King Paul T, Holdsworth Stephen R, Freezer Nicholas J, Villanueva Elmer, Holmes Peter W
Department of Respiratory and Sleep Medicine, Monash Medical Centre, Clayton, Melbourne 3168, Australia.
Respir Med. 2007 Aug;101(8):1633-8. doi: 10.1016/j.rmed.2007.03.009. Epub 2007 Apr 30.
There is minimal published longitudinal data about pathogenic microorganisms in adults with bronchiectasis. Therefore a study was undertaken to assess the microbiologic profile over time in bronchiectasis. A prospective study of clinical and microbiologic outcomes was performed. Subjects were assessed by a respiratory physician and sputum sample were collected for analysis. Subjects were followed up and had repeat assessment performed. Eighty-nine subjects were followed up for a period of 5.7+/-3.6 years. On initial assessment the two most common pathogens isolated were Haemophilus influenzae (47%) and Pseudomonas aeruginosa (12%) whilst 21% had no pathogens isolated. On follow-up review results were similar (40% H. influenzae, 18% P. aeruginosa and 26% no pathogens). The prevalence of antibiotic resistance of isolates increased from 13% to 30%. Analysis of a series of H. influenzae isolates showed they were nearly all nontypeable and all were different subtypes. Subjects with no pathogens isolated from their sputum had the mildest disease, while subjects with P. aeruginosa had the most severe bronchiectasis. Many subjects with bronchiectasis are colonized with the same bacterium over an average follow-up of 5 years. Different pathogens are associated with different patterns of clinical disease.
关于支气管扩张症成年患者体内致病微生物的纵向数据发表得很少。因此，开展了一项研究来评估支气管扩张症患者随时间推移的微生物学特征。对临床和微生物学结果进行了一项前瞻性研究。由呼吸内科医生对受试者进行评估，并采集痰液样本进行分析。对受试者进行随访并重复评估。89名受试者接受了为期5.7±3.6年的随访。在初次评估时，分离出的两种最常见病原体是流感嗜血杆菌（47%）和铜绿假单胞菌（12%），而21%的受试者未分离出病原体。在随访复查时，结果相似（40%为流感嗜血杆菌，18%为铜绿假单胞菌，26%未分离出病原体）。分离菌株的抗生素耐药率从13%升至30%。对一系列流感嗜血杆菌分离株的分析表明，它们几乎都是不可分型的，且均为不同亚型。痰液中未分离出病原体的受试者病情最轻，而感染铜绿假单胞菌的受试者支气管扩张最为严重。在平均5年的随访中，许多支气管扩张症患者感染的是同一种细菌。不同的病原体与不同的临床疾病模式相关。
