Ruderman J W, Srugo I, Morgan M A, Vinstein A L, Brunell P A
Division of Neonatalogy, Tarzana Regional Medical Center, University of California, Irvine School of Medicine, Orange.
J Perinatol. 1994 May-Jun;14(3):182-6.
Growth of > or = 10(5) colonies of bacteria per milliliter obtained at bronchoscopy in children and adults correlates with bacterial pneumonia. To determine whether quantitative tracheal aspirate cultures aid in diagnosis of pneumonia in the neonatal intensive care unit setting, tracheal aspirates were obtained from 25 infants who had recently undergone endotracheal intubation; 15 of the infants had suspected pneumonia and 10 control infants had undergone intubation for suspected apnea of prematurity (4 infants) or elective surgery (6 infants). Studies also were performed to detect Mycoplasma, Ureaplasma, viruses, and Pneumocystis. Tracheal aspirates from 2 of 15 infants with suspected pneumonia grew > or = 10(5) bacteria, and 1 was positive for respiratory syncytial virus. These infants were considered to have pneumonia. In 12 infants whose tracheal aspirates grew < 10(5) bacteria, respiratory decompensation later was explained by other causes in 11 infants, and there was one false-negative culture. There were three false-positive tracheal aspirates in the control group. We conclude that tracheal aspirates of infants who have recently had an endotracheal tube placed may be useful for diagnosing pneumonia and for identifying the causative agent.
儿童和成人支气管镜检查时每毫升获得的细菌菌落数≥10⁵与细菌性肺炎相关。为确定定量气管吸出物培养是否有助于新生儿重症监护病房环境下肺炎的诊断，从25名近期接受气管插管的婴儿中获取气管吸出物；其中15名婴儿疑似患有肺炎，10名对照婴儿因疑似早产呼吸暂停（4名婴儿）或择期手术（6名婴儿）接受了插管。还进行了检测支原体、脲原体、病毒和肺孢子菌的研究。15名疑似肺炎婴儿中有2名的气管吸出物培养出≥10⁵细菌，1名呼吸道合胞病毒检测呈阳性。这些婴儿被认为患有肺炎。在12名气管吸出物培养出的细菌数＜10⁵的婴儿中，11名婴儿后来的呼吸失代偿由其他原因解释，有1次培养结果为假阴性。对照组有3次气管吸出物培养结果为假阳性。我们得出结论，近期放置气管插管的婴儿的气管吸出物可能有助于诊断肺炎和识别病原体。
