Carlson David, McKeen Elizabeth, Mitchell Michael, Torres Brenda, Parad Richard, Comeau Anne Marie, O'Sullivan Brian P
Department of Pediatrics, University of Massachusetts Medical School and UMass Memorial Health Care, Worcester, Massachusetts, USA.
Pediatr Pulmonol. 2009 May;44(5):497-502. doi: 10.1002/ppul.21029.
The purpose of this preliminary study was to determine normal oropharyngeal flora in healthy, non-CF infants in order to help care givers better interpret culture results obtained from infants with CF.
Oropharyngeal cultures were obtained from 104 healthy infants <12 months old. Cultures were obtained using the same methods as for CF patients and were inoculated onto routine CF culture media. Approximately 20 infants from each of 5 age groups (0-2 days, 3 days to <3 months, 3 months to <6 months, 6 months to <9 months or 9 months to <1 year) were included in the well child sample. In addition, we reviewed serial results of upper airway cultures obtained during the first year of life from 20 CF-affected infants whose diagnosis was suggested by newborn screening.
Well infants in the first 48 hr of life had very few pathogenic organisms found in their oropharyngeal cultures; 1/21 had S. aureus. Of the 83 samples from infants over 48 hr of age, we found that 27% (23/83) had S. aureus in their oropharyngeal cultures. Many infants had polymicrobial cultures. Eleven percent of culture samples had E. coli, E. cloacae, H. influenzae, or M. catarrhalis. Three of 83 cultures were positive for non-mucoid Ps. aeruginosa (3.6%), while 2 others were positive for Ps. putida.
Healthy infants can have multiple gram-negative and gram-positive organisms recovered from their oropharynx. S. aureus and enteric gram-negative organisms, including non-mucoid Ps. aeruginosa, can be found in the oropharynx of well children up to 1 year of age. Care should be taken to not over interpret the presence of some of these organisms in the oropharyngeal cultures of asymptomatic CF infants.
本初步研究的目的是确定健康非囊性纤维化（CF）婴儿的正常口咽菌群，以帮助护理人员更好地解读CF婴儿的培养结果。
从104名12个月以下的健康婴儿中获取口咽培养物。培养物采用与CF患者相同的方法获取，并接种到常规CF培养基上。健康儿童样本中包括了来自5个年龄组（0 - 2天、3天至小于3个月、3个月至小于6个月、6个月至小于9个月或9个月至小于1岁）的各约20名婴儿。此外，我们回顾了20名经新生儿筛查提示诊断为CF的婴儿在生命第一年期间获得的上呼吸道培养物的系列结果。
出生后48小时内的健康婴儿口咽培养物中发现的致病微生物极少；21例中有1例检测到金黄色葡萄球菌。在48小时以上婴儿的83份样本中，我们发现27%（23/83）的口咽培养物中有金黄色葡萄球菌。许多婴儿的培养物为多种微生物混合感染。11%的培养样本中有大肠杆菌、阴沟肠杆菌、流感嗜血杆菌或卡他莫拉菌。83份培养物中有3份非黏液型铜绿假单胞菌呈阳性（3.6%），另有2份恶臭假单胞菌呈阳性。
健康婴儿的口咽中可培养出多种革兰氏阴性菌和革兰氏阳性菌。在1岁以下健康儿童的口咽中可发现金黄色葡萄球菌和肠道革兰氏阴性菌，包括非黏液型铜绿假单胞菌。对于无症状CF婴儿口咽培养物中某些此类细菌的存在，应注意避免过度解读。
