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[厌氧呼吸道感染——获取标本方法的评估]

[Anaerobic respiratory infection--evaluation of methods of obtaining specimens].

作者信息

Yamashita Y, Kohno S, Tanaka K, Iwamoto M, Maesaki S, Hashimoto A, Tomono K, Koga H, Hara K, Sugahara K

机构信息

Second Department of Internal Medicine, Nagasaki University School of Medicine.

出版信息

Kansenshogaku Zasshi. 1994 May;68(5):631-8. doi: 10.11150/kansenshogakuzasshi1970.68.631.

Abstract

Anaerobic cultures were performed on various kinds of specimens obtained from 67 patients with respiratory infections. The infections consisted of 33 cases of pneumonia, 14 cases of lung abscess, 6 cases of pyothorax, 9 cases of chronic lower respiratory tract infection, and 5 cases of infection of pulmonary cyst. Specimens included bronchoscopic specimens obtained using a single tube or protected catheter brush (PCB), transtracheal aspirate, percutaneous lung aspirate, aspirate using a suction tube through the tracheostomy or intubation tube, and pleural fluid. Anaerobes were isolated in 80% of pyothorax, 43% of lung abscess, and 15% of pneumonia (42% of aspiration pneumonia), respectively. Anaerobes isolated frequently in respiratory infections included Prevotella spp., Fusobacterium spp., and Peptostreptococcus spp. In regard to the type of specimen, bronchial aspirate obtained by bronchoscopy was useful in examination of pneumonia, and was useful as percutaneous lung aspirate in examination of lung abscess. But there was discrepancy of culture results between specimens obtained by different methods in the same patient. To confirm anaerobes as pathogens in respiratory infections, it is necessary to select an appropriate method to obtain specimens and to interpret the culture results comprehensively.

摘要

对67例呼吸道感染患者获取的各类标本进行了厌氧菌培养。感染包括33例肺炎、14例肺脓肿、6例脓胸、9例慢性下呼吸道感染和5例肺囊肿感染。标本包括使用单管或保护性导管刷(PCB)获取的支气管镜标本、经气管抽吸物、经皮肺抽吸物、通过气管造口术或插管管用吸管抽吸物以及胸腔积液。厌氧菌分别在80%的脓胸、43%的肺脓肿和15%的肺炎(42%的吸入性肺炎)中分离出来。呼吸道感染中频繁分离出的厌氧菌包括普雷沃菌属、梭杆菌属和消化链球菌属。就标本类型而言,支气管镜检查获取的支气管抽吸物对肺炎检查有用,对肺脓肿检查则作为经皮肺抽吸物有用。但同一患者不同方法获取的标本之间培养结果存在差异。为了在呼吸道感染中确认厌氧菌为病原体,有必要选择合适的标本获取方法并综合解读培养结果。

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