Brook Itzhak
Department of Pediatrics, Georgetown University School of Medicine, Washington, DC, USA.
Ann Otol Rhinol Laryngol. 2004 Oct;113(10):830-4. doi: 10.1177/000348940411301010.
Colonization of the tracheobronchial tree with microorganisms almost always follows tracheal intubation, tracheostomy, or the use of ventilatory tubes. Infection of the tracheostomy wound site frequently occurs after prolonged use of the tracheostomy. The long-term-ventilated child is at high risk for developing tracheobronchitis or nosocomial pneumonia, generally involving aerobic gram-negative or gram-positive bacteria. Several studies have illustrated the role of anaerobic bacteria in lower respiratory tract and tracheostomy wound site infection in intubated children. The predominant anaerobic bacteria were Peptostreptococcus spp and pigmented Prevotella and Porphyromonas spp. Most of these infections are due to polymicrobial aerobic-anaerobic bacterial flora. Appropriate management of mixed pulmonary aerobic and anaerobic infections requires the administration of antimicrobials that are effective against both the aerobic and anaerobic components of the infection.
气管支气管树被微生物定植几乎总是发生在气管插管、气管切开术或使用通气导管之后。气管切开术伤口部位的感染常在气管切开术长期使用后频繁发生。长期使用呼吸机的儿童发生气管支气管炎或医院获得性肺炎的风险很高，通常涉及需氧革兰氏阴性菌或革兰氏阳性菌。多项研究阐明了厌氧菌在插管儿童下呼吸道及气管切开术伤口部位感染中的作用。主要的厌氧菌是消化链球菌属以及产色素普雷沃菌属和卟啉单胞菌属。这些感染大多是由需氧菌与厌氧菌混合菌群引起的。对肺部需氧菌和厌氧菌混合感染进行恰当处理需要使用对感染的需氧菌和厌氧菌成分均有效的抗菌药物。
