While the world is grappling with the consequences of a global pandemic related to SARS-CoV-2 causing severe pneumonia, available evidence points to bacterial infection with Streptococcus pneumoniae as the most common cause of severe community acquired pneumonia (SCAP). Rapid diagnostics and molecular testing have improved the identification of co-existent pathogens. However, mortality in patients admitted to ICU remains staggeringly high.

The American Thoracic Society and Infectious Diseases Society of America have updated CAP guidelines to help streamline disease management. The common theme is use of timely, appropriate and adequate antibiotic coverage to decrease mortality and avoid drug resistance. Novel antibiotics have been studied for CAP and extend the choice of therapy, particularly for those who are intolerant of, or not responding to standard treatment, including those who harbor drug resistant pathogens. In this review, we focus on the risk factors, microbiology, site of care decisions and treatment of patients with SCAP.

尽管全世界都在应对与SARS-CoV-2相关的全球大流行所导致的严重肺炎的后果，但现有证据表明，细菌感染肺炎链球菌是导致严重社区获得性肺炎（SCAP）的最常见原因。快速诊断和分子检测提高了对共存病原体的鉴定。但是，入住ICU的患者的死亡率仍然高得惊人。

美国胸腔学会和美国传染病学会更新了CAP指南，以帮助简化疾病管理。共同的主题是使用及时，适当和适当的抗生素治疗以降低死亡率并避免耐药性。已经研究了用于CAP的新型抗生素，并扩展了治疗的选择，特别是对于那些对标准治疗不耐受或无反应的人，包括那些具有耐药性病原体的人。在这篇综述中，我们关注于SCAP患者的危险因素，微生物学，护理决策地点和治疗。