Background Appropriate antimicrobial therapy of community-acquired pneumonia （CAP） is mainly based on the distribution of etiology and antimicrobial resistance of major pathogens. We performed a prospective observat...Background Appropriate antimicrobial therapy of community-acquired pneumonia （CAP） is mainly based on the distribution of etiology and antimicrobial resistance of major pathogens. We performed a prospective observational study of adult with CAP in 36 hospitals in China. Methods Etiological pathogens were isolated in each of the centers, and all of the isolated pathogens were sent to Zhongshan Hospital for antimicrobial susceptibility tests using agar dilution. Results A total of 593 patients were enrolled in this study, and 242 strains of bacteria were isolated from 225 patients. Streptococcus pneumoniae （79/242, 32.6%） was the most frequently isolated pathogen, followed by Haemophilus influenzae （55/242, 22.7%） and Klebsiella pneumoniae （25/242, 10.3%）. Totally 527 patients underwent serological tests for atypical pathogens; Mycoplasma pneumoniae and Chlamydia pneumoniae infections were identified in 205 （38.9%） and 60 （11.4%） patients respectively. Legionella pneumophila infections were identified in 4.0% （13/324） of patients. The non-susceptibility rate of isolated Streptococcus pneumoniae to erythromycin and penicillin was 63.2% and 19.1% respectively. Six patients died from the disease, the 30-day mortality rate was 1.1% （6/533）. Conclusions The top three bacteria responsible for CAP in Chinese adults were Streptococcus pneumonia, Haemophilus influenza and Klebsiella pneumonia. There was also a high prevalence of atypical pathogens and mixed pathogens. The resistance rates of the major isolated pathogens were relatively low except for the high prevalence of macrolide resistance in Streptococcus pneumoniae.展开更多
Background Community-acquired pneumonia （CAP） is a common infectious disease throughout the world and the incidence continues to grow as the population ages.Aspiration is an important pathogenic mechanism for pneumo...Background Community-acquired pneumonia （CAP） is a common infectious disease throughout the world and the incidence continues to grow as the population ages.Aspiration is an important pathogenic mechanism for pneumonia in the elderly and the management of patients with community-acquired pneumonia with aspiration factors is a major medical problem.Our study aimed to assess whether moxifloxacin in comparison to levofloxacin plus metronidazole are effective and safe in the treatment of community-acquired pneumonia with aspiration factors.Methods In this prospective,multicenter,open-label,randomized controlled trial,77 patients with mild-to-moderate community-acquired pneumonia with aspiration factors were enrolled and randomly assigned to receive moxifloxacin or levofloxacin plus metronidazole.The primary efficacy variables were clinical outcomes in evaluable patients at a follow-up visit 7 to 14 days after the end of therapy.Results Seven days after the end of therapy a clinical cure was achieved for 76.7％ （23 of 37） of efficacy-evaluable patients in the moxifloxacin group and 51.7％ （15 of 40） of patients in the levofloxacin plus metronidazole group.There was a significant difference between the two groups （x2=4.002,P ＜0.05）.Bacteriological success rates were similar in the moxifloxacin group （93.3％） and levofloxacin plus metronidazole group （96.4％）,there was no significant difference between the two groups （P ＞0.05）.The overall adverse event rate was 10.8％ （4/37） in the moxifloxacin group versus 17.5％ （7/40） in the levofloxacin plus metronidazole group,there was no significant difference between the two groups （P＞0.05）.No serious adverse events were observed.Conclusions Moxifloxacin is effective and safe for treatment of community-acquired pneumonia with aspiration factors.And the regimen of moxifloxacin monotherapy is more convenient compared with levofloxacin plus metronidazole.展开更多
文摘Background Appropriate antimicrobial therapy of community-acquired pneumonia （CAP） is mainly based on the distribution of etiology and antimicrobial resistance of major pathogens. We performed a prospective observational study of adult with CAP in 36 hospitals in China. Methods Etiological pathogens were isolated in each of the centers, and all of the isolated pathogens were sent to Zhongshan Hospital for antimicrobial susceptibility tests using agar dilution. Results A total of 593 patients were enrolled in this study, and 242 strains of bacteria were isolated from 225 patients. Streptococcus pneumoniae （79/242, 32.6%） was the most frequently isolated pathogen, followed by Haemophilus influenzae （55/242, 22.7%） and Klebsiella pneumoniae （25/242, 10.3%）. Totally 527 patients underwent serological tests for atypical pathogens; Mycoplasma pneumoniae and Chlamydia pneumoniae infections were identified in 205 （38.9%） and 60 （11.4%） patients respectively. Legionella pneumophila infections were identified in 4.0% （13/324） of patients. The non-susceptibility rate of isolated Streptococcus pneumoniae to erythromycin and penicillin was 63.2% and 19.1% respectively. Six patients died from the disease, the 30-day mortality rate was 1.1% （6/533）. Conclusions The top three bacteria responsible for CAP in Chinese adults were Streptococcus pneumonia, Haemophilus influenza and Klebsiella pneumonia. There was also a high prevalence of atypical pathogens and mixed pathogens. The resistance rates of the major isolated pathogens were relatively low except for the high prevalence of macrolide resistance in Streptococcus pneumoniae.
文摘Background Community-acquired pneumonia （CAP） is a common infectious disease throughout the world and the incidence continues to grow as the population ages.Aspiration is an important pathogenic mechanism for pneumonia in the elderly and the management of patients with community-acquired pneumonia with aspiration factors is a major medical problem.Our study aimed to assess whether moxifloxacin in comparison to levofloxacin plus metronidazole are effective and safe in the treatment of community-acquired pneumonia with aspiration factors.Methods In this prospective,multicenter,open-label,randomized controlled trial,77 patients with mild-to-moderate community-acquired pneumonia with aspiration factors were enrolled and randomly assigned to receive moxifloxacin or levofloxacin plus metronidazole.The primary efficacy variables were clinical outcomes in evaluable patients at a follow-up visit 7 to 14 days after the end of therapy.Results Seven days after the end of therapy a clinical cure was achieved for 76.7％ （23 of 37） of efficacy-evaluable patients in the moxifloxacin group and 51.7％ （15 of 40） of patients in the levofloxacin plus metronidazole group.There was a significant difference between the two groups （x2=4.002,P ＜0.05）.Bacteriological success rates were similar in the moxifloxacin group （93.3％） and levofloxacin plus metronidazole group （96.4％）,there was no significant difference between the two groups （P ＞0.05）.The overall adverse event rate was 10.8％ （4/37） in the moxifloxacin group versus 17.5％ （7/40） in the levofloxacin plus metronidazole group,there was no significant difference between the two groups （P＞0.05）.No serious adverse events were observed.Conclusions Moxifloxacin is effective and safe for treatment of community-acquired pneumonia with aspiration factors.And the regimen of moxifloxacin monotherapy is more convenient compared with levofloxacin plus metronidazole.
