摘要

对美国65岁以上患者的社区获得性肺炎的研究表明，除了常见的病原体如肺炎链球菌和流感嗜血杆菌外，革兰氏阴性杆菌占了相当大的比例。在英国，还没有社区获得性肺炎的报道。我们进行了这样的研究，以确定临床特征，病因和结局。对73例患者(38名男性)进行了前瞻性研究，年龄从65岁到97岁(中位数79岁)。肺炎被定义为急性下呼吸道感染，胸片上有新的、以前未记录的阴影。将肺炎为预期终末期事件的严重慢性疾病患者排除在外。几乎所有患者(96%)都有呼吸道症状或体征，但许多患者的特征可能会掩盖肺炎的真正诊断。超过一半的患者有非呼吸道症状，超过三分之一的患者没有全身感染症状。在43%的患者中鉴定出病原体，最常见的是肺炎链球菌、流感嗜血杆菌和乙型流感病毒。革兰氏阴性杆菌未见。 The mortality rate was high (33%). Early deaths were due to infection whereas later deaths were associated with other factors, such as stroke (two patients) and pulmonary embolism (two patients). Prognostic indicators for mortality were apyrexia, systolic hypotension, increasing hypoxaemia, and new urinary incontinence. As the range of pathogens causing pneumonia was the same in the elderly in this study as in other age groups it is suggested that initial antibiotic treatment for patients in this age group should always cover S pneumoniae and H influenzae.