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Der Pneumologe

, Volume 2, Issue 1, pp 17–27 | Cite as

Ambulant erworbene Pneumonie

Häufige Erreger und Antibiotikaresistenz
  • M. W. R. PletzEmail author
Leitthema

Zusammenfassung

Die ambulant erworbene Pneumonie (engl. „community-acquired pneumonia“, CAP) ist die häufigste Ursache für Krankenhauseinweisungen und damit ein bedeutender Kostenfaktor im Gesundheitswesen. Häufigster Erreger ist Streptococcus pneumoniae, gefolgt von Chlamydophila pneumoniae, Mycoplasma pneumoniae, respiratorischen Viren und Haemophilus influenzae. Da zu Beginn der Erkrankung der Erreger meist nicht bekannt ist, kann initial nur empirisch therapiert werden. Voraussetzung für eine erfolgreiche empirische Therapie ist die Kenntnis des Erregerspektrums und der regionalen Resistenzsituation. Die meisten Therapierichtlinien empfehlen Makrolide, Betalaktame, Tetrazykline oder Fluorochinolone. Im vorliegenden Artikel werden die wichtigsten Erreger und die regionale Resistenzsituation vorgestellt. In Deutschland spielen resistente Erreger bei der CAP—im Gegensatz zur nosokomialen Pneumonie—noch keine große Rolle. Allerdings ist die Situation in anderen Ländern, u. a. beliebten Urlaubszielen wie Spanien, Frankreich und Griechenland, bedrohlicher, und auch hierzulande wird seit einigen Jahren ein kontinuierlicher Anstieg der Resistenzraten beobachtet.

Schlüsselwörter

Ambulant erworbene Pneumonie Ätiologie Resistenz Streptococcus pneumoniae Impfung 

Community-acquired pneumonia

Common pathogens and antimicrobial resistance

Abstract

Community-acquired pneumonia (CAP) is the most frequent cause for admission to the hospital and thus poses a significant economic burden on the healthcare system. Streptococcus pneumoniae is the most frequent cause of CAP, followed by Mycoplasma pneumoniae, Chlamydophila pneumoniae, respiratory viruses, and Haemophilus influenzae. Since the pathogen is not usually detectable at the onset of the disease, initial treatment has to be empiric. Successful empiric treatment has to be based on knowledge about pathogens and resistance pattern. Most clinical guidelines recommend macrolides, beta-lactams, tetracyclines, and fluoroquinolones for the treatment of CAP. This report provides information on the most frequent pathogens and regional resistance patterns. In contrast to nosocomial pneumonia, resistant pathogens are still a minor cause for CAP in Germany. However, in other countries such as Spain, France, and Greece, which are frequent destinations of German travelers, resistance rates are high. Also, in Germany itself resistance has been increasing in recent years.

Keywords

Community-acquired pneumonia Etiology Antimicrobial resistance Streptococcus pneumoniae Vaccination 

Notes

Interessenkonflikt:

Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.

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Copyright information

© Springer Medizin Verlag 2004

Authors and Affiliations

  1. 1.Department of Global Health/Rollins School of Public HealthEmory UniversityAtlanta
  2. 2.Department of Global Health/Rollins School of Public HealthEmory UniversityAtlantaUSA

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