Konishi M, Sawaki M, Mikasa K, Maeda K, Mori K, Teramoto S, Sakamoto M, Tsujimoto M, Takeuchi S, Hamada K
Second Department of Internal Medicine, Nara Medical University.
Kansenshogaku Zasshi. 1994 Oct;68(10):1264-70. doi: 10.11150/kansenshogakuzasshi1970.68.1264.
We performed transtracheal aspiration (TTA) in 1165 patients, who were suspected to have bronchopulmonary infection, from December 1978 to March 1993. We isolated pathogens from TTA in 806 patients (69.2%). We isolated H. influenzae (62 cases), S. pneumoniae (39 cases) and M. catarrhalis (24 cases) in patients with acute bronchitis, S. pneumoniae (65 cases), alpha-Streptococcus sp. (52 cases), H. influenzae (32 cases) and S. aureus (29 cases) in patients with pneumonia or lung abscess and H. influenzae (174 cases), S. pneumoniae (84 cases), P. aeruginosa (81 cases) and M. catarrhalis (42 cases) in patients with chronic lower respiratory tract infection. Anaerobic bacteria isolated from TTA included Peptostreptococcus sp. (19 cases), Bacteroides sp. (19 cases) and others. Mycoplasma pneumoniae was isolated from TTA in 8 patients with pneumonia without other organisms. Virus isolated from TTA included Rhinovirus (6 cases) and others. These results suggest that various pathogens affect the pathogenesis of bronchopulmonary infection. Therefore, we must diagnose the bronchopulmonary infection by the correct methods such as TTA.
1978年12月至1993年3月期间,我们对1165名疑似支气管肺部感染的患者进行了经气管吸引术(TTA)。我们从806名患者(69.2%)的TTA样本中分离出了病原体。在急性支气管炎患者中,我们分离出了流感嗜血杆菌(62例)、肺炎链球菌(39例)和卡他莫拉菌(24例);在肺炎或肺脓肿患者中,分离出了肺炎链球菌(65例)、α-链球菌属(52例)、流感嗜血杆菌(32例)和金黄色葡萄球菌(29例);在慢性下呼吸道感染患者中,分离出了流感嗜血杆菌(174例)、肺炎链球菌(84例)、铜绿假单胞菌(81例)和卡他莫拉菌(42例)。从TTA样本中分离出的厌氧菌包括消化链球菌属(19例)、拟杆菌属(19例)等。8例肺炎患者的TTA样本中分离出了肺炎支原体,且无其他病原体。从TTA样本中分离出的病毒包括鼻病毒(6例)等。这些结果表明,多种病原体影响支气管肺部感染的发病机制。因此,我们必须通过TTA等正确方法来诊断支气管肺部感染。