1

50

503.61503.616521

Lee SL & Wu SC. Medical utilization by patients with chronic diseases in Taiwan: chronic kidney disease, diabetes and hypertension. Taiwan Journal of Public Health. 2013 32(3):231.

2

3

4

:

:(small bronchi)(alveoli)(interstitium)

:(bacteria)(fungus)(virus)(parasite)

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5

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7

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N Engl J Med. 1999;340(3):207-14

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160.5 197.0

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Daniel M. Musher, Adriana M. Rueda, Anjum S. Kaka, and Sulaiman M. Mapara.The association between pneumococcal pneumonia and acute cardiac evenets. ClinicaI lnfectiou Diseases 2007;45:158

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COPD

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(2012)/Sethi S, Murphy TF. N Engl J Med. 2008 27; 359(22):2355-2365

11

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ReimarW. Thomsen, Anil Mor, Diabetes and Risk of Community-Acquired Respiratory Tract Infections, Urinary Tract Infections, and Bacteremia The , Open Infectious Diseases Journal, 2012, 6, (Suppl 1: M2) 27-39

62 41 351 62.4

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Clinical Infectious Diseases 2010; 51(S1):S81S87

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565

18

/:

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60%

Huang SS, et al. Vaccine. 2011;29:3398-3412.CDC. The Pink Book. Epidemiology and Prevention of Vaccine Preventable Diseases, 12th ed.http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/prinvac.pdf. Accessed May 30, 2011.http://www.cdc.gov.tw/, cases collected from 2007/10/15 to 2008/9/30

5~7%

(RRs)Incidence rate(95% CI)

100,00

0

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(3.2-9.9)X 48.4(24.8-94.6)X 6.4(3.7-10.9)X 11.4(5.9-21.9)X 3.4(1.8-6.4) X 38.3(15.9-92.2)

Kyaw, JID 2005;192:

8.8 51.4 93.7 62.9 100.40100200

Healthy

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Chronic heart

disease

Chronic lung

disease

Alcohol

abuse

Solid

Cancer

HIV/AIDS

hematological

cancer

19

Reference: ;2008~2012,192013x

20

PREVENAR 13 (PCV13)

13PNEUNMOVAX 23 (PPSV23)

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) 77~86%

75

75

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21

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65

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PPSV 23

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22

2015

2-65 PPSV232-65 PPSV23

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PPSV23 PPSV23

65PPSV23 12PCV13

65PPSV23 12PCV13

Standards of medical care in diabetes-2015

?

23

30 30

24

1.

2. 2-65: PPSV23 65: PCV13PPSV23 65PPSV23: PCV13 : 65PPSV23 + PCV13

3. 4.

25