(CAP) CAP CAP. (RVs) (PV) (RV + ) CAP. RVs ( CAP [2 / 26 (8%) P = 0.035] CAP [1 / 44 (2%) P = 0.001] P = 0.024] 26 (31%)]
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1 Andrés de Roux, MD; Maria A. Marcos, MD; Elisa Garcia, MD; Jose Mensa, MD; Santiago Ewig, MD, PhD; Hartmut Lode, MD, PhD; and Antoni Torres, MD, PhD, FCCP (CAP) CAP , CAP (RVs) (PV) (RV + ) CAP RVs ( ) (18%) RV 31 (9%) RV (39 64%) (CHF) PV CAP [8 / 26 (31%)] CAP [2 / 26 (8%) P = 0.035] CAP [1 / 44 (2%) P = 0.001] CHF [ (OR) % (CI) 1.4 ~ 163 P = 0.024] (OR %CI 0.04 ~ 0.6 P = 0.006) PV CAP RVs CAP ( ) CHF CAP (chronic heart faiure); (community-acquired pneumonia); (respiratory viral infection); (risk factor) (community-acquired pneumonia, [1,2] 1.62 ~ 3.79 CAP) 1 ~ 30 CHEST
2 [3~7] CAP ( 18 ) [10,11] [8~10] (Streptococcus Pneumonide SP) CAP CAP 5% ~ 34% [1] 25% CAP (respiratory virus RV) ( HIV CAP < 15 mg / d ) [3] ( CAP RVs) CAP ( 1) (Biotest 3 CAP Legionella urine antigen enzyme-linked immunoassay; (2) CAP (3) Biotest; Frankfurt am Main, Germany) CAP Hospital Clínic of Barcelona RVs A B (respiratory syncytial virus RSV) ( 3 A B BIO; Whittaker; Walkersville, MD RSV 1 2 Virion / Institut d'investigations Biomédiques August Pi i Serion; Serion Immunodiagnostica GmbH; Würzburg, Sunyer (Universitat de Barcelona, Barcelona, Spain) Germany) From the Servei de Pneumologia (Dr. de Roux and Torres), Institut Clínic de Pneumologia i Cirurgia Toràcica, and the Servei de Microbiologia (Dr. Marcos) and Servei de Malaties Infeccioses (Drs. Garcia and Mensa), Institut Clínic D Immunologia i Infeccions, Institut d'investigacions Biomèdiques August Pi i Sunyer Hospital Clínic, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain; Pneumologische Klinik (Dr. Ewig), Augusta Kranken Anstalt, Bochum, Germany; and the Department Lungenklinik Heckeshorn I (Dr. Lode), Zentralklinik Emil von Behring, Berlin, Germany. Correspondence to: Antoni Torres, MD, PhD, FCCP, Respiratory Intensive Care Unit, Institut Clinic de Pneumologia i Cirurgia Toracica, escalera 2, planta 3, Hospital Clinic, Villarroel 170, Barcelona, 08036, Spain; ub.es ( IgG 4 ) IgG (A B) 1: RSV 1 8 [12] (tracheobronchial aspirates, TBAS) ( ) 1 552
3 1 338 CAP RVs (n) 1 RV RVs (61 ) (31 ) A B 10 7 (1 2 3) RSV ( ) 9 5 B + + RSV A + 3 CAP 1 (pure viral pneumonia PV) (chronic heart failure CHF) ( COPD) (5) ( > 80 g) ( 10 > ); (6) ( < 90 mm Hg) > 30 / min ( 1.5 mg / dl) ICU (7) ( ); (8) (pneumonia severity index PSI) [14] ~ (PSI < 70) (PSI 70 ~ 90) (PSI 91 ~ 130) x ± s χ2 Fisher Student t Mann-Whitney (Bonferrone post hoc correction); 2 (mixed viral pneumonia logistic P < MP) RV P < SP TBAS ( 2 ( 10 5 cfu / ml) SP ): TBAS ( ) 2 MP (26 ) (n) / ( RSV ) ( ) (A B) (1 2 3 ) ( ) SP (5) SP (2) SP (2) C CAP C (4) C C H (2) L M M S [6,11,13] C + Ć SP + H (2) SP + Ć SP + C (3) C H ( ) ; (4) M S Ć (C burnetii) L CHEST
