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DOI: 10.1055/s-2005-863061
© Georg Thieme Verlag Stuttgart · New York
Risikofaktoren für die ambulant erworbene Pneumonie (Community Acquired Pneumonia)
Eine systematische ÜbersichtsarbeitRisk factors for community acquired pneumonia (CAP)A systematic reviewPublikationsverlauf
eingereicht: 29.7.2004
akzeptiert: 20.1.2005
Publikationsdatum:
17. Februar 2005 (online)

Zusammenfassung
Hintergrund und Fragestellung: Die ambulant erworbene Pneumonie (Community Acquired Pneumonia = CAP) ist in den westlichen Industrieländern die häufigste zum Tode führende Infektionskrankheit. Bislang lagen keine Deutschland-spezifischen Daten zu Inzidenz, Erregerspektrum und Risikofaktoren vor. Diese systematische Übersichtsarbeit betrachtet und beurteilt im internationalen Vergleich vorhandene Studien zu identifizierten Risikofaktoren einer CAP.
Methode: Die Medline Literatursuche umfasste 743 Artikel von 1966 bis Dezember 2003. Zehn publizierte Studien zu Risikofaktoren einer CAP wurden in die abschließende Bewertung eingeschlossen.
Ergebnisse: Alter, Geschlecht, Rauchen und pulmonale Vorerkrankungen konnten als Hauptrisikofaktoren ermittelt werden. Der Einfluss anderer Faktoren, wie Medikamente, Arbeitsstoffe, Alkohol und Sozialstatus, ist weniger gut belegt.
Folgerung: Die verfügbaren Daten zur CAP und deren Risikofaktoren, insbesondere in Deutschland, sind aktuell nicht ausreichend. Zur Verbesserung der Datenlage generiert das 2002 gegründete Kompetenznetzwerk für ambulant erworbene Pneumonie (CAPNETZ) umfassende Daten zur Häufigkeit und zu Risikofaktoren einer CAP.
Summary
Background and objective: Community acquired pneumonia (CAP) is the most frequent mortal infectious disease in the western industrial countries. So far no detailed information about incidence, pathogenetic agents, medical service and risk factors existed within Germany. This article reviews international studies, which identified risk factors for CAP.
Method: The MEDLINE database search comprised 743 articles from 1966 to December 2003. Ten published studies analysing risk factors for CAP were included in this study.
Results: Age, gender, smoking and chronic lung diseases ranged among the leading risk factors. Other variables, like medication, dangerous substances, alcohol or sociodemographic factors have so far been insufficiently proved.
Conclusion: Comparable data concerning CAP in Germany are currently inadequate. In order to improve the data situation, in 2002, the Community Acquired Pneumonia NETwork (CAPNET) was established. CAPNET assembles and soon intends to publish detailed information about incidence and risk factors of Community Acquired Pneumonia.
Literatur
- 1
Almirall J, Bolibar I, Balanzo X, Gonzalez C A.
Risk factors for community-acquired pneumonia in adults: a population-based case-control
study.
Eur Respir J.
1999;
13
349-355
Reference Ris Wihthout Link
- 2
Almirall J, Gonzalez C A, Balanzo X, Bolibar I.
Proportion of community-acquired pneumonia cases attributable to tobacco smoking.
Chest.
1999;
116
375-379
Reference Ris Wihthout Link
- 3
Almirall J, Bolibar I, Vidal J. et al .
Epidemiology of community-acquired pneumonia in adults: a population-based study.
Eur Respir J.
2000;
15
757-763
Reference Ris Wihthout Link
- 4
Arbeitsgruppe „Diagnostik ambulant erworbener Pneumonien” .
Deutsche Gesellschaft für Pneumologie: Empfehlungen zur Diagnostik der ambulant erworbenen
Pneumonie.
Pneumologie.
1997;
51
69-77
Reference Ris Wihthout Link
- 5
Baik I, Curhan G C, Rimm E B, Bendich A, Willett W C, Fawzi W W.
A Prospective Study of Age and Lifestyle Factors in Relation to Community-Acquired
Pneumonia in US Men and Women.
Arch Intern Med.
2000;
160
3082-3088
Reference Ris Wihthout Link
- 6
Bartlett J G, Dowell S F, Mandell L A, File T M, Musher D M, Fine M J.
Practice guidelines for the management of community-acquired pneumonia in adults.
Infectious Diseases Society of America.
Clin Infect Dis.
2000;
31
347-382
Reference Ris Wihthout Link
- 7
Burns D M.
Primary prevention, smoking, and smoking cessation: implications for future trends
in lung cancer prevention.
Cancer.
