Kinoshita A, Mukae H, Takase T, Ishino T, Kohno S, Kanda T, Yamaguchi K, Hirota M, Hara K
Department of Internal Medicine, Hokusho Central Hospital, Nagasaki.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Jun;28(6):875-81.
The authors investigated the isolation of Branhamella catarrhalis from sputum and the clinical features of bronchopulmonary infection due to B. catarrhalis from January of 1983 to December of 1987 at the Hokusyo Central Hospital. B. catarrhalis was cultured from 106 (3.8%) of 5,674 sputum specimens. The isolation rate did not vary during the 5 years from 1983 to 1987. Approximately 70% of the patients had some underlying bronchopulmonary disease. The strains of beta-lactamase-positive B. catarrhalis have increased recently in our hospital. Using 4 diagnostic criteria for bronchopulmonary infection by B. catarrhalis, 24 cases were detected. MIC was measured in 97 strains of B. catarrhalis (beta-lactamase positive 63 strains, negative 34 strains). beta-lactamase positive strains had a high MIC value for beta-lactam antibiotics, but antibiotics including beta-lactamase inhibitor markedly improved sensitivity to drugs. Negative strains showed good sensitivity to beta-lactam antibiotics. Cases of bronchopulmonary infection due to Branhamella catarrhalis and beta-lactamase-productive strains are increasing, therefore it is necessary to be careful in the choice of antibiotics.
作者于1983年1月至1987年12月在北九州中央医院研究了从痰液中分离出卡他布兰汉菌的情况以及由卡他布兰汉菌引起的支气管肺部感染的临床特征。在5674份痰液标本中,有106份(3.8%)培养出了卡他布兰汉菌。1983年至1987年这5年间,分离率没有变化。大约70%的患者患有一些潜在的支气管肺部疾病。我院最近产β-内酰胺酶的卡他布兰汉菌菌株有所增加。采用卡他布兰汉菌引起支气管肺部感染的4条诊断标准,共检测出24例。对97株卡他布兰汉菌(产β-内酰胺酶阳性63株,阴性34株)测定了最低抑菌浓度(MIC)。产β-内酰胺酶阳性菌株对β-内酰胺类抗生素的MIC值较高,但含β-内酰胺酶抑制剂的抗生素可显著提高其对药物的敏感性。阴性菌株对β-内酰胺类抗生素表现出良好的敏感性。由卡他布兰汉菌和产β-内酰胺酶菌株引起的支气管肺部感染病例正在增加,因此在选择抗生素时必须谨慎。