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目的 了解哈尔滨市成年重症肺炎患者病原学特点及流行特征,对突发公共卫生事件和不明原因疾病进行预警,指导临床治疗.方法 采用回顾性调查方法对126例重症肺炎患者的病原学检验结果和流行特征进行分析.结果患者男女比例为2.4∶1;年龄为19～89(61.0±17.7)岁;冬春季节高发,细菌和病毒检测阳性率分别在冬季和春季较高,混合感染阳性率在秋季较高;患有与未患基础性疾病患者的死亡率分别为32.6％和17.6％,老年人(≥60岁)死亡率为36.5％,中年和青年死亡率为17.3％.95.2％的患者检出病原微生物,其中细菌感染占49.2％(革兰阴性菌占66.1％,革兰阳性菌占33.9％),病毒感染占20.8％,真菌感染占2.5％,混合感染占27.5％.结论 成年重症肺炎患者病原菌感染以革兰阴性菌为主,真菌感染比例不高,病毒和革兰阳性菌感染占一定比例;病原学的分布受季节影响;有基础性疾病的患者和老年重症肺炎患者死亡率相对较高.“,”Objective To investigate the etiological characteristics and epidemic characteristics of adult patients with severe pneumonia of Harbin, provide early warning of public health events and unknown cause diseases, and guide clinical treatment. Methods The clinical and laboratory testing materials of patients were collected, and the results of the pathogeny and epidemiological characteristics of 126 patients were analyzed retrospectively. Results The ratio of male to female was 2. 4∶1; the age ranged from 19 to 89 ( 61. 0 ± 17. 7) ; the positive rates of bacteria and virus detection were higher in winter and spring, the virus and the mixed infection positive rate were higher in spring and autumn respectively; the mortality rate of patients with chronic diseases and patients without chronic diseases were 32. 6％ and 17. 6％, respectively; mortality rate was36. 5％ for the elderly and 17. 3％ for young and middle-aged. 95. 2％ of the patients were diagnosed with pathogenic microorganisms, of which the bacterial infection accounted for 49. 2％ ( Gram-negative bacteria accounted for 66. 1％, Gram-positive bacteria accounted for 33. 9％), virus infection accounted for 20. 8％, fungi accounted for 2. 5％, and mixed infection accounted for 27. 5％. Conclusion The pathogenic bacteria of severe pneumonia in adults are mainly gram-negative bacteria, and the proportion of fungal infection is not high, and the virus and gram-positive bacteria account for a certain proportion, the distribution of etiology is affected by the season, the mortality rate of elder patients and patients with chronic diseases ares relatively higher.