Murphy T V, Clements J F, Petroni M, Coury S, Stetler L
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas.
Pediatr Infect Dis J. 1989 Mar;8(3):148-51.
Oral and respiratory secretions of 31 children who were healthy or had mild upper respiratory infection, and who had a positive throat culture for Haemophilus influenzae type b, were cultured to determine which secretions contain this organism and how long it can be recovered from fomites. Rhinorrhea was present in 11 of 31 (34%) children and nasal mucus was positive for H. influenzae type b in 10 (91%). In 5 of these children the concentration of H. influenzae type b in nasal mucus was 10(4) to 10(7) colony-forming units/ml3. H. influenzae type b in nasal mucus applied to fomites were recovered for 12 hours. Cultures of saliva and cough secretions compared with nasal mucus were less often positive (3 of 31, P less than 0.001; 3 of 25, P less than 0.001, respectively) and contained fewer H. influenzae type b (5 and 15 colony-forming units, respectively). H. influenzae type b was recovered from the hand of 2 of 27 (7%) children; both children had positive cultures of saliva. These data indicate that H. influenzae type b can be found in oral and respiratory secretions of pharyngeal carriers and can contaminate children's hands. Nasal mucus was the most consistently positive secretion and contained the largest number of bacteria. Careful management of nasal mucus secretions is warranted in settings where transmission could occur to susceptible children.
对31名健康或患有轻度上呼吸道感染且b型流感嗜血杆菌咽拭子培养呈阳性的儿童的口腔和呼吸道分泌物进行培养，以确定哪些分泌物含有该病原体以及它能从污染物中存活多长时间。31名儿童中有11名（34%）出现鼻漏，其中10名（91%）的鼻黏液b型流感嗜血杆菌检测呈阳性。在其中5名儿童中，鼻黏液中b型流感嗜血杆菌的浓度为每毫升10⁴至10⁷菌落形成单位。涂抹在污染物上的鼻黏液中的b型流感嗜血杆菌可存活12小时。与鼻黏液相比，唾液和咳嗽分泌物的培养阳性率较低（分别为31例中的3例，P<0.001；25例中的3例，P<0.001），且b型流感嗜血杆菌数量较少（分别为5个和15个菌落形成单位）。27名儿童中有2名（7%）的手部检测出b型流感嗜血杆菌；这两名儿童的唾液培养均呈阳性。这些数据表明，b型流感嗜血杆菌可在咽部携带者的口腔和呼吸道分泌物中发现，并可污染儿童的手部。鼻黏液是最持续呈阳性的分泌物，且含有最多的细菌。在可能发生传播给易感儿童的环境中，有必要对鼻黏液分泌物进行仔细管理。
