Brown O E, Manning S C
Department of Otolaryngology, UT Southwestern Medical Center at Dallas 75235-9035, USA.
Int J Pediatr Otorhinolaryngol. 1996 Apr;35(2):97-105. doi: 10.1016/0165-5876(95)01290-7.
Infection of the intubated subglottis is felt to be one of the many factors involved in the pathogenesis of acquired cicatricial subglottic stenosis. The precise role of infection is unclear and the microbial flora has not been established. An analysis of subglottic culture material, from 22 intubated pediatric patients undergoing tracheotomy, has been performed to establish the nature of the subglottic microbial flora. Fifty-nine isolates were found, including 19 types of organisms. The number of isolates per patient ranged from one to eight, with an average of 2.7 isolates per patient. The most common isolates in the 22 patients were alpha-hemolytic Streptococcus viridans (17 isolates-77%), Neisseria sp. (6 isolates-27%), Pseudomonas sp. (5 isolates-22%), and coagulase negative Staphylococcus sp. (5 isolates-22%). This data indicates that colonization of the subglottis in intubated pediatric patients is polymicrobial in nature. alpha-Hemolytic Streptococcus viridans and Neisseria sp. were most common, with a shift in cultured flora towards Pseudomonas sp. in patients intubated for more than 10 days. In view of this, antimicrobial therapy may be of benefit in preventing acquired cicatricial subglottic stenosis.
气管插管患者声门下感染被认为是获得性瘢痕性声门下狭窄发病机制中的众多因素之一。感染的确切作用尚不清楚，微生物菌群也未明确。对22例接受气管切开术的插管儿科患者的声门下培养材料进行了分析，以确定声门下微生物菌群的性质。共发现59株分离菌，包括19种微生物。每位患者的分离菌数量从1株到8株不等，平均每位患者2.7株。22例患者中最常见的分离菌是草绿色溶血性链球菌（17株，占77%）、奈瑟菌属（6株，占27%）、假单胞菌属（5株，占22%）和凝固酶阴性葡萄球菌属（5株，占22%）。该数据表明，插管儿科患者声门下定植本质上是多微生物的。草绿色溶血性链球菌和奈瑟菌属最为常见，插管超过10天的患者培养菌群向假单胞菌属转变。鉴于此，抗菌治疗可能有助于预防获得性瘢痕性声门下狭窄。
