The incidence and risk factors for heterogeneous vancomycin intermediate Staphylococcus aureus / 中华内科杂志

Objectives To investigate the prevalence of heterogeneous vancomycin intermediate Staphylococcus aureus(hVISA) and the sensitivity of hVISA to novel antibiotics,and to explore the risk factors and infection attributable mortality associated with hVISA infection.Methods A total of 456 methicillin resistant Staphylococcus aureus (MRSA) isolates were isolated in Zhongshan Hospital from January,2008 to November,2010.All MRSA isolates were investigated for hVISA by two agar screening methods BHIA5T (brain-heart infusion containing teicoplanin 5 mg/L)or BHIA6V (brain-heart infusion containing vancomycin 6 mg/L),as well as macroEtest method(MET).Possible hVISA isolates were tested by modified population analysis profile-area under the curve (PAP-AUC).The minimal inhibitory concentrations(MICs) of vancomycin,teicoplanin and linezolid were determined by microbroth dilution as recommended by Clinical Laboratory Standards Institute(CLSI).The contribution difference between hVISA and vancomycin susceptible Staphylococcus aureus (VSSA) in different MIC range was compared.A retrospective case-control study of the patients with hVISA infection or VSSA infection was carried out and statistical analysis was performed using t test,Mann-Whitney test,x2 test and Fisher exact test.Results A total of 105 isolates of hVISA were screened by BHIA5T and BHIA6V (23.0％) with other 23 isolates by MET(5.0％) and 21 by PAP-AUC(4.6％).All isolates were 100％ sensitive to vancomycin,teicoplanin and linezolid.The vancomycin MIC [(1.76 ±-0.16) mg/L] in hVISA group was significantly higher than that in VSSA group[(1.09 ± 0.07)mg/L,P ＜ 0.01],which was a potential risk factor for hVISA infection.The retrospective study showed chronic obstructive pulmonary disease (COPD) was also a risk factor for hVISA infection of the lower respiratory tract.No significant difference in infection attributable mortality was showed between the hVISA group and the VSSA group.Conclusions The overall prevalence of hVISA in Zhongshan Hospital is estimated as 4.6％,while the prevalence of hVISA isolated from blood is as high as 12.5％.All isolates are 100％ sensitive to vancomycin and linezolid.COPD is a risk factor for hVISA infection of the lower respiratory tract.

The characteristics of CT imaging and diagnosis of pulmonary cryptococcosis in 42 cases with non-acquired immune deficiency syndrome / 中华内科杂志

Objective To further elucidate the CT characteristics and diagnostic approaches to non-acquired immune deficiency syndrome patients with pulmonary cryptococcosis. Methods The histories of forty-two pulmonary cryptococcosis (PC) patients diagnosed in Zhongshan Hospital from 2003 -2008 were collected and analyzed for demography data, underlying conditions, clinical symptoms, chest CT and diagnostic studies. Results None of the 42 PC patients had avian or its feces contacting history, and 71.4% (30/42) of them were immunocompetent. The most frequent CT lesions were multiple nodules (67. 9% ) with peripheral predominance (67. 9% ), and cavitations (50%) often presented within them. Masses/consolidation (31.4%) and patching lesions (2. 9% ) could exist occassionally. Positive detection rates of non-aggressive examinations including sputum, bronchoalveolar lavage fluid and bronchofibroscope aspiration were 4. 3%, 8. 3% and 6. 3% respectively, while those of aggressive approaches including transbrunchial lung biopsy (TBLB), thin needle aspiration biopsy (TNAB) and pneumonectomy by surgery were 64. 7%, 64. 3% and 100% respectively. Non-aggressive serum cryptococcus antigen test was performed in 14 patients who had been diagnosed by histopathology or pathogen culture, and all of them were positive. Conclusion Our study suggests that PC is common in immunocompetent population. Avian or its feces contacting is not so important as used opinion to PC differential diagnosis. CT characteristics of PC are diversiform and always change very slowly. Besides the most frequent multiple nodules with subpleural predominance, pulmonary lesions can present as masses, consolidation or patchings. Aggressive techniques such as TBLB and TNAB are benefit to clinical diagnosis of PC, and non-aggressive serum cryptococcus antigen test may be promising for its early diagnosis as well as clinical course follow-up and therapeutic effect evaluation.

