Taylor R F, Morgan D W, Nicholson P S, Mackay I S, Hodson M E, Pitt T L
Department of Cystic Fibrosis, Royal Brompton Hospital, London.
Thorax. 1992 Jun;47(6):426-8. doi: 10.1136/thx.47.6.426.
Pseudomonas aeruginosa infection is seldom eradicated in patients with cystic fibrosis despite intensive antipseudomonal treatment. Upper airway sites of infection may contribute to perpetuation of lower airways infection. This study was designed to find out which extrapulmonary sites are infected and whether the strains at these sites are identical to those in the lungs.
Sputum and upper airway samples from 42 patients were cultured for P aeruginosa and stool samples from 20 patients were also tested. Nineteen isolates from sputum and extrapulmonary sites from four patients were genotyped with the pCM tox probe.
P aeruginosa was isolated from the sputum of 36 patients, 34 of whom had infection in the upper airways. Six of the 20 patients tested were positive for P aeruginosa in the stool. The nasopharynx was colonised in 30 patients, the oropharynx in 29, the middle meatus in 13, the external nares in six, and the inferior turbinate in four. Three of four patients tested had the same strain of P aeruginosa (a different one in each individual) in the sputum and the upper airways, and in two of the three the stool isolate was a different strain.
Most adults with cystic fibrosis and P aeruginosa pulmonary infection have upper airway reservoirs of the organism and strains from these sites are identical to those in the lungs.
尽管进行了强化抗铜绿假单胞菌治疗，但囊性纤维化患者的铜绿假单胞菌感染很少能被根除。上呼吸道感染部位可能导致下呼吸道感染持续存在。本研究旨在找出哪些肺外部位受到感染，以及这些部位的菌株是否与肺部的菌株相同。
对42例患者的痰液和上呼吸道样本进行铜绿假单胞菌培养，并对20例患者的粪便样本进行检测。对4例患者痰液和肺外部位的19株分离菌用pCM毒力探针进行基因分型。
从36例患者的痰液中分离出铜绿假单胞菌，其中34例患者上呼吸道有感染。20例接受检测的患者中有6例粪便中铜绿假单胞菌呈阳性。30例患者鼻咽部有定植，29例口咽部有定植，13例中鼻道有定植，6例鼻前庭有定植，4例下鼻甲有定植。4例接受检测的患者中有3例痰液和上呼吸道中的铜绿假单胞菌菌株相同（每个个体不同），在这3例中的2例中，粪便分离菌是不同的菌株。
大多数患有囊性纤维化和铜绿假单胞菌肺部感染的成年人上呼吸道存在该病菌储存库，且这些部位的菌株与肺部的菌株相同。