4 1 356 CAP ( ) ( 1) (18%) 1 RV 31 (9%) 1 ( A B) RSV ( ) (10%) PV 26 (MP ) 26 (PV ) CAP CAP 26 (10%) MP 44 (17%) ( 2) SP 1 MP (12 ) 1 (9 ) SP 518 (38%) (5 ) (5 ) ( 70 (5 ) ( 2) (SP ) CAP ) ( ) CAP 2 PV y ( 1 0) CHF (2) SP CHF ( ) 6 CAP (68 18) (38%) SP (41%) (14.5%) (12%) (10%) CAP 1 CAP 26 2 RV CAP ( PV)
5 3 18%) ( 3) PV MP SP P (26 ) (26 ) (44 ) ( ) NS 12 (2) 4 (2) (65) 20 (80) 31 (40) NS CHF (3) 8 (31) (2) 2 (8) (2) 1 (2) (2) < (8) 3 (12) 2 (4.5) NS 0 2 (8) 4 (9) NS 3 (12) 0 10 (23) NS 3 (12) 0 10 (23) NS 2 (8) 2 (8) 4 (9) NS 14 (54) 15 (57) 23 (43) NS COPD 9 (35) 7 (27) 15 (34) NS > 80 g / d 2 (8) 6 (23) 4 (9) NS 7 (27) 9 (34) 14 (32) NS PSI + 7 (27) 2 (8) 8 (18) NS 4 (15) 7 (27) 12 (27) NS + 15 (58) 12 (46) 24 (54) NS PV PV [8 / 26 (31%)] MP [17 / 26 (65%)] P = PV SP [32 / 44 (73%)] P = SP SP [40 / 44 (91%)] PV [17 / 65 (65%)] P = % PV (SP 98% MP 69% ) 10% C ( 4), SP ( ), MP ( ), PV ( ) 4 x ± s (%) (2) (3) NS PV MP PV (26 ) MP (26 ) SP (44 ) P P = PV SP, P = (46) 14 (53) 26 (59) NS 17 (65) (2) 20 (77) 40 (90) (2) (3) 8 (31) (2) 17 (65) (2) 32 (73) (2) < (28) 11 (42) 23 (52) NS 19 (73) 13 (50) 31 (70) NS 22 (85) 18 (69) 31 (70) NS 3 MP CAP [22 / 26 (84%), P = 0.04] PV ( 54% 46%) SP 66% (30 / 44 ) (PV 54% MP 55% SP 34% ) COPD CAP CHF : PV [8 / 26 (31%)] MP [2 / 26 (8%)] P = PV SP [1 / 44 (2%)] P = 0.001( 3) 50% (PV 58% MP 46% SP 54%) PSI (PV 27% MP 8% SP PSI PV 17 (65) 18 (69) 36 (98) NS 2 (8) 4 (15) 9 (20) NS 3 (12) 2 (8) 4 (9) NS NS ( 1000 / µl) C (mg/d) l NS (mmhg) NS (mg / dl) NS (%) NS x ± s (%) NS (2) (3) PV MP, P = PV SP, P = CHEST
6 CAP PV CAP MP CAP ( 48 h 38 ) ( ) 18% CAP (2) SP CHF 30 / min (3) PV CAP MP PV [13 / 26 (50%)] MP [4 / 26 (15%)] P = MP 4 SP 2 PV PV (0%) MP [4 / 26 (15%)] P = PV SP [2 / 44 CAP 18% 9% RV (5%)] 1 ( RVs CAP 10% 5.5% SP ) ( 5) 11% [9,15,16] 20% CAP [9,15,16] Valencia [17] RV CAP SP CHF [ (OR) % (CI) 1.4 ~ 163 P = 0.024] (OR 20% CAP ( %CI 0.04 ~ 0.6 P = 0.006) ) 1 5 n (%) A B PV MP SP P (26 ) (26 ) (44 ) RSV CAP 4 (15) 4 (15) 8 (18) NS (2) 5 (19) 4 (15) 9 (20) NS > 30 /min 13 (50) (3) 4 (15) (3) 18 (41) (4) 5 (19) 3 (7) NS > 1.5 mg / dl 4 (15) 4 (15) 6 (13) NS ICU 2 (8) 5 (20) 5 (11) NS 0 2 (8) 3 (7) NS 1 (4) 4 (17) 4 (9) NS 0 (3) 4 (15) (3) 2 (5) (12) 7 (27) 7 (16) NS 0 0 1(2) NS PV ; (2) < 90 mm Hg; (3) [16] A B RSV CAP RVs CAP SP [18,19] CHF PV CAP 4 [15] 556
7 [20] [21] CHF 2 ~ 3 wk ( ) CAP CAP 80% [23~25] CAP CAP 277 CAP [15,26] Dowell [22] 3 RSV CAP RSP ( ) CAP CAP RSV CAP CAP ( ) 58% PSI PV 8% ICU [10] ( CAP ) CAP (2) [27] CAP CHF [23~25] CAP CAP ( ) CHEST
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