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卡他布兰汉菌引起的支气管肺部感染:经气管穿刺评估的11例病例

Bronchopulmonary infection due to Branhamella catarrhalis: 11 cases assessed by transtracheal puncture.

作者信息

Ninane G, Joly J, Kraytman M

出版信息

Br Med J. 1978 Feb 4;1(6108):276-8. doi: 10.1136/bmj.1.6108.276.

Abstract

Transtracheal punctures were performed in 193 miners of anthracosilicotic coal who presented with an acute exacerbation of chronic bronchitis. The transtracheal aspirates were bacteriologically positive in 104 patients. Branhamella catarrhalis was isolated in 15 patients; 10 of these responded to chemotherapy, as shown by the resolution of all symptoms and the disappearance of the organism on a repeat transtracheal puncture performed 48 hours after the end of treatment. One ampicillin-treated patient, whose bronchial secretions yielded a beta-lactamase-producing B catarrhalis, showed no improvement. But subsequent treatment with cefuroxime was followed by clinical and bacteriological recovery. B catarrhalis probably acted as an opportunistic respiratory pathogen in these patients, who were probably compromised hosts in view of their clinical history. B catarrhalis normally responds to the penicillins commonly used for respiratory infections, but if treatment fails a transtracheal puncture is essential to identify the strain and determine an appropriate antibiotic.

摘要

对193名患有慢性支气管炎急性加重的煤矽肺矿工进行了经气管穿刺。104例患者的经气管吸出物细菌学检查呈阳性。15例患者分离出卡他布兰汉菌;其中10例对化疗有反应,表现为所有症状消退,且在治疗结束48小时后再次进行经气管穿刺时该菌消失。1例接受氨苄西林治疗的患者,其支气管分泌物培养出产β-内酰胺酶的卡他布兰汉菌,治疗无效。但随后使用头孢呋辛治疗后临床和细菌学均恢复。卡他布兰汉菌在这些患者中可能作为机会性呼吸道病原体起作用,鉴于他们的临床病史,这些患者可能是免疫功能受损宿主。卡他布兰汉菌通常对常用于呼吸道感染的青霉素有反应,但如果治疗失败,经气管穿刺对于鉴定菌株和确定合适的抗生素至关重要。

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