2000;
89
2506-2509
Reference Ris Wihthout Link
- 8
Coggon D, Inskip H, Winter P, Pannett B.
Lobar pneumonia: an occupational disease in welders.
Lancet.
1994;
344
41-43
Reference Ris Wihthout Link
- 9
Esposito A L.
Aspirin impairs antibacterial mechanisms in experimental pneumococcal pneumonia.
Am Rev Respir Dis.
1984;
130
857-862
Reference Ris Wihthout Link
- 10
Esposito A L, Poirier W J, Clark C A.
The cardiac glycoside digoxin disrupts host defense in experimental pneumococcal pneumonia
by impairing neutrophil mobilization.
Am Rev Respir Dis.
1989;
140
1590-1594
Reference Ris Wihthout Link
- 11
Farr B M, Woodhead M A, Macfarlane J T. et al .
Risk factors for community-acquired pneumonia diagnosed by general practitioners in
the community.
Respir Med.
2000;
94
422-427
Reference Ris Wihthout Link
- 12
Farr B M, Bartlett C L, Wadsworth J, Miller D L. British Thoracic Society Pneumonia Study Group .
Risk factors for community-acquired pneumonia diagnosed upon hospital admission.
Respir Med.
2000;
94
954-963
Reference Ris Wihthout Link
- 13
Fernandez-Sola J, Junque A, Estruch R, Monforte R, Torres A, Urbano-Marquez A.
High alcohol intake as a risk and prognostic factor for community-acquired pneumonia.
Arch Intern Med.
1995;
155
1649-1654
Reference Ris Wihthout Link
- 14
Fielden N M.
Community-acquired pneumonia.
Perspect Respir Nurs.
1998;
9
1-2
Reference Ris Wihthout Link
- 15
Garibaldi R A.
Epidemiology of community-acquired respiratory tract infections in adults. Incidence,
etiology, and impact.
Am J Med.
1985;
78
32-37
Reference Ris Wihthout Link
- 16
Ginesu F, Pirina P.
Etiology and risk factors of adult pneumonia.
J Chemother.
1995;
7
277-285
Reference Ris Wihthout Link
- 17
Goodman R M, Yergin B M, Landa J F.
Relationship of smoking history and pulmonary function tests to tracheal mucous velocity
in nonsmokers, young smokers, ex-smokers, and patients with chronic bronchitis.
Am Rev Respir Dis.
1978;
117
205-214
Reference Ris Wihthout Link
- 18
Johnson P, Irving L, Turnidge J.
Community-acquired pneumonia.
Med J Aust.
2002;
176
341-347
Reference Ris Wihthout Link
- 19
Jokinen C, Heiskanen L, Juvonen H. et al .
Incidence of community-acquired pneumonia in the population of four municipalities
in eastern Finland.
Am J Epidemiol.
1993;
137
977-988
Reference Ris Wihthout Link
- 20
Koivula I, Sten M, Makela P H.
Risk factors for pneumonia in the elderly.
Am J Med.
1994;
96
313-320
Reference Ris Wihthout Link
- 21
Lipsky B A, Boyko E J, Inui T S, Koepsell T D.
Risk factors for acquiring pneumococcal infections.
Arch Intern Med.
1986;
146
2179-2185
Reference Ris Wihthout Link
- 22
Loeb M, McGeer A, McArthur M, Walter S, Simor A E.
Risk factors for pneumonia and other lower respiratory tract infections in elderly
residents of long-term care facilities.
Arch Intern Med.
1999;
159
2058-2064
Reference Ris Wihthout Link
- 23
Lopez A D, Murray C C.
The global burden of disease.
Nat Med.
1998;
4
1241-1243
Reference Ris Wihthout Link
- 24
Macfarlane J T.
Community acquired pneumonia.
Br J Dis Chest.
1987;
81
116-127
Reference Ris Wihthout Link
- 25
Marrie T J, Durant H, Yates L.
Community-acquired pneumonia requiring hospitalization: 5-year prospective study.
Rev Infect Dis.
1989;
11
586-599
Reference Ris Wihthout Link
- 26
Marrie T J.
Pneumococcal pneumonia: epidemiology and clinical features.
Semin Respir Infect.
1999;
14
227-236
Reference Ris Wihthout Link
- 27
Marrie T J.
Community-acquired pneumonia in the elderly.
Clin Infect Dis.
2000;
31
1066-1078
Reference Ris Wihthout Link
- 28
Marston B J, Plouffe J F, File T M. et al. The Community-Based Pneumonia Incidence Study Group .
Incidence of community-acquired pneumonia requiring hospitalization. Results of a
population-based active surveillance Study in Ohio.
Arch Intern Med.
