Fujita J, Negayama K, Takigawa K, Kubo A, Yamaji Y, Fujita T, Yamagishi Y, Hata Y, Shiotani T, Takahara J
First Department of Internal Medicine, Kagawa Medical School.
Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Jul;30(7):1215-21.
Pseudomonas cepacia is a gram negative rod, having no fermentative activity on glucose. This organism was detected in the sputum, throat swab, or throat washing of 22 inpatients treated between January, 1990, and December, 1990, at the First Department of Internal Medicine, Kagawa Medical School. The primary diseases for which these 22 patients were hospitalized were leukemia in 12, malignant lymphoma in 5, lung cancer in 2, myelodysplastic syndrome in 1, and embryonal cell carcinoma in 1. Twelve of the 22 patients had episodes of pneumonia which complied clinically with the diagnostic criteria provided to facilitate the National Nosocomial Infection Study. The complication of pneumonia occurred in 7 patients with leukemia, 2 with malignant lymphoma, 2 with lung cancer, and 1 with myelodysplastic syndrome. In 10 of these 12 patients, the organism was detected before the onset of pneumonia. All 22 patients in whom the organism was demonstrated had received antibiotics. The antibiotics which was most frequently used to treat these patients 1 month before detection of Pseudomonas cepacia were amikacin and ceftizoxime, which were used in 13 patients. Of the antibiotics in which the susceptibility to Pseudomonas cepacia was, evaluated, minocycline was effective in 100% (21/21), ceftazidime in 50% (11/22), and ofloxacin in 27.3% (6/22). Physicians should be especially aware of the possibility of colonization and nosocomial respiratory infection by Pseudomonas cepacia in patients with severe underlying diseases.
洋葱伯克霍尔德菌是一种革兰氏阴性杆菌，对葡萄糖无发酵活性。1990年1月至12月期间，在香川医科大学第一内科接受治疗的22例住院患者的痰液、咽拭子或咽喉冲洗液中检测到了这种细菌。这22例患者住院的主要疾病为白血病12例、恶性淋巴瘤5例、肺癌2例、骨髓增生异常综合征1例、胚胎性细胞癌1例。22例患者中有12例发生了符合全国医院感染研究诊断标准的肺炎发作。肺炎并发症发生在7例白血病患者、2例恶性淋巴瘤患者、2例肺癌患者和1例骨髓增生异常综合征患者中。在这12例患者中的10例中，在肺炎发作前检测到了该细菌。所有检测到该细菌的22例患者均接受过抗生素治疗。在检测到洋葱伯克霍尔德菌前1个月，最常用于治疗这些患者的抗生素是丁胺卡那霉素和头孢唑肟，13例患者使用过这两种抗生素。在评估了对洋葱伯克霍尔德菌敏感性的抗生素中，米诺环素的有效率为100%（21/21），头孢他啶为50%（11/22），氧氟沙星为27.3%（6/22）。医生应特别注意患有严重基础疾病的患者发生洋葱伯克霍尔德菌定植和医院内呼吸道感染的可能性。
