Tano Y, Matsushima T, Kobashi Y, Adachi M, Kimura M, Tanabe J
Second Department of Medicine, Kawasaki Medical School, Kawasaki Hospital, Okayama, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Feb;32(2):146-51.
Throat secretions (TS) and bronchial secretions aspirated from tracheostomy sites (TSTA) from six subjects with long term tracheostomy were simultaneously collected and then cultured every two weeks from January, 1990, to December, 1992. Isolated bacteria were mainly alpha-streptococci (96.2%) and Neisseria (69.6%) in TS, and Pseudomonas aeruginosa (75.7%) in TSTA. In all cases, P. aeruginosa was isolated from and colonization of the lower respiratory tract by this organism was apparent 24.4 months, on average, after tracheostomy. There were ten episodes of respiratory infection in five cases, eight of which occurred after colonization. P. aeruginosa was the causative organism in seven of these episodes. Findings in patients with long term tracheostomy indicated separate colonization of the upper and lower respiratory tracts and that P. aeruginosa colonized the lower respiratory tract. The colonization of the lower respiratory tract by P. aeruginosa would thus appear to be an important factor inducing respiratory infection.
1990年1月至1992年12月期间，对6名长期行气管切开术的患者，同时采集其咽喉分泌物（TS）和气管切开部位吸出的支气管分泌物（TSTA），每两周进行一次培养。TS中分离出的细菌主要为α-链球菌（96.2%）和奈瑟菌（69.6%），TSTA中主要为铜绿假单胞菌（75.7%）。在所有病例中，气管切开术后平均24.4个月从下呼吸道分离出铜绿假单胞菌，且该菌在下呼吸道的定植明显。5例患者发生了10次呼吸道感染，其中8次发生在定植后。这些感染中有7次的致病菌为铜绿假单胞菌。长期气管切开术患者的研究结果表明，上、下呼吸道存在独立定植，且铜绿假单胞菌定植于下呼吸道。因此，铜绿假单胞菌在下呼吸道的定植似乎是诱发呼吸道感染的一个重要因素。
