Objective: Worldwide, community-acquired pneumonia (CAP) is a common infection that occurs in older adults, who may have pulmonary comorbidities, including chronic obstructive pulmonary disease (COPD). Although there have been clinical studies on the coexistence of CAP with COPD, there remain some controversial findings. This review presents the current status of COPD in CAP patients, including the disease burden, clinical characteristics, risk factors, microbial etiology, and antibiotic treatment.
Data sources: A literature review included full peer-reviewed publications up to January 2018 derived from the PubMed database, using the keywords "community-acquired pneumonia" and "chronic obstructive pulmonary disease".
Study selection: Papers in English were reviewed, with no restriction on study design.
Results: COPD patients who are treated with inhaled corticosteroids are at an increased risk of CAP and have a worse prognosis, but data regarding the increased mortality remains unclear. Although Streptococcus pneumoniae is still regarded as the most common bacteria isolated from patients with CAP and COPD, Pseudomonas aeruginosa is also important, and physicians should pay close attention to the occurrence of antimicrobial resistance, particularly in these two organisms.
Conclusions: COPD is a common and important predisposing comorbidity in patients who develop CAP. COPD often aggravates the clinical symptoms of patients with CAP, complicating treatment, but generally does not appear to affect prognosis.
社区获得性肺炎合并慢性阻塞性肺疾病研究现状摘要目的：社区获得性肺炎（CAP）是世界范围内常见的感染性疾病,常发生于老年人中，这类病人往往合并肺部疾病，其中包括慢性阻塞性肺病（COPD）。虽然已有许多相关CAP合并COPD的临床研究，结果仍存在一些争议。本文的主要目的是对以下方面进行回顾和总结：疾病负担、临床特征、危险因素、微生物病原学和抗生素治疗。 数据来源：综述包括来自2018年1月之前PubMed数据库中全部同行评审的文献，使用关键词“社区获得性肺炎”和“慢性阻塞性肺病”。 研究选择：对相关英文文献进行综述，研究类型无限制。 结果：COPD应用吸入性糖皮质激素治疗可能导致发生CAP的风险升高，且往往预后较差，但在病死率方面存在争议。肺炎链球菌仍被认为是最常见的细菌，但铜绿假单胞菌也很重要，临床医生应密切关注抗菌药物耐药性的发生，特别对于这两种细菌。 结论：COPD为患者常见且重要的合并症，往往导致CAP的发生。COPD加重CAP患者的临床症状，使得治疗变得复杂，但对于预后往往影响不大。.
Keywords: Chronic Obstructive Pulmonary Disease; Community-Acquired Pneumonia; Morbidity; Treatment.