Maeda K, Sawaki M, Mikasa K, Konishi M, Teramoto S, Mori K, Sakamoto M, Tsujimoto M, Takeuchi S, Hamada K
Second Department of Internal Medicine, Nara Medical University.
Kansenshogaku Zasshi. 1994 Dec;68(12):1472-8. doi: 10.11150/kansenshogakuzasshi1970.68.1472.
We performed a clinical study of 20 cases (33 episodes) of respiratory infections due to mucoid Pseudomonas aeruginosa by transtracheal aspiration (TTA) in the recent 10 years. There was only one pneumonia without underlying chronic lower respiratory infection (CLRTI) case positive for mucoid P. aeruginosa and others were all CLRTI among 33 TTA trials. In contrast, nonmucoid P. aeruginosa was recovered from 9 cases of respiratory infections without underlying CLRTI among 46 TTA trials. Monomicrobial infection of mucoid P. aeruginosa was 69.7%, and polymicrobial infection containing mucoid P. aeruginosa was 30.3%, and Haemophilus influenzae was the most frequent microorganism recovered with mucoid P. aeruginosa. The recovery rate of mucoid P. aeruginosa among P. aeruginosa-colonized cases was 56.3% in diffuse panbronchiolitis, and that was 42.9% and 40.0% in bronchiectasis and chronic bronchitis, respectively. Mortality due to pneumonia with nonmucoid P. aeruginosa was 46.1%, but there was no fatal pneumonia case with mucoid P. aeruginosa. In CLRTI, laboratory data were not remarkably different between mucoid and non-mocoid P. aeruginosa-colonized cases. Thus, these results suggest that mucoid P. aeruginosa is a more important organism in persistent infections in the lower respiratory tract compared with nonmucoid P. aeruginosa, and further investigations is required on the mechanism and clinical role of this infection.
我们对近10年通过经气管吸引（TTA）确诊的20例（33次发作）黏液型铜绿假单胞菌引起的呼吸道感染进行了一项临床研究。在33次TTA检测中，仅有1例无潜在慢性下呼吸道感染（CLRTI）的肺炎病例黏液型铜绿假单胞菌检测呈阳性，其他均为CLRTI病例。相比之下，在46次TTA检测中，9例无潜在CLRTI的呼吸道感染病例分离出非黏液型铜绿假单胞菌。黏液型铜绿假单胞菌单一微生物感染占69.7%，包含黏液型铜绿假单胞菌的多微生物感染占30.3%，流感嗜血杆菌是与黏液型铜绿假单胞菌共同检出最频繁的微生物。在弥漫性泛细支气管炎中，铜绿假单胞菌定植病例中黏液型铜绿假单胞菌的检出率为56.3%，在支气管扩张症和慢性支气管炎中分别为42.9%和40.0%。非黏液型铜绿假单胞菌所致肺炎的死亡率为46.1%，但黏液型铜绿假单胞菌所致肺炎无致死病例。在CLRTI中，黏液型和非黏液型铜绿假单胞菌定植病例的实验室数据无明显差异。因此，这些结果表明，与非黏液型铜绿假单胞菌相比，黏液型铜绿假单胞菌在持续性下呼吸道感染中是更重要的病原体，需要对这种感染的机制和临床作用进行进一步研究。
