Laudat P, Legros B, Audurier A, Loulergue J, de Gialluly C, Lapierre F
Pathol Biol (Paris). 1985 May;33(5):435-9.
Bacteriology was performed on 57 specimens collected by the Wimberley protected catheter bronchoscopy technique (PCB) from 42 ventilated patients with severe head trauma hospitalized in the neurosurgical intensive care unit to determine the etiology of their pneumopathy. All patients had a nasotracheal tube upon arrival at the intensive care unit. For each sample, smears were examined and cultures under aerobic and anaerobic conditions as well as with CO2 were performed. In 34 (59%) of the 57 cases, examination of smears allowed rapid diagnosis and appropriate chemotherapy. In 47 (82%) cases, culture was positive, with a single pathogen being recovered in half of cases. The most prevalent organisms among the 75 species isolated were S. aureus (38%), P. aeruginosa (15%), Klebsiella (12%), Haemophilus (8%), and Pneumococcus (9%). Consistency with positive cultures of blood or pleural effusion samples was recorded in 92% of cases. Narrow spectrum antibiotic therapy can be chosen according to the results of PCB bacteriology and rapid automated antibiotic sensitivity testing obtained within 24 hours. PCB is therefore recommended in pulmonary infections in intensive care units.
对神经外科重症监护病房收治的42例重度颅脑外伤通气患者，采用温伯利保护导管支气管镜技术（PCB）采集了57份标本进行细菌学检查，以确定其肺部疾病的病因。所有患者入院时均已插入鼻气管导管。对每份样本进行涂片检查，并在需氧、厌氧及二氧化碳环境下进行培养。57例中有34例（59%）涂片检查可实现快速诊断并进行适当的化疗。47例（82%）培养结果呈阳性，半数病例仅分离出单一病原体。分离出的75种菌种中，最常见的是金黄色葡萄球菌（38%）、铜绿假单胞菌（15%）、克雷伯菌（12%）、嗜血杆菌（8%）和肺炎球菌（9%）。92%的病例血样或胸腔积液样本的培养结果与之相符。可根据PCB细菌学检查结果及24小时内获得的快速自动药敏试验结果选择窄谱抗生素治疗。因此，推荐在重症监护病房的肺部感染中采用PCB技术。
