Brook I
Department of Pediatrics, Georgetown University School of Medicine, Washington, DC, USA.
Arch Otolaryngol Head Neck Surg. 1998 Jan;124(1):35-8. doi: 10.1001/archotol.124.1.35.
To assess the bacteriology of nosocomial sinusitis in mechanically ventilated children.
Retrospective review of sinus aspirate specimens obtained from 20 children with nosocomial sinusitis. The specimens were processed for aerobic and anaerobic bacteria.
A total of 58 isolates (2.9 per specimen), 30 aerobic or facultative (1.5 per specimen) and 28 anaerobic (1.4 per specimen), were recovered. Aerobes only were present in 8 patients (40%), anaerobes only in 5 (25%), and mixed aerobic and anaerobic flora in 7 (35%). The predominant aerobes were Pseudomonas aeruginosa (6 isolates), Staphylococcus aureus (5 isolates), Escherichia coli (3 isolates), and Klebsiella pneumoniae (3 isolates). The predominant anaerobes were Peptostreptococcus species (8 isolates), Prevotella species (6 isolates), and Fusobacterium species (4 isolates). Forty-one beta-lactamase bacteria were recovered from 14 specimens (70%). Thirty isolates similar to the sinus isolates were also recovered from the trachea, 6 from blood culture specimens, and 6 from other sites. Anaerobes were more commonly isolated from sinus aspirate samples obtained after 18 days of mechanical ventilation (21 vs 7, P<.05 by chi2).
This study demonstrates the polymicrobial aerobic-anaerobic flora of nosocomial sinusitis in mechanically ventilated children.
评估机械通气儿童医院获得性鼻窦炎的细菌学情况。
回顾性分析从20例医院获得性鼻窦炎患儿获取的鼻窦抽吸物标本。对标本进行需氧菌和厌氧菌处理。
共分离出58株菌（每个标本2.9株），其中30株需氧菌或兼性厌氧菌（每个标本1.5株），28株厌氧菌（每个标本1.4株）。仅需氧菌存在于8例患者（40%）中，仅厌氧菌存在于5例（25%）中，需氧菌和厌氧菌混合菌群存在于7例（35%）中。主要的需氧菌为铜绿假单胞菌（6株）、金黄色葡萄球菌（5株）、大肠埃希菌（3株）和肺炎克雷伯菌（3株）。主要的厌氧菌为消化链球菌属（8株）、普雷沃菌属（6株）和梭杆菌属（4株）。从14个标本（70%）中分离出41株β-内酰胺酶细菌。还从气管中分离出30株与鼻窦分离株相似的菌株，从血培养标本中分离出6株，从其他部位分离出6株。厌氧菌更常见于机械通气18天后获得的鼻窦抽吸样本中（21株对7株，χ²检验P<0.05）。
本研究证实了机械通气儿童医院获得性鼻窦炎的需氧菌-厌氧菌混合菌群情况。
