of patients had urine antigen tests and serum serology. Results: We enrolled 104 CAP suspected patients in the study group according to the BTS guidelines for CAP. Among these patient’s sputum AFB smear positivity was observed in 21 cases (20.19%). 18 (17.30%) patients turned out to be sputum gram stain positive, but their respective cultures didn’t show any growth. 65 (62.50%) of them turned out to be gram stain and culture positive for bacteriological aetiology. The Commonest cause for CAP among sputum and blood culture positive cases was Streptococcus pneumoniae (19/65) followed by, Klebsiella pneumoniae (17/65), Staphylococcus aureus (13/65), Pseudomonas aeruginosa (8/65), Escherichia coli (4/65), Acinetobactor spp. (3/65). Conclusion: Tuberculosis is one of the leading causes of CAP in TB-prevalent areas. Our diagnostic index may help clinicians identify pulmonary TB cases immediately from CAP and initiate appropriate isolation and optimal treatment.
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