Thadepalli H, Rambhatla K, Niden A H
JAMA. 1977 Sep 5;238(10):1037-40. doi: 10.1001/jama.238.10.1037.
Of 4,200 patients admitted to an acute-care county hospital, 126 (3%) were proved to have pulmonary tuberculosis, among whom 35 (28%) had several sputum smears negative for acid-fast bacilli. On transtracheal aspiration, 31 to 35 had acid-fast bacilli in the aspirate. Eighteen of these 35 (51%) patients had associated infections caused by aerobic or anaerobic bacteria. Tuberculin skin tests were negative in 14 of 35 patients with negative sputum specimens (40%). Ten of 18 patients (56%) with associated bacterial infections had negative skin tests to purified protein derivative. Smear and culture of transtracheal aspirate for tubercle bacilli may be invaluable in establishing the diagnosis when pulmonary tuberculosis is suspected.
在一家县级急症医院收治的4200名患者中，有126人（3%）被证实患有肺结核，其中35人（28%）的多次痰涂片抗酸杆菌检查呈阴性。经气管抽吸检查，31至35人的抽吸物中发现抗酸杆菌。这35名患者中有18人（51%）伴有需氧菌或厌氧菌引起的感染。35例痰标本阴性的患者中有14例（40%）结核菌素皮肤试验呈阴性。18例伴有细菌感染的患者中有10例（56%）对纯化蛋白衍生物皮肤试验呈阴性。当怀疑患有肺结核时，经气管抽吸物涂片和培养结核杆菌对于确诊可能非常重要。