Prognostic factors related to community acquired pneumonia / 中华临床感染病杂志

Objective To investigate the prognosis and related factors of community acquired pneumonia (CAP). Methods From August 2003 to March 2009, 689 CAP cases from 37 hospitals of 23 cities in China were enrolled. The onset information and clinical outcomes in one month of onset were recorded. Pearson Chi-square test and Logistic regression test were performed using the SPSS 12.0 software to identify prognosis-related factors. Results Among 689 patients there were 396 male and 293 female. The median age was (53 19) years old, 247 patients (35.8%) were≥65 years old. Forty four patients died with a fatality rate of 6.4%. Univariate analysis identified 19 risk factors, they were age≥65 years old, smoking, aspiration, use of antimicrobial agents in 3 months, use of immunodepressant in 2 months, heart failure, chronic renal failure, chronic liver disease, eerebrovascular disease, diabetes, emaciation, altered mental status, respiratory rate > 28/min, pulse > 100/min, lower diastolic blood pressure, neutrophil ratio > 0.9, ALT >40 U/L, elevated blood urea nitrogen level and PORT classification ≥Ⅳ. By multivariate analysis, use of antimicrobial agents in 3 months, respiratory rate > 28/min, pulse > 100/min and PORT classifications≥Ⅳ were identified as the independent risk factors for mortality. Conclusions The general fatality rate of CAP is low in China. Use of antimicrobial agents in 3 months, respiratory rate > 28/min, pulse > 100/min and PORT classifications≥Ⅳ are independent risk factors for mortality.

Multi-center clinical studies on pazufloxacin sodium chloride injection in treatment for acute bacterial infections / 中华全科医师杂志

Objective To evaluate efficacy and safety of locally-produced pazufloxacin mesilate sodium chloride injection in the treatment of bacterial infections of respiratory and urinary tract.Methods A multi-center double-blind randomized controlled clinical trial was carried out to evaluate efficacy and safety of pazufloxacin mesilate sodium chloride in treatment for acute bacterial infection, as compared to those of levofloxacin hydrochloride and glucose injection as control treatment.A total of 244 patients with acute bacterial infection of respiratory and urinary tract were enrolled in the studies.120 in trial group and 120 in control group, with four withdrawals.Pazufloxacin mesilate and levofloxacin were administered intravenously by drip at a dose of 300 mg and 200 mg, every 12 hours for 7 to 14 days for trial and control groups, respectively.Resuits Overall efficacy of pazufloxacin mesilate was 77.0 percent and 93.5 percent in treatment for acute bacterial infections of respiratory and urinary tract.respectively, and that of levofloxacin was 80.6 percent and 89.6 percent, respectively.Overall bacterial clearance rate WaS 91.5 percent for pazufloxacin mesilate, 89.6 percent for respiratory tract infection and 94.1 percent for urinary tract infection, respectively.and 93.4 percent for levofloxacin, 97.3 percent for respiratory tract infection and 89.7 percent for urinary tract infection, respectively.No significant difference in adverse drug reactions between the two groups(P＞0.05)was found, with 4.88 percent and 7.44 percent for trial and control groups, respectively.Conclusions Pazufloxacin mesilate sodium chloride injection produced locally is a safe and effective antibiotic in treatment for acute infections of respiratory and urinary tract.

A multicenter prospective cohort study on risk factors for hospital-acquired pneumonia in the elderly / 中华内科杂志

Objective To investigate the incidence and the risk factors for hospital-acquired pneumonia(HAP)in the elderly in Shanghai.Methods This was a muhicenter prospective clinical cohort study.A total of 5299 patients more than 65 years old.admitted into 31 secondary or tertiary hospitals in Shanghai,were enrolled.Measurements of the demographic and potential risk factors reflecting illness severity,nutrition,drug exposure,surgery and ventilation were performed.Pneumonia was classified by the definition of Chinese Medical Association.Risk factors were analyzed by univariate Pearson Chi-squared test and multivariable logistic regression analysis with backward(Likelihood ratio).Resuits Of the enrolled patients,2805 male and 2494 female,255(4.81%)developed hospital-acquired pneumonia.The incidence was 46.75/1000 hospitalizations.Among them 38 died:and the rough mortality was 14.90%.The incidence of HAP was higher in ICU(21.43%),hematology(12.17%),chest surgery(11.41%),and respiratory medicine(7.92%)departments.The mean of acute physiology and chronic health evaluation (APACHE Ⅱ)score was 8.3±3.4(5-31).Multivariable logistic regression analysis with backward (Wald)method found that admission into secondary hospitals.admission into ICU,history of chronic obstructive pulmonary disease≥10 years,immunosuppression,administration of antibiotics,insertion of nasogastric tube,mechanical ventilation,administration of H-2 antagonists or antacid and≤7 d,central nervous system diseases,depressed level of consciousness,supine position,albumin＜35g/L were independent risk factors of HAP in the elderly.Conclusion Hospital-acquired pneumonia in the elderly was the usual type of nosocomial infections.The risk factors identified from this study may prove useful to target future clinical interventions to prevent HAP in the elderly.

