French G L, Homi J
Crit Care Med. 1979 Nov;7(11):487-91. doi: 10.1097/00003246-197911000-00002.
Over a 12-month period, 27% of patients in a new ICU grew bacterial pathogens from sputum or tracheal cultures. The commonest isolates were Pseudomonas aeruginosa and Klebsiella species. Endotracheal intubation, the length of time intubated, and antimicrobial therapy all predisposed to the isolation of organisms from sputum. No patient developed a gram-negative pneumonia, and there was no case of septicemia associated with a positive sputum culture. The presence of epithelial or pus cells in sputum was unrelated to the culture results. It was concluded that the growth of colonic bacteria from sputum or tracheal aspirates was of little prognostic or clinical significance. No significant common environmental site or cross-infection pathway was identified: sinks were contaminated by patients rather than vice versa. Most sputum isolates were probably endogenous in origin.
在为期12个月的时间里，新建重症监护病房（ICU）中27%的患者痰液或气管培养物中培养出了细菌病原体。最常见的分离菌是铜绿假单胞菌和克雷伯菌属。气管插管、插管时间长短以及抗菌治疗均易导致痰液中分离出微生物。没有患者发生革兰氏阴性菌肺炎，也没有与痰液培养阳性相关的败血症病例。痰液中上皮细胞或脓细胞的存在与培养结果无关。得出的结论是，痰液或气管吸出物中结肠细菌的生长对预后或临床意义不大。未发现明显的常见环境部位或交叉感染途径：水槽是被患者污染，而非相反。大多数痰液分离菌可能起源于内源性。
