Johanson W G, Woods D E, Chaudhuri T
J Infect Dis. 1979 Jun;139(6):667-73. doi: 10.1093/infdis/139.6.667.
Factors that promote oropharyngeal colonization of seriously ill patients with gram-negative bacilli are as yet poorly understood. In this investigation, 34 subjects who required intensive care were studied; 18 (53%) were colonized with gram-negative bacilli. Oropharyngeal epithelial cells of all colonized patients contained adherent bacilli. Fewer alpha-hemolytic streptococci but greater numbers of Pseudomonas aeruginosa and Klebsiella pneumoniae (P less than or equal to 0.01) adhered in vitro to buccal epithelial cells from colonized patients than to cells from noncolonized patients. Adherence of bacilli to buccal cells was inhibited in vitro by concanavalin A but not by bovine serum albumin or phytohemagglutinin. Brief exposure of buccal cells to trypsin increased adherence of bacilli. Prior adherence of one species of bacilli inhibited subsequent adherence of a second species. These findings suggested that epithelial cells of the upper respiratory tract contain binding sites for gram-negative bacilli. Factors associated with serious illness appear to increase the availability of these binding sites, thus facilitating colonization of the upper respiratory tract with gram-negative bacilli.
促进重症患者口咽部被革兰氏阴性杆菌定植的因素目前仍知之甚少。在本研究中，对34名需要重症监护的受试者进行了研究；其中18人（53%）被革兰氏阴性杆菌定植。所有定植患者的口咽上皮细胞均含有黏附的杆菌。与未定植患者的细胞相比，在体外，定植患者颊上皮细胞黏附的α-溶血性链球菌较少，但铜绿假单胞菌和肺炎克雷伯菌的数量较多（P≤0.01）。伴刀豆球蛋白A在体外可抑制杆菌对颊细胞的黏附，但牛血清白蛋白或植物血凝素则无此作用。颊细胞短暂暴露于胰蛋白酶可增加杆菌的黏附。一种杆菌的预先黏附会抑制第二种杆菌随后的黏附。这些发现表明，上呼吸道上皮细胞含有革兰氏阴性杆菌的结合位点。与重症相关的因素似乎会增加这些结合位点的可及性，从而促进上呼吸道被革兰氏阴性杆菌定植。
