chẩn đoán và xử trí viêm phổi cộng đồng





 !"#
 !"#
$%&'(%
$%&'(%
)*%+,
)*%+,

-./0%12
-./0%12
–
34.567(8
34.567(8
–
-6.-4790
-6.-4790

:60;<=>12
:60;<=>12

)''?
)''?

)@;0,A
)@;0,A
–
B:7C(8
B:7C(8

–
)CCD:E7
)CCD:E7
–
FGHG3./47
FGHG3./47

&@
&@
I-6@;%2
I-6@;%2
)*%+,A
)*%+,A

JHC0@D&K
JHC0@D&K
E6.?67
E6.?67
<L=
<L=

S. pneumoniae
S. pneumoniae
;>%M&
;>%M&
–


466N666%O2
466N666%O2

–
P.44790D,A
P.44790D,A
•
?37F>
?37F>
–
-.-37,A(8
-.-37,A(8
•
>>
>>
–
M. catarrhalis, H. influenzae, C. pneumoniae, M.
M. catarrhalis, H. influenzae, C. pneumoniae, M.
pneumoniae, Legionella
pneumoniae, Legionella
Q
Q
Key Bacterial Pathogens of CAP:
Key Bacterial Pathogens of CAP:
A Global Meta-Analysis
A Global Meta-Analysis
Fine MJ et al. JAMA 1996; 275(2):134-41.
•
Study cohorts: N = 127
•
Total patients: N = 33,148
•
Total patients reporting

data: N = 6866
S. pneumoniae
S. pneumoniae
66%
66%
Other
12%
Legionella
spp.
4%
M. pneumoniae
7%
H. influenzae
12%
RSTC0M0U%
RSTC0M0U%




,VF%;FV%V
,VF%;FV%V
W%VCV
W%VCV
X,ROM8Y;
X,ROM8Y;
,VNN
,VNN



J%V;;%NZVV;;%
J%V;;%NZVV;;%
,<[&8
,<[&8
,VF%NQV%%N
,VF%NQV%%N
\Q%V
\Q%V
0%]
0%]
\Q%VN,V
\Q%VN,V
%%VCVN)
%%VCVN)
^_`a
^_`a
,VN V;N
,VN V;N
)
)
^_a
^_a
WCV;,VN
WCV;,VN
N ;%%
N ;%%
RSTO#C0,A
RSTO#C0,A
A)A
A)A

,VN\Q%V
,VN\Q%V
0<=
0<=
\Q%VNbN,VN
\Q%VNbN,VN
%%VCV
%%VCV
0 D;+
0 D;+
,V
,V
^c;Vd%
^c;Vd%
^c;Vd%N,VN
^c;Vd%N,VN


\Q%VN V;N
\Q%VN V;N
\QVV
\QVV
F<e;f
F<e;f
,VN V;N
,VN V;N
bN;%F%VN%%VCV
bN;%F%VN%%VCV
)gh<LK
)gh<LK

W%VCVN,VN
W%VCVN,VN
V;N\Q%V
V;N\Q%V
\VV%V
\VV%V
i0;#
i0;#

\Y
\Y

)K%_-E./6;HO8a
)K%_-E./6;HO8a

)%_ jk:66;HO8a
)%_ jk:66;HO8a

j%;V
j%;V

ALMU
ALMU
–
J@g
J@g
–
(H>
(H>


l:4N666./6N666O
l:4N666./6N666O
/
/

,C&<L
,C&<L

)GFC&<Lm><`
)GFC&<Lm><`
Key Bacterial Pathogens of CAP:
Key Bacterial Pathogens of CAP:
A Global Meta-Analysis
A Global Meta-Analysis
Fine MJ et al. JAMA 1996; 275(2):134-41.
•
Study cohorts: N = 127
•
Total patients: N = 33,148
•
Total patients reporting

data: N = 6866
S. pneumoniae
S. pneumoniae
66%
66%
Other
12%
Legionella
spp.
4%
M. pneumoniae
7%
H. influenzae
12%
;%F%V%V
;%F%V%V
RST
RST

G%F<[K467<L;`467
G%F<[K467<L;`467

ni+o<L%<L
ni+o<L%<L

UC0 /6±
UC0 /6±

pFV%FVFV%V
pFV%FVFV%V


jVV_QVQVcVVFVVV%c;cVVa
jVV_QVQVcVVFVVV%c;cVVa

4.:47cV%_^q%;P7a
4.:47cV%_^q%;P7a
;%F%V%V
;%F%V%V
i0;#
i0;#

$mM0
$mM0
–
%*rN%N%!%
%*rN%N%!%
–


–
G*r
G*r

,
,
–
)#F<`#sC
)#F<`#sC
–
)#;%r

)#;%r
J;%%,V%
J;%%,V%
i0;#
i0;#

/.:67nCi0<Lm&Gi
/.:67nCi0<Lm&Gi



)@;0g2`
)@;0g2`

Z#;%<L.<L*%<Lm&
Z#;%<L.<L*%<Lm&

%;\N%%%
%;\N%%%

Z#0'
Z#0'

,>mM0
,>mM0
ZVV;;%\VV
ZVV;;%\VV
RST
RST


C0om^<L
C0om^<L
–
b#C00
b#C00
–
$m;#o<L%<L
$m;#o<L%<L
–
0FSCD<LMC&<L
0FSCD<LMC&<L

n>rE6UZVV;;%
n>rE6UZVV;;%
–
L. pneumophila
L. pneumophila
_:4]G%a%M&
_:4]G%a%M&
–
567ZVV;;%;F
567ZVV;;%;F
L. pneumophila
L. pneumophila
tG%]:
tG%]:
ZVV;;%\VV
ZVV;;%\VV
i0;#
i0;#


!GY[
!GY[
–
A^<LNY;NC0;]NrFSN
A^<LNY;NC0;]NrFSN
p\jR
p\jR

%u;C%
%u;C%

vCM;%r
vCM;%r

@%r-4.467Nm
@%r-4.467Nm

i0H>
i0H>

ZR k366N%B:/6N2C(H
ZR k366N%B:/6N2C(H
TM File Infect Dis Clin NA 1998
TM File Infect Dis Clin NA 1998
)(%r^<%%
)(%r^<%%
w
w


Zx%T$\xG
Zx%T$\xG
–


(Gx>YNeY>y
(Gx>YNeY>y

zSHC0>Y
zSHC0>Y

)H*%TFST
)H*%TFST
–


SGH>YN
SGH>YN


ZVV;;%N
ZVV;;%N
c;Vd%N%%
c;Vd%N%%

A<%%VF{;#;%
A<%%VF{;#;%
–



)N Qc;Vd%VVCNQVF
)N Qc;Vd%VVCNQVF
%0HKC
%0HKC
M
M

&
&

\8G*r%;&C0_
\8G*r%;&C0_
|
|
,\a
,\a
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