Matsuura T, Suzuki K, Yamakoshi M, Yamamoto T, Yamamoto T, Yoshitomo K, Tonegawa K, Ariga K, Odawara F
Department of Internal Medicine, Nagoyashi Koseiin Geriatric Hospital.
Kansenshogaku Zasshi. 1997 May;71(5):397-404. doi: 10.11150/kansenshogakuzasshi1970.71.397.
To investigate the significance of oropharyngeal flora and gastric flora in elderly patients receiving nasogastric tube feeding, throat secretions and gastric aspirates were cultured and the pH of the latter was measured. Of 116 bacterial isolates from throat secretions of 27 elderly patients, 30 were beta-streptococci and 28 were Pseudomonas aeruginosa. Bacteria isolated from gastric aspirates numbered 86 and 24 (27.9%) of them were the same species as those found in the throat secretions. Patients with gastric pH were below 3.5 had significantly lower concentrations of gram-negative bacili in gastric aspirates. We also studied oropharyngeal flora in 33 elderly patients who were admitted to Nagoyashi Koseiin Geriatric Hospital. The major bacterial isolates from throat swabs of bedridden patients were gram-negative bacilli and beta-streptococci, especially group B streptococci (GBS). We measured the level of antibody to GBS in these patients. Those from whom GBS were isolated had high titers. These results suggest that in elderly patients receiving enteral nasogastric) tube feeding, large numbers of bacteria colonize the oral cavity and stomach. The measurement of type-specific antibody to GBS may be useful in managing such patients.
为了研究口咽菌群和胃内菌群在接受鼻饲管喂养老年患者中的意义，对咽喉分泌物和胃吸出物进行培养，并测量胃吸出物的pH值。在27例老年患者咽喉分泌物分离出的116株细菌中，30株为β-链球菌，28株为铜绿假单胞菌。从胃吸出物中分离出的细菌有86株，其中24株（27.9%）与在咽喉分泌物中发现的细菌种类相同。胃内pH值低于3.5的患者胃吸出物中革兰氏阴性杆菌浓度显著较低。我们还对入住名古屋市小泉医院老年科的33例老年患者的口咽菌群进行了研究。卧床患者咽喉拭子分离出的主要细菌为革兰氏阴性杆菌和β-链球菌，尤其是B组链球菌（GBS）。我们检测了这些患者血清中抗GBS抗体水平。分离出GBS的患者抗体滴度较高。这些结果提示，在接受肠内（鼻饲）管喂养的老年患者中，大量细菌定殖于口腔和胃内。检测GBS型特异性抗体可能有助于这类患者的管理。
