Maeda K, Sawaki M, Kita E, Mikasa K, Konishi M, Sakamoto M, Tsujimoto M, Takeuchi S, Hamada K, Kunimatsu M
Second Department of Internal Medicine, Nara Medical University.
Kansenshogaku Zasshi. 1994 Apr;68(4):479-85. doi: 10.11150/kansenshogakuzasshi1970.68.479.
We performed a clinical study of 16 cases (18 episodes) of Pseudomonas pneumonia by transtracheal aspiration (TTA) from April 1983 to March 1993. The isolation rate of Pseudomonas aeruginosa (P. aeruginosa) among 235 episodes of pneumonias with positive microorganism by TTA was 7.7%. All patients had one or more underlying disease. The most frequent underlying disease was chronic lower respiratory tract infection, followed by lung epidermoid cell carcinoma. More than half of the cases had been given antibiotics prior to the occurrence of pneumonia, and administration of adrenal corticosteroid, heavy smoking habit, and aspiration were seen as other predisposing factors concerning the onset of pneumonias. Monomicrobial infection of P. aeruginosa was 61.1%, and polymicrobial infection containing P. aeruginosa was 38.9%. Community-acquired pneumonia was 61.1% and hospital-acquired pneumonia was 38.9%; the rates of polymicrobial infections and prior administration of antibiotics were higher in the latter group. Mortality due to Pseudomonas pneumonia was 27.8% and the levels of serum albumin and total protein at the onset of pneumonia were significantly lower in the fatal cases than in the recovered cases. It was considered that not only general underlying disease which weaken the immunological resistance of the host, but local bronchial lesion was also important to the onset of the Pseudomonas pneumonia. Also, nutrition is an important prognostic factor on the host's side.
1983年4月至1993年3月，我们通过经气管吸引术（TTA）对16例（18次发作）铜绿假单胞菌肺炎患者进行了临床研究。在235次经TTA检测出微生物阳性的肺炎发作中，铜绿假单胞菌（P. aeruginosa）的分离率为7.7%。所有患者均有一种或多种基础疾病。最常见的基础疾病是慢性下呼吸道感染，其次是肺表皮样细胞癌。超过半数的病例在肺炎发生前已使用过抗生素，使用肾上腺皮质激素、重度吸烟习惯和误吸被视为与肺炎发病相关的其他易感因素。铜绿假单胞菌单一微生物感染占61.1%，包含铜绿假单胞菌的多微生物感染占38.9%；社区获得性肺炎占61.1%，医院获得性肺炎占38.9%；后一组的多微生物感染率和先前使用抗生素的比例更高。铜绿假单胞菌肺炎导致的死亡率为27.8%，肺炎发作时死亡病例的血清白蛋白和总蛋白水平显著低于康复病例。据认为，不仅削弱宿主免疫抵抗力的一般基础疾病，局部支气管病变对铜绿假单胞菌肺炎的发病也很重要。此外，营养是宿主方面的一个重要预后因素。