A clinical studv of 49 cases of invasive pulmonary aspergillosis / 中华内科杂志

Objective studyring the proven and probable invasive pulmonary aspergillosis(IPA) eases of some hospitals in Shanghai to provide evidence fur the improvement of IPA clinical diagnosis and therapy.Methotis Fortv-nine IPA cases were retrospectively analyzed for demography data,host tactors,underlying conditions.chest CT,microorganism and histopathology examination,as well as therapy and clinical outcome.ResultsOf 49 subjects including 19(38.8%)proven and 30(61.2%)probable IPA,3 pailents(6.1%)had no host factors,25 patients(51.0%)had IPA associated host factors and underlying conditions.while 21 patients(42.9%)had uncertained fundamental diseases.Chest CT evaluation demonstrated that radiological lesions include nodules in 29 patients,patching in 15,mass in 12,consolidation in 10.cavitation in 34,Halo sign in 19,air bronchogram in 18,crescentic sign in 6,bilateral in 33 and multifocal lesions in 38.The yielding rate of fungus culture in sputum was 26.5%(13/49),and in bronchoalveolar lavage fluid was 66.7%(10/15).Eleven of thirty-six patients(30.6%)had positive results of serum galactomannan antigen tests.Nineteen of twenty-one patients(90.5%)were proven as IPA by lung histologic examinations.Aspergillus fumigatus was the most common pathogen 81.0%(17/21).The responding rate to initial anti-fugus therapy wag 50%(21/42).Conclusion Our study suggests that in IPA patients,bilateral,muhifocal and nodular lesion could be the most common radiological characteristic,while Halo and crescentic sign occar occasionally.Invasive technologies are more valuable to IPA diagnosis.

Impact Factors of Pseudomonas aeruginosa Biofilms Formation / 中华医院感染学杂志

OBJECTIVE To compare the difference of Pseudomonas aeruginosa(PAE) biofilms formation in different conditions including incubated time,temperature,attaching materials,and flowing speed.METHODS PAE biofilms were established in a chemostat-coupled MRD and detected with the method of viable bacteria counting.The number of CFU/disc was measured in different culture time(8h,24h or 72h),different temperature(23℃ or 37℃),different adherent materials(glass or silicone),different flow velocities(30ml/h or 90ml/h) and different culture media(M63 medium,M-H croth or LB broth).RESULTS Keeping the other conditions invariable,the log10CFU/disc of viable bacteria in 8h,24h or 72h biofilms were 4.01?0.26,4.59?0.49 or 5.20?0.47,respectively(P

Change of the concentration of IFN-? and infectious Aspergillus organisms in lung in the model of invasive pulmonary aspergillosis / 中国实用内科杂志

Objective To establish the model of invasive pulmonary aspergillosis (IPA) and assay the influence on the host defense against Aspergillus infection when immunity was suppressed in mice.Methods Immunocompromised mice were made by treatment with cyclophosphamide administered intraperitoneally (i.p.).Suspension of conidia was applied to the nostrils of mice to make the model of IPA.Lungs were harvested and homogenized.Portions of homogenates were cultured to determine the number of CFU.IFN-? in bronchoalveolar lavage fluid was determined by a cytokine-specific ELISA kit.Reverse transcription PCR (RT-PCR) analysis was done to determine the mRNA of IFN-? in lung cells.Mortality of different rice was calculated.Results Compared with immunocompetent mice,the immunocompromised mice demonstrated a high mortality and had significantly higher concentration of infectious Aspergillus organisms in their lung tissues.In accordance with the increase of Aspergillus organisms,the levels of IFN-? in lung tissues got higher.Lung sections from immunocompromised mice revealed patterns of lesions characterized by signs of bronchial wall damage,peribronchial necrosis,and the presence of numerous infiltrating inflammatory cells.Conidia and hyphae were seen in these mice.In contrast,these features were not observed in immunocompetent mice whose lungs were characterized by few inflammatory cells infiltration,and few fungal growth after inoculation.Conclusion The levels of IFN-? in lung tissues are related to the infectious Aspergillus organisms.The immunity and T cells play a major role in host defense against Aspergillus infection.

