肺炎支原体可在人与人之间传播。该病原体具有独特的细胞器,使其能够附着于呼吸道纤毛上皮细胞。此外,它能在各种表面进行运动,这被认为会促使感染。[5]Waites KB, Talkington DF. Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev. 2004;17:697-728.
http://www.ncbi.nlm.nih.gov/pubmed/15489344?tool=bestpractice.com
肺炎支原体可能会产生毒素,引起持续性咳嗽。[26]Kannan TR, Baseman JB. ADP-ribosylating and vacuolating cytotoxin of Mycoplasma pneumoniae represents unique virulence determinant among bacterial pathogens. Proc Natl Acad Sci USA. 2006;103:6724-6729.
http://www.ncbi.nlm.nih.gov/pubmed/16617115?tool=bestpractice.com
另一种可能的特点是宿主对肺炎病原体的免疫反应,可能会引起哮喘急性加重。[27]Johnston SL, Martin RJ. Chlamydophila pneumoniae and Mycoplasma pneumoniae: a role in asthma pathogenesis? Am J Respir Crit Care Med. 2005;172:1078-1089.
http://www.ncbi.nlm.nih.gov/pubmed/15961690?tool=bestpractice.com
肺炎衣原体同样可在人与人之间传播。一旦感染,它的细胞内生活方式使其能够在多种细胞中生长,如巨噬细胞、平滑肌细胞和血管内皮细胞。它具有抑制纤毛运动能力,导致持续性咳嗽。[9]File TM Jr, Tan JS. Chlamydia pneumoniae pneumonia. Semin Respir Critical Care Med. 2000;21(4):285-94.
http://www.ncbi.nlm.nih.gov/pubmed/16088739?tool=bestpractice.com
同肺炎支原体一样,对感染的免疫反应可能会引起哮喘的急性加重。[27]Johnston SL, Martin RJ. Chlamydophila pneumoniae and Mycoplasma pneumoniae: a role in asthma pathogenesis? Am J Respir Crit Care Med. 2005;172:1078-1089.
http://www.ncbi.nlm.nih.gov/pubmed/15961690?tool=bestpractice.com
当人类暴露于受嗜肺军团菌污染的水时,可发生嗜肺军团菌感染。以前认为不会发生人与人之间的传播,但 2016 年报道病例提示有人际间传播。[28]Correia AM, Ferreira JS, Borges V, et al. Probable person-to-person transmission of legionnaires' disease. N Engl J Med. 2016 Feb 4;374(5):497-8.
http://www.ncbi.nlm.nih.gov/pubmed/26840151?tool=bestpractice.com
在宿主内,嗜肺军团菌侵袭吞噬细胞,并利用宿主对自身有益的反应,从而逃避降解和杀伤。[25]Fields BS, Benson RF, Besser RE. Legionella and Legionnaires' disease: 25 years of investigation. Clin Microbiol Rev. 2002 Jul;15(3):506-26.
http://www.ncbi.nlm.nih.gov/pubmed/12097254?tool=bestpractice.com
[29]Cunha BA, Burillo A, Bouza E. Legionnaires' disease. Lancet. 2016 Jan 23;387(10016):376-85.
http://www.ncbi.nlm.nih.gov/pubmed/26231463?tool=bestpractice.com
贝氏柯克斯体通过吸入或摄入受污染的动物制品而传播。罕见人与人之间传播。尽管贝氏柯克斯体会导致肺炎,但在许多情况下,它可引起急性肝炎伴或不伴肺炎或慢性全身性感染。[21]Marrie TJ. Coxiella burnetii pneumonia. Eur Respir J. 2003 Apr;21(4):713-9.
https://erj.ersjournals.com/content/21/4/713.long
http://www.ncbi.nlm.nih.gov/pubmed/12762362?tool=bestpractice.com