[经气管抽吸术对老年人肺炎多重微生物感染的研究]

[Studies of polymicrobial infection on pneumonia by transtracheal aspiration in the elderly].

作者信息

Yamamoto K, Yamada Y, Hayashi Y, Takeuchi T, Adachi S, Suzuki K, Yamamoto T

机构信息

First Department of Internal Medicine, Nagoya City University, Medical School.

出版信息

Kansenshogaku Zasshi. 1990 Nov;64(11):1433-8. doi: 10.11150/kansenshogakuzasshi1970.64.1433.

DOI:10.11150/kansenshogakuzasshi1970.64.1433

PMID:2126799

Abstract

We studied the polymicrobial infection by transtracheal aspiration (TTA) on pneumonia in the elderly. Incidence of mixed isolation of organisms from TTA was 35% or 39 out of 111 episodes. The principal organisms in polymicrobial infection detected from TTA were S. aureus (N.23), P. aeruginosa (N. 15), K. pneumoniae (N. 12) and S. pneumoniae (N. 11). The principal combination of mixed infection were S. aureus + P. aeruginosa (N.7), S. aureus + K. pneumoniae (N.5), S. aureus + S. marcescens (N.5), S. aureus + S. pneumoniae (N.5), S. aureus + Anaerobes (N.4) and K. pneumoniae + P. aeruginosa (N.4). Hospital acquired pneumonia was of a higher rate of mixed infection than the nursing home acquired pneumonia. In the mixed infection on pneumonia in the elderly, normal upper airway flora was highly detected with pathogens from transtracheal aspirates. From these results, we realize that aspiration and superinfection were important factors in mixed infection in the elderly.

摘要

我们通过经气管吸引术（TTA）研究了老年人肺炎的多重微生物感染情况。在111例病例中，经TTA分离出混合菌的发生率为35%，即39例。从TTA检测到的多重微生物感染中的主要病原体为金黄色葡萄球菌（23例）、铜绿假单胞菌（15例）、肺炎克雷伯菌（12例）和肺炎链球菌（11例）。混合感染的主要组合为金黄色葡萄球菌+铜绿假单胞菌（7例）、金黄色葡萄球菌+肺炎克雷伯菌（5例）、金黄色葡萄球菌+黏质沙雷菌（5例）、金黄色葡萄球菌+肺炎链球菌（5例）、金黄色葡萄球菌+厌氧菌（4例）和肺炎克雷伯菌+铜绿假单胞菌（4例）。医院获得性肺炎的混合感染率高于养老院获得性肺炎。在老年人肺炎的混合感染中，经气管吸出物中的病原体与正常上呼吸道菌群高度相关。从这些结果来看，我们认识到误吸和二重感染是老年人混合感染的重要因素。