目的 探讨肠杆菌社区获得性肺炎（EnCAP）的临床特征和影响 30 d 病死率的因素。 方法 回顾性分析我院 2010 年至 2015 年收治的 EnCAP 237 例和肺炎链球菌社区获得性肺炎（SpCAP）120 例，比较两组的人口学、基础病、临床症状体征、相关实验室检查和影像学，以及治疗和预后。单因素分析和 Logistic 回归分析影响 EnCAP 30 d 病死率的危险因素。 结果 和 SpCAP 组相比，EnCAP 组脑血管疾病（19.8% 比 8.3%）、慢性肝病（8.4% 比 1.7%）、慢性肾病（5.1% 比 0.0%）、吸入因素（11.0% 比 0.0%）比例高，PSI 分级（2.9±1.3 比 2.5±0.8）/CURB-65 评分（1.1±0.1 比 0.6±0.4）更高；意识改变（12.2% 比 0.0%）常见，血白细胞计数[（9.5±5.7）×10 9/L 比（10.4±4.8）×10 9/L]、血红蛋白[（125.0±9.0）g/L 比（135.0±15.0）g/L]、白蛋白[（32.0±8.0）g/L 比（36.0±9.4）g/L]水平低，合并胸腔积液者（30.4% 比 12.5%）更常见；在合理经验性抗感染治疗比例接近的条件下，两者临床结局类似，但 EnCAP 住院时间更长（12.0 d 比 7.0 d）。Logistic 回归分析证实血红蛋白（ OR 0.087，95% CI 0.857～0.981）、合理的经验性抗感染治疗（ OR 0.108，95% CI 0.011～0.151）和脓毒性休克（ OR 1.700，95% CI 0.781～38.326）是影响 EnCAP 30 d 病死率的独立危险因素。 结论 EnCAP 的临床表现不同于SpCAP。脓毒性休克是 EnCAP 30 d 死亡的独立危险因素，血红蛋白与合理的经验性抗感染治疗是保护因素，能够降低 30 d 病死率
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