衣原体和支原体(原文).pptVIP

Features of Mycoplasma pneumoniae and M pneumoniae Pneumonia Organism Slow-growing, pleomorphic, nonmotile bacteria Lacks a conventional bacterial cell wall, bound instead by a single, triple-layered membrane Pneumonia M pneumoniae infection occurs worldwide, throughout the year, without significant seasonal variations Children and young adults are most often infected Transmission is from person to person by droplet inhalation Clinical Manifestation of Infection With M pneumoniae Features of Chlamydia pneumoniae and C pneumoniae Pneumonia Organism Obligate intracellular, gram-negative bacillus Exists in 2 forms, infective elementary bodies, and reproductive reticulate bodies Multiplies within membrane-bound vacuoles in eukaryotic host cells, and are dependent on host for energy (ATP) and nucleotide biosynthesis Pneumonia Involved in a wide spectrum of respiratory tract infections in both immunocompetent and immunocompromised hosts Elderly patients and those with coexisting cardiopulmonary disease are more likely to have severe disease Often present as part of a mixed infection Life Cycle of Chlamydia Species1,2 C pneumoniae Infections Incidence of C pneumoniae and M pneumoniae in Outpatient CAP Infections Incidence of M pneumoniae Acute Infectionin Children With Lower Respiratory Tract Diseases Incidence of C pneumoniae Acute Infection in Children With LRT Diseases Clinical Response in These Children Following Antibiotic Therapy Age-Related Hospital Admissions for CAP Role of Co-Infection in CAP Outcome Effect of Macrolide Inclusion on Length of Hospital Stay Effect of Macrolide Inclusion on Mortality 30-Day Mortality, % (95% CI) Community LCF Total dwelling dwelling study cohortInitial antimicrobial regimens (n = 9751) (n = 3194) (n = 12,945) Second-generation 9.3 23.5 11.7cephalosporin only Second-generation 7.8 13.0 8.4cephalosporinplus macrolides Non-pseudomonal third- 10.7 26.2 14.9generation cephalosporins only Non-pseudomonal third- 6.8 24.3 9