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Abstract

Objective: To investigate the characteristics of pathogen distribution in patients with acute community-acquired lower respiratory tract infections(ACALRTIs) and treatment strategies for critically ill patients.
Methodology: This was a retrospective study. Clinical data were collected from 218 patients diagnosed with ACALRTIs who received treatment at Changde Hospital, Xiangya School of Medicine, Central South University (The first people’s hospital of Changde city) between January, 2022 to June, 2024. Based on the presence or absence of complications during treatment, patients were divided into an observation group without complications and a control group with complications. The clinical treatment outcomes, clinical symptoms, blood gas analysis indicators were compared between the two groups.
Results: The sputum smear positivity rate in the observation group was 75.68%, significantly higher than the 54.65% observed in the control group (P< 0.05). However, there was no significant difference in sputum culture positivity between the two groups (P> 0.05). The overall response rate in the observation group was 94.00%, significantly higher than the 84.75% in the control group (P< 0.05). After treatment, the observation group had a shorter time to fever resolution, cough resolution, and disappearance of pulmonary wheezing compared to the control group (P< 0.05, respectively). The observation group also showed higher SaO2 and PaO2 levels, while PaO2, PCT, WBC, CRP, and ESR levels were lower than those in the control group (P< 0.05, respectively).
Conclusion: ACALRTIs are primarily caused by bacterial, viral, and atypical pathogens. The use of bronchoalveolar lavage under fiberoptic bronchoscopy may improve blood gas parameters and inflammatory marker levels, alleviate clinical symptoms.