Ferrer Marcellés A, Martínez Ojeda E, Falcó Ferrer V, de la Torre Tejedor E, González Fuente T
Servicio de Microbiología y Parasitología, Hospital Vall d'Hebrón, Universidad Autónoma de Barcelona.
An Med Interna. 1997 Nov;14(11):554-8.
We have designed a retrospective study in order to know the clinical significance of the isolation of Moraxella (Branhamella) catarrhalis (MC) in respiratory specimens of adult hospitalized patients.
We performed a Gram stain and culture on blood-agar, MacConkey media and quantitative culture in chocolate-agar to all respiratory samples. In patients with a clinical diagnosis of pneumonia BCYE-alpha was added. During 2 years (1992-1993) MC was isolated in respiratory specimens from 52 patients. We revised the clinical history of all these patients.
MC was isolated in 60 respiratory specimens (sputum and/or tracheobronchial aspirates) from 52 patients. The Gram stain showed gram-negative cocci in 77% and gram-positive cocci in 17% of the cases. MC grew in pure culture in 28 specimens (46.6%). In 23% of cases MC was isolated with Streptococcus pneumoniae and in 21% with Haemophilus influenzae. Fifty-two stocks (86.6%) produced beta-lactamase. Twelve patients had a clinical diagnosis of pneumonia, 8 of them had an underlying chronic respiratory disease. Other 24 patients with an underlying chronic respiratory disease had a bronchial infection as a cause of exacerbation of their respiratory disease. Seven patients without an underlying chronic respiratory disease had a clinical episode of acute bronchitis. Finally, in 9 patients the isolation of MC was considered a colonization.
In 17% cases MC was identified as a gram-positive cocci in the Gram stain, which may cause false diagnosis. The etiological importance of MC in episodes of acute exacerbation of patients with an underlying chronic respiratory disease is high.
我们设计了一项回顾性研究，以了解在成年住院患者的呼吸道标本中分离出卡他莫拉菌（莫拉菌属）（MC）的临床意义。
我们对所有呼吸道样本进行革兰氏染色，并在血琼脂、麦康凯培养基上进行培养，以及在巧克力琼脂上进行定量培养。对于临床诊断为肺炎的患者，添加BCYE-α培养基。在两年（1992 - 1993年）期间，从52例患者的呼吸道标本中分离出了MC。我们查阅了所有这些患者的临床病史。
从52例患者的60份呼吸道标本（痰液和/或气管支气管吸出物）中分离出了MC。革兰氏染色显示，77%的病例为革兰氏阴性球菌，17%为革兰氏阳性球菌。28份标本（46.6%）中MC为纯培养生长。23%的病例中MC与肺炎链球菌一起分离出，21%与流感嗜血杆菌一起分离出。52株菌株（86.6%）产生β-内酰胺酶。12例患者临床诊断为肺炎，其中8例有潜在的慢性呼吸道疾病。另外24例有潜在慢性呼吸道疾病的患者因支气管感染导致其呼吸道疾病加重。7例无潜在慢性呼吸道疾病的患者有急性支气管炎的临床发作。最后，9例患者中MC的分离被认为是定植。
在17%的病例中，MC在革兰氏染色中被鉴定为革兰氏阳性球菌，这可能导致误诊。MC在有潜在慢性呼吸道疾病患者急性加重发作中的病因学重要性较高。
