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1、RespiratoryDiseasesPneumoniaDr.BijieHU（胡必杰）ZhongshanHospitalofFudanUniversityShanghai8/6/20211Dr.HUBijie8/6/20212Dr.HUBijieSeminRespirInfect9(3):140-52，1994mortality(per10000)MortalityTrendswithPneumoniafrom1900to1990inUSA02040608010012014016018020019001910192019301940195019601970198019908/6
2、/20213Dr.HUBijie8/6/20214Dr.HUBijie19902020CardiovasculardiseaseCerebrovasculardiseasesLowerrespiratoryinfectionsDiarrheaPerinataldiseaseCOPDTuberculosisMorbilliTrafficaccidentsLungcancerGastriccancerHIVsuicideEditorial,Lancet,1997,349:1263.MortalityForecastbyWHO8/6/20215Dr.HUBijieEpidemiolo
3、gy6thleadingcauseofdeathinU.S.NumberoneAmongtheinfectiousdiseases5.6millionpatientsannuallyinUSIncidence5~10/1,000/yearMortalityinOPDpatients1-5%,butInpatients25%,ICU50-60%8/6/20216Dr.HUBijieDefinitionPneumoniaistheinflammationoflowerrespiratorytractsincludingalveoli,interstitialtissues,andb
4、ronciolesbythemicroorganisms,chemicalirritationsorbyanimmunologicalprocess8/6/20217Dr.HUBijieClassifications&TerminologyMild,moderate,severeLobarvsinterstitialInfectionsvs.noninfectionsBacterial,viral,fungal,parasiticPrimaryvs.SecondaryCommunityAcquiredPneumoniaNosocomialPneumoniaVentilatorA
5、ssociatedPneumioniaTypicalvs.AtypicalImmunecompromisedvs.Normalimmunity8/6/20218Dr.HUBijieKeyBacterialPathogensofCAP: AGlobalMeta-AnalysisFineMJetal.JAMA1996;275(2):134-41.Studycohorts:N=127Totalpatients:N=33,148Totalpatientsreportingdata:N=6866S.pneumoniae66%Other12%Legionellaspp.4%M.pneumo
6、niae7%H.influenzae12%8/6/20219Dr.HUBijieCausativepathogensin5,961adultsadmittedtohospitalwithCAPidentifiedin26prospectivestudiesfrom10EuropeancountriesSpneumoniaeCpneumoniaeViralMycoplasmapneumoniaeLegionellaspHinfluenzaeG-negenterobacteriaCpsittaciiCoxiellaburnetiiStaphaureusMcatarrhalisOth
7、erWoodheadM.Chest1998;183S-187S8/6/202110Dr.HUBijiePathogensofHospitalAcquiredPneumonia(HAP)MildtomoderateHAPorearlysevereHAPStreptococcuspneumoniaeHaemophilusinfluenzaMSSAKlebsiellaPneumoniaeEnterobacter,Ecoli,Proteus,SerratiaSevereHAPPseudomonasA