1997;
157
1709-1718
Reference Ris Wihthout Link
- 29
Metlay J P, Fine M J.
Testing strategies in the initial management of patients with community-acquired pneumonia.
Ann Intern Med.
2003;
138
109-118
Reference Ris Wihthout Link
- 30
Meyer R J, Town G I, Harre E. et al .
An audit of the assessment and management of adults admitted to Christchurch Hospital
with community acquired pneumonia.
NZ Med J.
1997;
110
349-352
Reference Ris Wihthout Link
- 31
Monge V, San-Martin M, Gonzalez A.
The burden of community-acquired pneumonia in Spain.
Eur J Public Health.
2001;
11
362-364
Reference Ris Wihthout Link
- 32
Nelson S, Summer W R, Jakab G J.
Aminophylline-induced suppression of pulmonary antibacterial defenses.
Am Rev Respir Dis.
1985;
131
923-927
Reference Ris Wihthout Link
- 33
Niederman M S, Bass J B, Campbell G D. et al. American Thoracic Society. Medical Section of the American Lung Association .
Guidelines for the initial management of adults with community-acquired pneumonia:
diagnosis, assessment of severity, and initial antimicrobial therapy.
Am Rev Respir Dis.
1993;
148
1418-1426
Reference Ris Wihthout Link
- 34
Nielsen S V, Henrichsen J.
Incidence of invasive pneumococcal disease and distribution of capsular types of pneumococci
in Denmark 1989 - 94.
Epidemiol Infect.
1996;
117
411-416
Reference Ris Wihthout Link
- 35
Palmer K T, Poole J, Ayres J G, Mann J, Burge P S, Coggon D.
Exposure to metal fume and infectious pneumonia.
Am J Epidemiol.
2003;
157
227-233
Reference Ris Wihthout Link
- 36
Randall B.
Increasing US mortality from infectious diseases.
JAMA.
1996;
275
1399-1400
Reference Ris Wihthout Link
- 37
Riquelme R, Torres A, el Ebiary M. et al .
Community-acquired pneumonia in the elderly: A multivariate analysis of risk and prognostic
factors.
Am J Respir Crit Care Med.
1996;
154
1450-1455
Reference Ris Wihthout Link
- 38
Ruiz M, Ewig S, Marcos M A. et al .
Etiology of Community-Acquired Pneumonia: Impact of Age, Comorbidity, and Severity.
Am J Respir Crit Care Med.
1999;
160
397-405
Reference Ris Wihthout Link
- 39
Spoto S, De Galasso L, Costantino S.
Community-acquired pneumonia.
Clin Ter.
2002;
153
225-227
Reference Ris Wihthout Link
- 40
Stelianides S, Golmard J L, Carbon C, Fantin B.
Influence fo Socioeconomic Status on Features and Outcome of Community-Acquired Pneumonia.
Eur J Clin Microbiol Infect Dis.
1999;
18
704-708
Reference Ris Wihthout Link
- 41
Stiefelhagen P.
At risk for pneumonia. Fatal droplets.
MMW Fortschr Med.
2001;
143
4-8
Reference Ris Wihthout Link
- 42
Straus W L, Plouffe J F, File T M. et al. Ohio legionnaires Disease Group .
Risk factors for domestic acquisition of legionnaires disease.
Arch Intern Med.
1996;
156
1685-1692
Reference Ris Wihthout Link
- 43
Syrjälä H, Broas M, Suramo I, Ojala A, Lahde S.
High-resolution computed tomography for the diagnosis of community-acquired pneumonia.
Clin Infect Dis.
1998;
27
358-363
Reference Ris Wihthout Link
- 44
Tuschy P, Lorenz J.
Atypische Erreger der ambulant erworbenen Pneumonie.
Dtsch Med Wochenschr.
2004;
129
503-508
Reference Ris Wihthout Link
- 45
Welte T, Marre R, Suttorp N.
Kompetenznetzwerk ambulant erworbene Pneumonie: Strukturen und Ziele.
Pneumologie.
2003;
57
34-41
Reference Ris Wihthout Link
- 46
Woodhead M, Torres A.
Definition and classification of community-acquired and nosocomial pneumonias.
Eur Respir Mon.
1997;
3
1-12
Reference Ris Wihthout Link
- 47 www.sign.ac.uk
Reference Ris Wihthout Link
Dr. med. Yvonne Kohlhammer
Projektgruppe CAPNETZ, Institut für Sozialmedizin, Universitätsklinikum Schleswig-Holstein
- Campus Lübeck -
Beckergrube 43-47
23552 Lübeck
Telefon: +49/451/7992532
eMail: yvonne.kohlhammer@sozmed.uni-luebeck.de
