中华预防医学杂志
中華預防醫學雜誌
중화예방의학잡지
CHINESE JOURNAL OF
2013年
12期
1089-1094
,共6页
刘慧%肖新才%陆剑云%陈宗遒%罗雷%杨智聪
劉慧%肖新纔%陸劍雲%陳宗遒%囉雷%楊智聰
류혜%초신재%륙검운%진종주%라뢰%양지총
肺炎%哨点监测%社区获得性感染
肺炎%哨點鑑測%社區穫得性感染
폐염%초점감측%사구획득성감염
Pneumonia%Sentinel surveillance%Community-acquired infections
目的 分析2009-2012年广州市社区获得性肺炎(CAP)的流行特征及病原谱.方法 于2009-2012年以广州市11个区(县级市)的14间大型综合性医院作为肺炎病例监测哨点医院,开展CAP病例监测,4年共监测就诊病例18 982 223例,按照年份、年龄及季节分层,分析CAP病例病原谱特点.结果 2009-2012年共监测就诊病例18 982 223例,其中CAP病例56 618例.CAP病例数由2009年的8677例增至2012年的19 947例,CAP病例占就诊病例总数比例由0.22％(8677/3 893 800)增至0.41％(19 947/4 839 766),差异有统计学意义(x2=2693.00,P＜0.05).住院CAP病例中,≤5岁和＞65岁者占66.05％(10 954/16 585);单一病原体感染病例占88.11％(14 613/16 585),混合感染病例占4.17％ (691/16 585).单一感染病原体类型构成中细菌所占比例最大,为65.25％ (10 821/16 585),其次为支原体[13.54％(2245/16 585)]、病毒[9.01％(1494/16 585)],最低为衣原体[0.32％ (53/16 585)].病毒所致CAP比例逐年升高,由4.74％(146/3081)增至11.64％ (525/4512),差异有统计学意义(x2=135.32,P＜0.05).各年龄组CAP病例均以细菌感染多见,随着年龄增高,细菌感染所致CAP比例不断增大,由≤5岁组的48.35％(2993/6191)增至＞65岁组的81.31％(3873/4763),差异有统计学意义(x2=1632.00,P＜0.05).儿童(≤15岁)非典型病原体(支原体、衣原体)感染率[25.99％(1805/6945)]高于成年人(≥16岁)的5.12％ (494/9640),差异有统计学意义(x2=1472.00,P ＜0.05).未发现季节对病原体分布的影响.2009-2012年,住院CAP死亡病例共433例,＞65岁组病死率最高[4.70％(224/4763)],6～15岁组病死率最低[0.27％ (2/754)].结论 2009-2012年广州市社区CAP发病呈上升趋势,细菌为优势病原体,儿童和老年人是CAP的高发人群,混合感染呈现较低水平.
目的 分析2009-2012年廣州市社區穫得性肺炎(CAP)的流行特徵及病原譜.方法 于2009-2012年以廣州市11箇區(縣級市)的14間大型綜閤性醫院作為肺炎病例鑑測哨點醫院,開展CAP病例鑑測,4年共鑑測就診病例18 982 223例,按照年份、年齡及季節分層,分析CAP病例病原譜特點.結果 2009-2012年共鑑測就診病例18 982 223例,其中CAP病例56 618例.CAP病例數由2009年的8677例增至2012年的19 947例,CAP病例佔就診病例總數比例由0.22％(8677/3 893 800)增至0.41％(19 947/4 839 766),差異有統計學意義(x2=2693.00,P＜0.05).住院CAP病例中,≤5歲和＞65歲者佔66.05％(10 954/16 585);單一病原體感染病例佔88.11％(14 613/16 585),混閤感染病例佔4.17％ (691/16 585).單一感染病原體類型構成中細菌所佔比例最大,為65.25％ (10 821/16 585),其次為支原體[13.54％(2245/16 585)]、病毒[9.01％(1494/16 585)],最低為衣原體[0.32％ (53/16 585)].病毒所緻CAP比例逐年升高,由4.74％(146/3081)增至11.64％ (525/4512),差異有統計學意義(x2=135.32,P＜0.05).各年齡組CAP病例均以細菌感染多見,隨著年齡增高,細菌感染所緻CAP比例不斷增大,由≤5歲組的48.35％(2993/6191)增至＞65歲組的81.31％(3873/4763),差異有統計學意義(x2=1632.00,P＜0.05).兒童(≤15歲)非典型病原體(支原體、衣原體)感染率[25.99％(1805/6945)]高于成年人(≥16歲)的5.12％ (494/9640),差異有統計學意義(x2=1472.00,P ＜0.05).未髮現季節對病原體分佈的影響.2009-2012年,住院CAP死亡病例共433例,＞65歲組病死率最高[4.70％(224/4763)],6～15歲組病死率最低[0.27％ (2/754)].結論 2009-2012年廣州市社區CAP髮病呈上升趨勢,細菌為優勢病原體,兒童和老年人是CAP的高髮人群,混閤感染呈現較低水平.
