Berger R, Arango L
Crit Care Med. 1985 Oct;13(10):833-6. doi: 10.1097/00003246-198510000-00011.
We identified retrospectively 19 critically ill, intubated patients in whom tracheobronchial secretions had been cultured before antimicrobials were administered. Each of these patients had bacterial nosocomial pneumonia, as diagnosed by a positive bacterial culture from blood, pleural fluid, percutaneously aspirated lung material, special endobronchial brushings, and/or postmortem lung specimens. In 11 (58%) patients, the predominant organism in the tracheobronchial secretions was the same one identified in the diagnostic culture. However, in eight (42%) patients, the infecting bacteria were either not predominant or did not grow in the culture of respiratory secretions. We conclude that standard microbiologic studies of central tracheobronchial secretions are not always reliable for establishing the etiology of a bacterial nosocomial pneumonia in this type of patient.
我们回顾性地确定了19例重症插管患者，这些患者在使用抗菌药物之前已对气管支气管分泌物进行了培养。这些患者均患有细菌性医院获得性肺炎，诊断依据为血液、胸腔积液、经皮肺穿刺取材、特殊支气管刷检和/或尸检肺标本的细菌培养呈阳性。11例（58%）患者气管支气管分泌物中的主要病原体与诊断性培养中确定的病原体相同。然而，8例（42%）患者的感染细菌在呼吸道分泌物培养中要么不占优势，要么未生长。我们得出结论，对于确定这类患者细菌性医院获得性肺炎的病因，中央气管支气管分泌物的标准微生物学研究并不总是可靠的。
