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          , ,  , ,  .     , ,   ,        ,   , ,   ,            [ .., 1995].

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      2  [ . ., 1995].

      3.86  1000.      5    75 .      5%,   ,  ,   21.9%,     20%,    46% [ . ., 1999].

         .        :   ,   ,   ,   ,   .       ,    .

     ,       ,          .             .         -        ,   :     30% [ . ., 2000].

                       .       ,  ,    25%          [ J1. .,  . ., 1997].    ,  47%           ,   20%       [Hann D. L. et al., 1991; Bone R. ., 1991].

          .              ,              .               .        .

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 . .,  . . ,     // . 1997. 1. . 18  24.

 . .  //  . . 1999. . 7. 17, . 825  829.

 . . :    // Materia Medica. 1995. 4, . 5  10.

 . .     // . . 1995, 3, . 3  7.

. .   //  . , . 8. 17, 2000, . 727.

Bone R. . Chlamydial pneumonia and asthma: apotential relationship// JAMA. 1991, Vol.26. N 2, P.265.

Gilbert ., Kapoor IV. N.. Marrie T. J. et al. Variation in antibiotic use and costs in patiets with community-acquired pneumonia// J. Gen. Intern. Med. 1994, Vol.9. P. 53.

Hann D. L., Dodge R. IV., Golubjatnikov R. Association of Chlamydia pneumoniae (Strain TWAR) infection with wheezing, astmatic bronchitis, and adult-onset asthma// JAMA. 1991, Vol. 26. N 2, P. 225  230.




 1

   


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 . . /  .:   //    . . 2.  . . . . /  . . . , .: -, 1998. . 349  383.

 . .  //  . . . 7  17. 1999. . 825.

 . .,  . . /  .:  .  .  . . . , . ., . .. ., 2000, 190 .

 ()        /     09.10.1998. 300/ (     1/99.). .: , 1999, 40 .

 . .   //  . . . 8, 17. 2000. . 727  730.




 2




     [      H3J1, 1999],         .

1.  :

Streptococcus pneumoniae' ;

Mycoplasma pneumoniae' ;

Haemophilus influenzae" ;

Influenza virus' ;

Chlamydia (Chlamydophila) pneumoniae' ;

Legionella spp.;

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  ;

 20 30%    .

2.  :

 :

Staphylococcus aureus.

Streptococcus pneumoniae.

 :

Pseudomonas aeruginosa.

Klebsiella pneumoniae.

Escherichia coli.

Proteus mirabilis.

Legionella pneumophila.

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;

Aspergillus, Candida ;

Pneumocystis carini.

           .     1970-          ,   , , , ,    .          .       ,     60    ,        [ . ., 2000].        (5  15%)        .      .

           , . .     ,       S. pneumoniae (15  35%).    ,    ,  Legionella pneumophila,       ( 10%)  Haemophilus influenzae [ . ., . ., 2001].  ,                    Staphylococcus aureus,  , Klebsiella pneumoniae, Pseudomonas aeruginosa.     5%   ,       .     ,    .      ,  . pneumoniae  Ch. pneumoniae,           .



 1

     ( . . , 2000)






 2

 ,      [Ewig S., 1997]






3.          ( )    (Bacteroides fragilis, Bacteroides melaninogenicus, Fusobacterium nucleatum, Peptococcus  .)         .

4.           ,  , Pneumocystis carinii,  ,       ,    .

               .    ,   S.pneumoniae,     .          Alexander Project   -  S. pneumoniae    (, )  51.4% .  S. pneumoniae       45.9  60.6% [Felmingham D. et al., 1999, 2000].   1975.       ,   .  1990.       20%,        (3- [ . .,  . ., 1996].

  S. pneumoniae        ,   :     -1,          9%,   ,        .         .     ,  P. aeruginosa    55%,    47,     60,    45%,   P. aeruginosa       12% [ . .,  . ., 2000].


 

 . .,  . .   //  . , 2001. . 9, 5, . 177  178.

 . .,  . .     . ., 1996. 176 .

 . .  // Consilium-medicum. . 2. 10, 2000, . 396  400.

 ()        /     09,10.1998. 300/ (     1/99.). .: , 1999. 40 .

 . .,  . .    //  .:  .  /  . . . , . . , . . . ̄ 2000, 190 .

European Study on Community-acquired pneumonia (ESOCAP) Commitee. Guidelines for management of adult community-acquired lower respiratory tract infections// Eur. Respir. J. 1998, N 11, P. 986  991.

Ewig S. Community-acquired pneumonia. Epidemiology, risk, and prognosis// Eur. Respir. Mon. 1997. N3, P. 13  35.

Felmingham ., Washington J., and the Alexander Project Group. Trends in the antimicrobial susceptibility of bacterial respiratory tract patogens  findings of the Alexander Project 1992  1996// J. Chemother. 1999  N11. P. 5  21.

Felmingham D., Gruneberg R. N., and the Alexander Project Group. The Alexander Project 1996  1997: latest susceptibility data from this international study of bacterial patogens from community-aquired lower respiratory tract infections// J. Antimicrob. Chemother. 2000, N 45, P. 191  203.

Guidelines from the Infectious Diseases Society of America. Communityacquired pneumonia in adults: guidelines for management// Clin. Infect. Dis. 1998, N 26, P. 811  838.




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