목적 분석2009-2012년엄주시사구획득성폐염(CAP)적류행특정급병원보.방법 우2009-2012년이엄주시11개구(현급시)적14간대형종합성의원작위폐염병례감측초점의원,개전CAP병례감측,4년공감측취진병례18 982 223례,안조년빈、년령급계절분층,분석CAP병례병원보특점.결과 2009-2012년공감측취진병례18 982 223례,기중CAP병례56 618례.CAP병례수유2009년적8677례증지2012년적19 947례,CAP병례점취진병례총수비례유0.22％(8677/3 893 800)증지0.41％(19 947/4 839 766),차이유통계학의의(x2=2693.00,P＜0.05).주원CAP병례중,≤5세화＞65세자점66.05％(10 954/16 585);단일병원체감염병례점88.11％(14 613/16 585),혼합감염병례점4.17％ (691/16 585).단일감염병원체류형구성중세균소점비례최대,위65.25％ (10 821/16 585),기차위지원체[13.54％(2245/16 585)]、병독[9.01％(1494/16 585)],최저위의원체[0.32％ (53/16 585)].병독소치CAP비례축년승고,유4.74％(146/3081)증지11.64％ (525/4512),차이유통계학의의(x2=135.32,P＜0.05).각년령조CAP병례균이세균감염다견,수착년령증고,세균감염소치CAP비례불단증대,유≤5세조적48.35％(2993/6191)증지＞65세조적81.31％(3873/4763),차이유통계학의의(x2=1632.00,P＜0.05).인동(≤15세)비전형병원체(지원체、의원체)감염솔[25.99％(1805/6945)]고우성년인(≥16세)적5.12％ (494/9640),차이유통계학의의(x2=1472.00,P ＜0.05).미발현계절대병원체분포적영향.2009-2012년,주원CAP사망병례공433례,＞65세조병사솔최고[4.70％(224/4763)],6～15세조병사솔최저[0.27％ (2/754)].결론 2009-2012년엄주시사구CAP발병정상승추세,세균위우세병원체,인동화노년인시CAP적고발인군,혼합감염정현교저수평.
Objective To investigate the epidemic characteristics and pathogenic spectrum of community acquired pneumonia (CAP) in Guangzhou from 2009 to 2012.Method 14 major comprehensive hospitals were selected from 11 districts as sentinel hospitals for CAP cases surveillance,including 18 982 223 in total during the 4 years.The characteristics of pathogenic spectrum of CAP were stratified and analyzed by year,age and season.Results 18 982 223 cases were included in the surveillance from year 2009 to 2012,in which 56 618 cases were CAP.The number of CAP cases increased from 8677 in year 2009 to 19 947 in year 2012 in Guangzhou; while the percentage of visits for CAP raised from 0.22％ (8677/3 893 800) to 0.41％ (19 947/4 839 766).The difference showed statistical significance (x2 =2693.00,P ＜ 0.05).Among the hospitalized CAP cases,66.05 ％ (10 954/16 585) were aged ≤ 5 years old or ＞66 years old.The percentage of cases infected by a single pathogen was 88.11％ (14 613/16 585),while co-infected cases accounted for 4.17％ (691/16 585).Bacteria accounted for the largest proportion of 65.25％ (10 821/16 585) as a single pathogen,followed by mycoplasma 13.54％ (2245/16 585),virus 9.01％ (1494/16 585) and chlamydia 0.32％ (53/16 585).The proportion of virus infection was increasing from 4.74％ to 11.64％.The difference showed statistical significance (x2 =135.32,P ＜ 0.05).Bacteria infection was the leading causes for CAP cases in all age groups; however the percentage increased with the increasing of ages.The rate of bacterial infection was increased from 48.35％ (2993/6191) among children aged ≤5 years old to 81.31％ (3873/4763) among adults aged over 65 years (x2 =1632.00,P ＜0.05).The rate of atypical pathogens (mycoplasma,chlamydia) for children (≤ 15 years old) (25.99％,1805/6945) was higher than that for adults aged ≥ 16 years old (5.12％,494/9640) (x2 =2.11,P ＜0.05).The effect from season on the pathogenic spectrum was not observed.433 hospitalized CAP cases were dead from 2009 to 2012.Case fatality rate was highest among people aged over 65 years old (4.70％,224/4763) and lowest among children aged between 6 to 15 years old (0.27％,2/754).Conclusion The incidence of community acquired pneumonia was rising in Guangzhou from 2009 to 2012.Bacteria was the dominant pathogen.Children and old people were the high-risk population of community acquired pneumonia;while co-infection was still at low level.