A comparative study of clinical manifestations caused by tuberculosis in immunocompromised and non-immunocompromised patients / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To characterize the differences between clinical manifestations in immunocompromised patients (ICPs) and non-immunocompromised patients (non-ICPs) with tuberculosis.</p><p><b>METHODS</b>Underlying diseases, clinical presentations, misdiagnosis, treatment and prognosis, etc, were analyzed retrospectively in 115 tuberculosis patients, including 39 ICPs and 76 non-ICPs.</p><p><b>RESULTS</b>Compared with non-ICPs, the individuals who were ICP had more expectoration (64.1% vs 35.5%), pulmonary moist rale (41.0% vs 9.2%), miliary pulmonary tuberculosis (30.8% vs 2.6%), pleural effusion (48.7% vs 25.0%) and lymphadenopathy (18.0% vs 4.0%). ICPs had less lung cavity (15.4% vs 22.4%) and pleural thickening (15.4% vs 23.7%) compared to non-ICPs. Pulmonary tuberculosis in ICPs was prone to be misdiagnosed as pneumonia (23.1% vs 6.6%). Pulmonary tuberculosis was found in the apicoposterior segment (SI + SII) in more cases in non-ICPs (21.7%, 10/46) than ICPs (10.3%, 3/29). The diagnostic value of tuberculin skin test and adenosine deaminase in pleural effusions was limited in ICPs. ICPs had significantly poorer prognoses than non-ICPs.</p><p><b>CONCLUSION</b>The clinical manifestations of ICPs with tuberculosis are atypical, misdiagnosis often occurs, resulting in a worse prognosis.</p>

The application of the acute physiology and chronic health evaluation Ⅲ score system in the patients with lower respiratory tract infections of pseudomonas aeruginosa in intensive care unit / 中国呼吸与危重监护杂志

ObjectiveTo predict the opportunity of infection and evaluate the severity of illness and prognosis for patients with lower resp iratory tract infections in intensive care unit (ICU) using the acute physiology and chronic health evaluation Ⅲ (APACHEⅢ) MethodsThe clini cal data of 115 cases with infections of pseudomonas aeruginosa (PA) in lowe r respiratory tract and 116 cases without PA infections were analyzed and evalua ted with APACHEⅢ score system ResultsAPACHEⅢ scores of non -survivors were significantly higher than those of survivors [(55 29?15 83) vs (25 97?14 39),P

Character of pnemocystis pneumonia complicated AIDS and non-AIDS immunocomprised host / 中国实用内科杂志

Common feactures of pnemocystis pneumonia(PCP) complicated AIDS and non-AIDS imunnocomprised host were fever,progressive dyspnea and radiographic diffuse interstitial infiltration.There are also obvious differences between them,including the former have more moderate symptoms,fewer organism load in pulmonary,more lightly neutrophil inflammatory reaction,slower response and more adverse effect of treatment with SMZco.Recognizing these characters will help to find PCP early and give timely diagnosis and treatment. Abstract:Summ ary: Common feactures of pnemocystis pneumon ia(PCP) comp licated AIDS and non-AIDS imunnocomprised host were fever,progressive dyspnea and rad iograph ic d iffuse interstitial infiltration.There are also obvious d ifferences be-tween them,inc lud ing the form er have more moderate symp-tom s,fewer organ ism load in pu lmonary,more lightly neutroph il inflamm atory reaction,slower response and more adverse effect of treatm entw ith SMZco.Recogn izing these characters w ill help to find PCP early and give tim ely d iagnosis and treatm ent.

