Minah G E, Rednor J L, Peterson D E, Overholser C D, Depaola L G, Suzuki J B
J Clin Microbiol. 1986 Aug;24(2):210-3. doi: 10.1128/jcm.24.2.210-213.1986.
Aerobic and facultative gram-negative bacilli (GNB) have been reported to increase on various body surfaces in the seriously ill and debilitated patient. This study examined quantitative aspects of GNB succession at five oral sites in cancer patients before and during myelosuppressive chemotherapy. GNB concentrations increased sharply during chemotherapy at 25 to 50% of the oral sites in both acute nonlymphocytic leukemia and small-cell lung carcinoma patients. Most sites did not exhibit shifts of GNB to levels higher than 0.1% of the cultivable flora. When shifts occurred, all sites sampled in the mouth were usually affected and GNB usually represented more than 10% of the cultivable flora. Low levels of indigenous microflora were observed in most sites exhibiting GNB shifts. None of the subjects harboring high levels of GNB developed the symptoms of acute infection which are commonly observed in myelosuppressed patients. Although Pseudomonas aeruginosa and Klebsiella pneumoniae were recovered from some sites, most GNB were nonpathogenic species of Pseudomonas; Pseudomonas pickettii was the most frequently recovered.
据报道，在重症和虚弱患者的各种体表部位，需氧和兼性革兰氏阴性杆菌（GNB）数量会增加。本研究检测了癌症患者在骨髓抑制化疗前后五个口腔部位GNB演替的定量情况。在急性非淋巴细胞白血病和小细胞肺癌患者中，化疗期间25%至50%的口腔部位GNB浓度急剧增加。大多数部位的GNB水平未升至高于可培养菌群的0.1%。当发生变化时，口腔内所有采样部位通常都会受到影响，且GNB通常占可培养菌群的10%以上。在大多数出现GNB变化的部位，观察到本地微生物群水平较低。携带高水平GNB的受试者均未出现骨髓抑制患者常见的急性感染症状。虽然从一些部位分离出了铜绿假单胞菌和肺炎克雷伯菌，但大多数GNB是假单胞菌的非致病菌种；皮氏假单胞菌是最常分离出的菌种。
