Jaffar-Bandjee M C, Lazdunski A, Bally M, Carrère J, Chazalette J P, Galabert C
CERM, Hôpital Renée Sabran, Giens, Hyères, France.
J Clin Microbiol. 1995 Apr;33(4):924-9. doi: 10.1128/jcm.33.4.924-929.1995.
Secretion of Pseudomonas aeruginosa elastase, exotoxin A, and alkaline protease in sputum during bronchopulmonary exacerbations was examined in 18 cystic fibrosis patients chronically infected with this microorganism. The patients were studied during one or several exacerbation periods necessitating hospitalizations of 12 to 20 days. In all cases, P. aeruginosa was present in bronchial secretions at admission and was not eradicated after treatment. The P. aeruginosa density decreased significantly after antibiotic therapy but remained greater than 10(6) CFU/g of sputum in most cases. Significant amounts of P. aeruginosa exoproteins were measured in total homogenized bronchial secretions by immunoenzymatic assays. The detection of higher levels of exoproteins at admission, the significant decrease after treatment, and the absence of exoproteins during intercrisis phases constituted arguments for a renewal of virulence of P. aeruginosa during exacerbations. Nevertheless, the concomitant changes in bacteria load and the triggering of the inflammatory process and immune complex formation could also contribute to pulmonary exacerbations.
在18例长期感染铜绿假单胞菌的囊性纤维化患者中，检测了支气管肺恶化期间痰液中铜绿假单胞菌弹性蛋白酶、外毒素A和碱性蛋白酶的分泌情况。这些患者在一个或几个恶化期接受了研究，这些恶化期需要住院12至20天。在所有病例中，入院时支气管分泌物中均存在铜绿假单胞菌，治疗后未被根除。抗生素治疗后铜绿假单胞菌密度显著降低，但大多数情况下仍高于10(6) CFU/g痰液。通过免疫酶测定法在总匀浆支气管分泌物中检测到大量铜绿假单胞菌外蛋白。入院时检测到较高水平的外蛋白，治疗后显著降低，且在病情缓解期未检测到外蛋白，这些都支持了铜绿假单胞菌在恶化期间毒力恢复的观点。然而，细菌载量的伴随变化以及炎症过程和免疫复合物形成的触发也可能导致肺部恶化。