The benefit of ertapenem on hospital ecology / 中国实用内科杂志

Resistance to antibiotic therapy is a worldwide problem with severe clinical and economic consequences.Among hospitalized patients,antibiotic resistance has been associated with increases in morbidity and mortality,prolonged hospitalization,and increased hospital costs.An important cause of antibiotic resistance is the selection of resistant bacterial strains as a result of inappropriate and/or excessive antibiotic prescribing in the hospital setting;important strategies to control resistance include monitoring and auditing drug use as well as surveillance and reporting of resistance patterns among hospital flora.Traditional antibiotics,such as cephalosporins and fluoroquinolones,are often linked to the emergence of multidrug-resistant gram-negative bacteria,particularly acinetobacter and pseudomonas spp,and increasingly,enterobacteriaceae.Accordingly,the treatment strategy is to think to choose an antibiotics with adequate infection control and lower resistance selection.Studies of relation between antibiotic consumption and antibiotic resistance show that ertapenem,a group 1 carbapenem,can not reduce the susceptibly of other antibiotics to pseudomonas spp,enterobacteriaceae and the others,and be benefit on hospital ecology. Abstract:Summ ary:Resistance to antib iotic therapy is a worldw ide prob lem w ith severe c lin ical and econom ic consequences.A-mong hosp italized patients,antib iotic resistance has been assoc iated w ith increases in morb id ity and mortality,prolonged hosp italization,and increased hosp ital costs.An important cause of antib iotic resistance is the selection of resistant bacteri-al strains as a resu lt of inappropriate and /or excessive antib iotic prescrib ing in the hosp ital setting;important strategies to control resistance inc lude mon itoring and aud iting drug use as well as surve illance and reporting of resistance patterns a-mong hosp ital flora.Trad itional antib iotics,such as cephalosporins and fluoroqu inolones,are often linked to the em ergence ofmu ltidrug-resistant gram-negative bacteria,particu larly ac inetobacter and pseudomonas spp,and increasingly,enterobac-teriaceae.Accord ingly,the treatm ent strategy is to th ink to choose an antib iotics w ith adequate infection control and lower resistance selection.Stud ies of relation between antib iotic consumption and antib iotic resistance show that ertapenem,a group 1 carbapenem,can not reduce the susceptib ly of other antib iotics to pseudomonas spp,enterobacteriaceae and the others,and be benefit on hosp ital ecology.

Inflammatory reaction and alterations of pulmonary surfactant in Pseudomonas Aeruginosa pneumonia in immunocompromised rats / 中华医学杂志(英文版)

Pulmonary surfactant ( PS ) compromises lipids and surfactant proteins (SP) and lines on the alveolar air-liquid interface. It can reduce surface tension, prevent alveoli from collapse and reduce alveoli edema by disaturated dipalmitoylphosphatidylcholine. It also modulates the pulmonary immunology by SP-A and SP-D. In this study,we established a rat model of immunocompromised host (ICH) with pulmonary infection of Pseudomonas aeruginosa (P. aeruginosa), then studied its pulmonary inflammatory reaction and analyzed the concentration of lipids and SP-A in bronchoalveolar lavage fluid (BALF) during infection.

Sensible consideration for appropriate use of the respiratory quinolonone antimicrobial agents / 中国实用内科杂志

In the light of inappropriate use and confused assessment for the respiratory quinolone antimicrobial agents,this paper discussed four aspects,e.g.development on indications of respiratory quinolone use,new evidences of CAP treatment with Moxifloxacin and its significance,evaluation of collateral damage of quinolone antimicrobial agents and notices of quinolone use.

A control study of the risk factors of 122 cases of septicemia / 中华医院管理杂志

Objective To explore the risk factors of septicemia in hospitals. Methods A retrospective control study of cases was conducted, using SPSS software to conduct single factor and Iogistic regression analysis so as to screen possible risk ractors. Results Differences of 14 factors were shown to be statistically significant in the analysis of single factors. Further Iogistic regreasion analysis of the 14 factors indicate that the following are independent risk factors of septicemia in hospitals: basic diseases(OR = 5.3), tumor chemotherapy(OR=15.9), albumin＜30g/L(0R=5.9), vascular catheterization ＞ 2 days(OR= 5.2), operation time＞ 4 hours(OR= 4.9), continuous use of antibiotics(OR=1.1), and simultaneous use of more than 2 kinds of antibiotics(OR= 9.0).Conclusion Septicemia in hospitals results from the synergistic effect of a variety of factors. The possible risk factors that have been screened need to be further confirmed through perspective studies and clinical trials.

Antimicrobial Therapy of Pulmonary Infections Guides by Pharmacokinectic/Pharmacodynamic Principle on Antibiotic / 医药导报

The Clinical effiency of antimicrobial therapy depend on the pharmacokinectic/pharmacodynamic parameters of antibiotics except antibacterial spectrum and activity. The penetration of antibiotics in the respiratory organ and pharmacokinectic/pharmacodynamic parameters correlating with antibacterial efficiency are descrided. It is emphasized that antibiotic treatment regime on the pulmonary infections should be based the pharmacokinectic/pharmacodynamic principle.

