Læknablaðið - 15.02.1989, Síða 18
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LÆKNABLAÐIÐ
Af þremur algengustu orsökum lungnabólgu í
rannsókninni var dánarhlutfall hæst af völdum
H. influenzae en lægst af völdum Legionella spp
og rennir það frekari stoðum undir þá kenningu
að legionellosis komi oft fyrir sem væg
lungnabólga (19, 20). Mun hærra dánarhlutfall
var meðal sjúklinga sem veiktust af lungnabólgu
meðan á dvöl á sjúkrahúsinu stóð en innlagðra
sjúklinga og á það vafalaust rætur að rekja til
undirliggjandi sjúkdóma. Sjúklingar sem létust af
völdum candida albicans sýkingar og
cytomegaloveiru sýkingar höfðu hlotið
mótefnabælandi meðferð vegna illkynja
sjúkdóms.
Flest tilfelli lungnabólgu greindust yfir
vetrarmánuðina og á það jafnt við um
inniliggjandi sjúklinga sem innlagða. Þessi
árstíðasveifla var svipuð fyrir Streptococcus
pneumoniae, Haemophilus influenzae og
Legionella spp. Árstíðasveifla fyrir legionellosis
líkist frekar því sem lýst hefur verið í Danmörku
(19) og Englandi (2) heldur en í Bandaríkjunum
(25) þar sem dátapest er algengust á sumrin og
haustin.
Við meðhöndlun sjúklinga með lungnabólgu er
nauðsynlegt að hafa í huga að Streptococcus
pneumoniae, Haemophilus influenzae og
Legionella spp greindust í meira en helmingi
lungnabólgusjúklinga á Borgarspítalanum og að
Staphylococcus aureus fannst eingöngu í
sjúklingum eldri en 70 ára.
SUMMARY
In order to investigate the epidemiology and etiology of
pneumonia in adult Icelandic patients a prospective
study was performed on the medical department of
Reykjavík City Hospital. Pneumonia was diagnosed on
105 occations in 97 patients during a period of 12
months, community acquired on 82 occations and
hospital acquired on 23 occations. Etiologic agents were
found in 65% of the cases and mixed infections were
found in 11% of the patients. Most often Streptococcus
pneumoniae (26%), Haemophilus influenzae (15%) and
Legionella spp (14%) were found and no significant
difference was noted in community and hospital
acquired pneumonias regarding these three bacteria.
Staphylococcus aureus and gram negative
enterobacteriae were found in 6% and 5% of the cases
respectively. The patients’ median age was 71 years
(range 16-94 years) and case fatality ratio was 15% for
community acquired pneumonias and 35% for hospital
acquired pneumonias.
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