Balasaniants G S, Torkatiuk E A
Zh Mikrobiol Epidemiol Immunobiol. 2010 Nov-Dec(6):7-11.
To study microbial spectrum of respiratory tract in patients with pulmonary diseases.
Culture of sputum/bronchial lavage fluid (S/BLF) and bronchoalveolar lavage fluid obtained from 36 HIV-negative patients with infiltrative pulmonary tuberculosis (IT), 18 patients with community-acquired pneumonia (CAP), 18 patients with lung cancer (LC) was performed on 5% blood agar using method of serial dilutions. Following concentrations of microorganisms were considered as diagnostic: 10(6) CFU/ml--in sputum, 10(4) CFU/ml--in bronchial lavage fluid, 10(3) CFU/ ml--in bronchoalveolar lavage fluid.
Nonspecific microflora in S/BLF was isolated 94.4% of patients (34--IT, 17--CAP, and 17-LC), and in bronchoalveolar lavage fluid - in 69.4%, 61.1%, and 77.8% of patients respectively. Nonspecific microflora was presented as both monoculture and microbial associations. In group of patients with IT, the most frequent were associations of bacteria from Nesseriaceae family and streptococci, streptococci and staphylococci, streptococci and fungi from Candida genus. In group of patients with CAP, monocultures of microorganisms were detected rarely, whereas, in contrast, microbial associations were detected more frequently. In patients with LC, monocultures of microorganisms were isolated from S/ BLF in 2 cases and from broncoalveolar lavage fluid--in 9 cases; associations were detected in overwhelming majority of patients, more frequently--combination of streptococci and Neisseria, streptococci and yeast-like fungi. In patients with IT and CAP, Streptococcus pneumoniae was the most frequently detected microorganism, whereas non-fermenting bacteria predominated in lavage fluid. Diagnostic titers from bronchoalveolar lavage fluid in patients with CAP were detected only for Acinetobacter calcoaceticus, Citrobacterfreundii, and Escherichia coli. S.pneumoniae and Staphylococcus spp. were most frequently isolated from S/BLF in patients with LC, whereas in broncoalveolar lavage fluid of such patients S. pneumoniae, Pseudomonas aeruginosa, and non-fermenting bacteria were detected in titers exceeding diagnostic threshold.
Species composition of nonspecific microflora during IT, CAP, and LC was virtually the same; microorganisms were detected in equal proportions.
研究肺部疾病患者呼吸道的微生物谱。
采用连续稀释法，对36例HIV阴性的浸润性肺结核（IT）患者、18例社区获得性肺炎（CAP）患者、18例肺癌（LC）患者的痰液/支气管灌洗液（S/BLF）及支气管肺泡灌洗液进行5%血琼脂培养。以下微生物浓度被视为诊断标准：痰液中10(6) CFU/ml，支气管灌洗液中10(4) CFU/ml，支气管肺泡灌洗液中10(3) CFU/ml。
94.4%的患者（34例IT患者、17例CAP患者和17例LC患者）的S/BLF中分离出非特异性菌群，支气管肺泡灌洗液中分别为69.4%、61.1%和77.8%的患者分离出非特异性菌群。非特异性菌群以单一培养物和微生物组合形式存在。在IT患者组中，最常见的是奈瑟菌科细菌与链球菌、链球菌与葡萄球菌、链球菌与念珠菌属真菌的组合。在CAP患者组中，很少检测到微生物单一培养物，相反，微生物组合的检测更为频繁。在LC患者中，2例患者的S/BLF中分离出微生物单一培养物，9例患者的支气管肺泡灌洗液中分离出微生物单一培养物；绝大多数患者检测到组合，更常见的是链球菌与奈瑟菌、链球菌与酵母样真菌的组合。在IT和CAP患者中，肺炎链球菌是最常检测到的微生物，而灌洗液中以非发酵菌为主。CAP患者支气管肺泡灌洗液中仅检测到醋酸钙不动杆菌、弗氏柠檬酸杆菌和大肠杆菌的诊断滴度。LC患者中，肺炎链球菌和葡萄球菌属最常从S/BLF中分离出来，而在这些患者的支气管肺泡灌洗液中，肺炎链球菌、铜绿假单胞菌和非发酵菌的检测滴度超过诊断阈值。
IT、CAP和LC期间非特异性菌群的种类组成基本相同；微生物检测比例相当。