Antiviral Drugs in the Treatment of Respiratory Virus Infections / 医药导报

Virus infection is a cause of respiratory tract infections and predisposes the patients to secondary bacterial infections. With the graying” of the population and the increase of organ transplantation, immunocompromised hosts (ICH) and the rate of human immunodeficiency virus (HIV) infection as well as the emergence of such new pathogens as Hantavirus and Ebola virus in recent years, the morbidity of respiratory tract infections is growing high. There come the new challenges in the management of the respiratory tract infections. This paper is to introduce the application of antiviral drugs in the treatment of respiratory tract infections and discuss about the methodology of the administration of these drugs.

Different effect of Ceftazidime on the early and mature Pseudomonas aeruginosa biofilm bacteria / 中华检验医学杂志

Objective To observe the effect of Ceftazidime on the early and mature Pseudomonas aeruginosa biofilm bacteria. Method The early and mature PA biofilm were formed through the chemostat combined Robbins device. Then 64 ?g/ml Ceftazidime was applied to the early and mature PA biofilm bacteria for 24 hours respectively. Scanning electronic microscope(SEM) was used to observe the effect of Ceftazidime on early and mature biofilm. The difference between the viable bacteria in early and mature biofilm was analyzed by statistical method. Result 24 hours after Ceftazidime was added, Pseudomonas aeruginosa in early biofilm was killed on the whole while there were still numbers of bacteria in mature biofilm. Statistical analysis demonstrates a great variance in viable counts. Conclusion Pseudomonas aeruginosa in mature biofilm is more tolerant to antibiotics than that in early biofilm.

Alteration of surfactant protein A and D in bronchoalveolar lavage fluid in rats with pneumocystis carinii pneumonia / 中华传染病杂志

@#Objective To study the alteration of surfactant protein A and D(sp-A,SP-D)result-ing from pneumcystis carinil pneumonia(PCP)and investigate its implication in the pathogenesis of PCP.Methods SD rat models of PCP were induced by subcutaneous injection of 25 mg cortisone acetate,normal control and negative control as well as bacterial pneumonia group were set up for comparison.During 8～12weeks.broncboalveolar lavage fluid (BALF) of rats was collected.Total nucleate cells of BALF were counted and differentiated as well as the concentrations of surfactant protein A(SP-A)and surfactant pro-tein D(SP-D)were measured by immunoblotting assay.Results The rats were divided into three im-munosuppressive groups,plus a norrflal control group. Group A: normal control(n=6)consisted of healthy SD rats;group B:negative control(n=6)employed rats with cortisone acetate injection over 8weekz without tung infection;group C:bacterial pneumonia(n=11),rats were injected with cortisone ac-etate over 8 weeks and resulted in bacterial pneumonia without other pathogens isolated;group D(n=14):rats were injected with cortisone acetate during 8～12 weeks and resulted in PCP without other pathogens isolated.During PCP infection,the total cell counts and the percentage of polymorphonuclears (PMNs)in BALF were significantly increased(P<0.01),but were lower than those in the bacterial pneumonia group.The concentration of SP-A of BALF in PCP(45.1 μg/ml 4±22.1 μg/m1)was signifi-cantly increased in comparison with that in negative control group(16.2 μg/ml±9.9 gg/ml,P<0.05)and that in bacterial pneumonia group(6.2 μg/ml±5.6 μg/ml,P<0.001).We also found that the rela-tive content of SP-D was significantly higher in PCP(24 249±4 780 grey values)than that in both nega-tive control(13 384±2 887 grey values,P<0.001)and bacterial pneumonia group(11 989±2 750 grey values,P<0.001).SP-A and SP-D were also higher in moderate to severe group of PCP than those seen in mild group(P<0.01,P<0.001).Conclusion There was obvious increase of SP-A and SP-D in PCP rats,and particularly,the change of which was greater than that in bacterial pneumonia.Therefore,the alteration of SP-A and SP-D may be of implication in the prevention and management of PCP.

Current concern for community-acquired pneumonia / 中国实用内科杂志

Current concerned topics for community-acquired pneumonia(CAP)have been reviewed.There are 3 aspects,including(1)the modified penicillin susceptibility breakpoint of Streptococcus pneumonia and choice of antibiotics treating CAP.(2)Risk factors,which may influence CAP conditions and pathogens were evaluated.(3)Severe CAP and complicating severe sepsis and controversy of glucocorticoid treatment.