Brook I, Shah K
Department of Pediatrics, Georgetown University, Washington, DC, USA.
Otolaryngol Head Neck Surg. 1998 Oct;119(4):357-60. doi: 10.1016/S0194-5998(98)70078-6.
The microbiologic features of infected sinus aspirates in nine children with neurologic impairment were studied. Anaerobic bacteria, always mixed with aerobic and facultative bacteria, were isolated in 6 (67%) aspirates and aerobic bacteria only in 3 (33%). There were 24 bacterial isolates, 12 aerobic or facultative and 12 anaerobic. The predominant aerobic isolates were Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus (2 each) and Proteus mirabilis, Pseudomonas aeruginosa, Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae (1 each). The predominant anaerobes were Prevotella sp. (5), Peptostreptococcus sp. (4), Fusobacterium nucleatum (2), and Bacteroides fragilis (1). Beta-lactamase-producing bacteria were isolated from 8 (89%) patients. Organisms similar to those recovered from the sinuses were also isolated from tracheostomy site and gastrostomy wound aspirates in five of seven instances. This study demonstrates the uniqueness of the microbiologic features of sinusitis in neurologically impaired children, in which, in addition to the organisms known to cause infection in children without neurologic impairment, facultative and anaerobic gram-negative organisms that can colonize other body sites are predominant.
对9名神经功能障碍儿童感染性鼻窦抽吸物的微生物学特征进行了研究。在6份（67%）抽吸物中分离出总是与需氧菌和兼性菌混合的厌氧菌，仅在3份（33%）抽吸物中分离出需氧菌。共分离出24株细菌，其中12株为需氧菌或兼性菌，12株为厌氧菌。主要的需氧菌分离株为肺炎克雷伯菌、大肠埃希菌和金黄色葡萄球菌（各2株）以及奇异变形杆菌、铜绿假单胞菌、流感嗜血杆菌、卡他莫拉菌和肺炎链球菌（各1株）。主要的厌氧菌为普雷沃菌属（5株）、消化链球菌属（4株）、具核梭杆菌（2株）和脆弱拟杆菌（1株）。8名（89%）患者分离出产β-内酰胺酶的细菌。在7例中的5例中，从气管造口部位和胃造口伤口抽吸物中也分离出与从鼻窦中分离出的相似的微生物。本研究证明了神经功能障碍儿童鼻窦炎微生物学特征的独特性，其中，除了已知可导致无神经功能障碍儿童感染的微生物外，可在身体其他部位定植的兼性和厌氧革兰氏阴性菌占主导地位。
