Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
PLoS One. 2020 Jun 25;15(6):e0234558. doi: 10.1371/journal.pone.0234558. eCollection 2020.
Recently, our understanding of the elusive bacterial communities in the lower respiratory tract and their role in chronic lung disease has increased significantly. However, little is known about the respiratory microorganisms in patients with endobronchial tuberculosis (EBTB), which is a chronic inflammatory disease characterized by destruction of the tracheobronchial tree due to Mycobacterium tuberculosis (MTB) infection. We retrospectively reviewed data for histopathologically and microbiologically confirmed EBTB patients diagnosed at a tertiary referral hospital in South Korea between January 2013 and January 2019. Bacterial cultures were performed on bronchial washing from these patients at the time of EBTB diagnosis. A total of 216 patients with EBTB were included in the study. The median age was 73 years and 142 (65.7%) patients were female. Bacteria were detected in 42 (19.4%) patients. Additionally, bacterial co-infection was present in 6 (2.8%) patients. Apart from MTB, the most common microorganisms identified were Staphylococcus aureus (n = 14, 33.3%) followed by Klebsiella species (n = 12, 28.6%; 10 Klebsiella pneumoniae, 2 Klebsiella oxytoca), Streptococcus species (n = 5, 11.9%), Enterobacter species (n = 4, 9.5%), and Pseudomonas aeruginosa (n = 3, 7.1%). A variety of microorganisms were isolated from the bronchial washing indicating that changes in microorganism composition occur in the airways of patients with EBTB. Further studies are needed to investigate the clinical significance of this finding.
最近，我们对下呼吸道中难以捉摸的细菌群落及其在慢性肺部疾病中的作用有了更深入的了解。然而，对于支气管内膜结核（EBTB）患者的呼吸道微生物知之甚少，EBTB 是一种慢性炎症性疾病，由于结核分枝杆菌（MTB）感染导致气管支气管树破坏。我们回顾性分析了 2013 年 1 月至 2019 年 1 月期间在韩国一家三级转诊医院经组织病理学和微生物学确诊的 EBTB 患者的数据。在 EBTB 诊断时，对这些患者的支气管冲洗液进行了细菌培养。共纳入 216 例 EBTB 患者。患者中位年龄为 73 岁，142 例（65.7%）为女性。42 例（19.4%）患者检测到细菌。此外，6 例（2.8%）患者存在细菌合并感染。除 MTB 外，最常见的微生物是金黄色葡萄球菌（n = 14，33.3%），其次是克雷伯菌属（n = 12，28.6%；10 株肺炎克雷伯菌，2 株产酸克雷伯菌）、链球菌属（n = 5，11.9%）、肠杆菌属（n = 4，9.5%）和铜绿假单胞菌（n = 3，7.1%）。支气管冲洗液中分离出多种微生物，表明 EBTB 患者气道中微生物组成发生变化。需要进一步研究以探讨这一发现的临床意义。
