Nouraei S A Reza, Petrou Michael A, Randhawa Prem S, Singh Arvind, Howard David J, Sandhu Guri S
Department of Otolaryngology, Charing Cross Hospital, London, England, UK.
Arch Otolaryngol Head Neck Surg. 2006 Oct;132(10):1086-90. doi: 10.1001/archotol.132.10.1086.
To investigate whether airway granulation, a common occurrence during laryngotracheal reconstructive surgery and a common cause of delays in definitive treatment and treatment failure, is associated with a microbial etiology.
Prospective case-control study.
Tertiary referral airway reconstruction unit.
Patients who had an airway stent as part of their treatment for laryngotracheal stenosis.
All airway stents were sent for microbiological analysis. Information about patient demographics, lesion characteristics, and presence of airway granulation tissue at different times during treatment were obtained and correlated against the microbiological findings from airway stents.
A chi2 test was used to correlate airway colonization with specific pathogens and occurrence of airway granulation. Logistic regression analysis was used to identify independent microbiological predictors of airway granulation.
Thirty-one airway stents were removed from 26 patients. The mean (SD) age at presentation was 42 (18) years, and postintubation tracheal stenosis was the most common etiology. There were highly significant associations between stent colonization with Staphylococcus aureus and Pseudomonas aeruginosa and the occurrence of airway granulation (P<.02), and these microorganisms were independently associated with the risk of developing airway granulation. Furthermore, S aureus was associated with persistence of airway granulation on average 4 months following removal of the stent.
Airway granulation seems to be associated not with polymicrobial airway colonization but with infection with specific pathogenic microorganisms. All patients undergoing laryngotracheoplasty should receive antibiotic prophylaxis to cover these microorganisms, and the development and use of antibiotic-impregnated airway stents should be explored.
探讨气道肉芽组织（这是喉气管重建手术中常见的情况，也是导致确定性治疗延迟和治疗失败的常见原因）是否与微生物病因相关。
前瞻性病例对照研究。
三级转诊气道重建科室。
接受气道支架治疗喉气管狭窄的患者。
所有气道支架均送去进行微生物分析。获取患者人口统计学信息、病变特征以及治疗期间不同时间点气道肉芽组织的存在情况，并将其与气道支架的微生物学检查结果进行关联分析。
采用卡方检验将气道定植与特定病原体及气道肉芽组织的发生情况进行关联分析。采用逻辑回归分析确定气道肉芽组织的独立微生物学预测因素。
从26例患者中取出31个气道支架。就诊时的平均（标准差）年龄为42（18）岁，插管后气管狭窄是最常见的病因。金黄色葡萄球菌和铜绿假单胞菌在支架上定植与气道肉芽组织的发生之间存在高度显著的关联（P<0.02），并且这些微生物与气道肉芽组织形成的风险独立相关。此外，金黄色葡萄球菌与支架取出后平均4个月气道肉芽组织持续存在有关。
气道肉芽组织似乎并非与多种微生物在气道定植有关，而是与特定致病微生物感染有关。所有接受喉气管成形术的患者均应接受预防性抗生素治疗以覆盖这些微生物，并且应探索开发和使用含抗生素的气道支架。
