Civen R, Jousimies-Somer H, Marina M, Borenstein L, Shah H, Finegold S M
Wadsworth Veterans Affairs Medical Center, Los Angeles, California, USA.
Clin Infect Dis. 1995 Jun;20 Suppl 2:S224-9. doi: 10.1093/clinids/20.supplement_2.s224.
We conducted a retrospective study to update the bacteriology of 46 cases of anaerobic empyema that were originally studied between 1976 and 1993 at the Wadsworth Anaerobic Bacteriology Clinical Research Laboratory (Los Angeles). Anaerobic bacteriologic studies were completed for all 46 pleural fluid specimens, and aerobic bacteriologic studies were completed for 41 of these specimens. Thirty-seven clinical charts were available for review. A total of 161 anaerobic isolates (3.5 per patient) representing 64 species or groups were recovered. The most common isolates were as follows: Fusobacterium nucleatum (19); Prevotella oris-buccae group (13, 9 of which were P. oris); Bacteroides fragilis group (11, 4 of which were B. fragilis); pigmented Prevotella species (17, 8 of which were in the Prevotella intermedia-nigrescens group); Peptostreptococcus species (17, 9 of which were Peptostreptococcus micros); Eubacterium species (7); Lactobacillus species (8); Actinomyces species (7); and Clostridium species (7). Nineteen if the cases were of purely anaerobic etiology; of these, eight were caused by a single organism: F. nucleatum (five cases); B. fragilis (two cases); and Prevotella mangus (one case). Of the 45 aerobic isolates (1.1 per patient), viridans streptococci were most common (21 isolates), followed by group D nonenterococcal streptococcus (four isolates). Only nine gram-negative rods (six enteric and three nonenteric organisms) and one Staphylococcus aureus isolate were recovered. The susceptibility to penicillin of 64 isolates was examined with the use of the spiral gradient method; 21 (33%) of these isolates were beta-lactamase positive (MICs ranged from 1.1 to > or = 54 micrograms/mL vs < or = 0.27 micrograms/mL for beta-lactamase-negative strains).
我们进行了一项回顾性研究，以更新1976年至1993年期间在洛杉矶沃兹沃思厌氧菌临床研究实验室最初研究的46例厌氧性脓胸的细菌学情况。对所有46份胸腔积液标本都完成了厌氧菌学研究，其中41份标本还完成了需氧菌学研究。有37份临床病历可供查阅。共分离出161株厌氧菌（每位患者3.5株），代表64个种或菌群。最常见的分离菌如下：具核梭杆菌（19株）；口腔 - 颊普雷沃菌属组（13株，其中9株为口腔普雷沃菌）；脆弱拟杆菌属组（11株，其中4株为脆弱拟杆菌）；产色素普雷沃菌属种（17株，其中8株属于中间普雷沃菌 - 变黑普雷沃菌群）；消化链球菌属种（17株，其中9株为微小消化链球菌）；真杆菌属种（7株）；乳杆菌属种（8株）；放线菌属种（7株）；梭菌属种（7株）。19例病例为纯厌氧病因；其中8例由单一微生物引起：具核梭杆菌（5例）；脆弱拟杆菌（2例）；曼氏普雷沃菌（1例）。在45株需氧菌分离株（每位患者1.1株）中，草绿色链球菌最常见（21株），其次是D组非肠球菌性链球菌（4株）。仅分离出9株革兰氏阴性杆菌（6株肠道菌和3株非肠道菌）和1株金黄色葡萄球菌。使用螺旋梯度法检测了64株分离菌对青霉素的敏感性；其中21株（33%）为β - 内酰胺酶阳性（最低抑菌浓度范围为1.1至≥54微克/毫升，而β - 内酰胺酶阴性菌株为≤0.27微克/毫升）。
