Tsujimoto M, Sawaki M, Mikasa K, Konishi M, Maeda K, Sakamoto M, Hamada K, Mori K, Teramoto S, Ueda K, Hirai T, Kita E, Narita N
Second Department of Internal Medicine, Nara Medical University.
Kansenshogaku Zasshi. 1996 Sep;70(9):947-54. doi: 10.11150/kansenshogakuzasshi1970.70.947.
We have performed a clinical study on chronic lower respiratory tract infection (CLRTI) with Haemophilus influenzae (H. influenzae) by transtracheal aspiration (TTA) and analyzed clinical factors of the acute exacerbation. In 40 episodes (38 cases) of H. influenzae isolated from CLRTI, monobacterial infection with H. influenzae were 21 episodes and polymicrobial infection were 19 episodes. We classified the disease into acute exacerbated (27 episodes) and stable (13 episodes) phase and the former episodes were divided into bronchitis type (7 episodes) and pneumonia type (20 episodes). Polymicrobial infections were seen more in the pneumonia type (13 episodes) than in the bronchitis type (2 episodes). The principal organism detected with H. influenzae were alpha-Streptococcus and Neisseria sp. in the bronchitis type and S. pneumoniae in the pneumonia type. The acute exacerbated cases were divided into the following 4 patterns; 1. polymicrobial infection with continuous infection of P. aeruginosa, 2. monomicrobial infection after acute upper respiratory tract infection, 3. polymicrobial infection with S. pneumoniae after continuous infection of H. influenzae, 4. bacterial replacement by P. aeruginosa after acute exacerbation. The results of the study suggests that polymicrobial infection is an important chronic lower respiratory tract infection when caused H. influenzae.
我们通过经气管吸引术(TTA)对流感嗜血杆菌(H. influenzae)引起的慢性下呼吸道感染(CLRTI)进行了一项临床研究,并分析了急性加重的临床因素。在从CLRTI分离出的40例(38例患者)流感嗜血杆菌感染病例中,流感嗜血杆菌单一细菌感染为21例,多微生物感染为19例。我们将疾病分为急性加重期(27例)和稳定期(13例),前者又分为支气管炎型(7例)和肺炎型(20例)。多微生物感染在肺炎型(13例)中比在支气管炎型(2例)中更常见。与流感嗜血杆菌共同检测到的主要病原体在支气管炎型中为α-链球菌和奈瑟菌属,在肺炎型中为肺炎链球菌。急性加重病例分为以下4种模式:1. 铜绿假单胞菌持续感染的多微生物感染;2. 急性上呼吸道感染后的单一细菌感染;3. 流感嗜血杆菌持续感染后肺炎链球菌的多微生物感染;4. 急性加重后铜绿假单胞菌的细菌替代。研究结果表明,多微生物感染是流感嗜血杆菌引起的重要慢性下呼吸道感染。