Maningo E, Watanakunakorn C
Department of Internal Medicine, St. Elizabeth Hospital Medical Center, Youngstown, Ohio 44501-1790, USA.
J Infect. 1995 Sep;31(2):89-92. doi: 10.1016/s0163-4453(95)91985-6.
Xanthomonas maltophilia and Pseudomonas cepacia are Gram-negative bacilli that are considered to opportunistic pathogens. These bacteria may cause colonization and infection, especially in acutely ill patients. Between 1 July 1990 and 30 June 1992 sputum [correction of suptum] culture results from patients in the critical care units were surveyed daily. During the 2 year period, sputum from 27 patients grew X. maltophilia. It was hospital-acquired in 26 patients. A total of 26 patients were mechanically ventilated for between 1 day and 8 months (median 19 days) before sputum cultures grew X. maltophilia. Various antimicrobial agents were prescribed for 25 of the 27 patients before they acquired X. maltophilia infection. The case fatality was 44.4%. Sputum from 79 patients grew P. cepacia. It was hospital-acquired in all who were ventilated for between 1 day and 50 days (median 9 days) before sputum cultures grew P. cepacia. Several antimicrobial agents were given to 77 patients before P. cepacia was isolated from them. The case fatality rate was 51.9%. In the majority of cases, the positive cultures indicated colonization. Patients with APACHE II scores >15 experienced a higher fatality (55.6% vs. 22.2%, P<0.05 for X. maltophilia and 56.9% vs.28.6%, P<0.05 for P. cepacia).
嗜麦芽窄食单胞菌和洋葱伯克霍尔德菌是革兰氏阴性杆菌，被认为是机会致病菌。这些细菌可能导致定植和感染，尤其是在重症患者中。在1990年7月1日至1992年6月30日期间，对重症监护病房患者的痰培养结果进行了每日调查。在这两年期间，27例患者的痰中培养出嗜麦芽窄食单胞菌。其中26例为医院获得性感染。在痰培养出嗜麦芽窄食单胞菌之前，共有26例患者接受了1天至8个月（中位数19天）的机械通气。在27例患者中，有25例在感染嗜麦芽窄食单胞菌之前使用了各种抗菌药物。病死率为44.4%。79例患者的痰中培养出洋葱伯克霍尔德菌。所有在痰培养出洋葱伯克霍尔德菌之前接受了1天至50天（中位数9天）机械通气的患者均为医院获得性感染。在从77例患者中分离出洋葱伯克霍尔德菌之前，给他们使用了几种抗菌药物。病死率为51.9%。在大多数情况下，阳性培养结果表明为定植。急性生理与慢性健康状况评分系统（APACHE II）评分>15的患者病死率更高（嗜麦芽窄食单胞菌感染患者为55.6%对22.2%，P<0.05；洋葱伯克霍尔德菌感染患者为56.9%对28.6%，P<0.05）。
