摘要
目的观察慢性阻塞性肺疾病急性加重(AECOPD)患者下呼吸道细菌、真菌和病毒的感染情况。方法对32例AECOPD患者进行诱导痰的细茵、真菌培养,以痰中的下呼吸道病原茵浓度≥10^((7))CFU/ml作为诊断AECOPD病原茵感染的标准;同时应用间接免疫荧光法和细胞培养病毒分离法检测呼吸道常见的7种病毒:甲型流感病毒、乙型流感病毒、副流感病毒Ⅰ型、副流感病毒Ⅱ型、副流感病毒Ⅲ型、呼吸道合胞病毒和腺病毒。结果合格痰标本32份,痰培养检出40株茵,其中22株茵量≥10^((7))CFU/ml,来自16例患者,其中单一茵感染者8例,混合茵感染者8例。G^((+))球菌占22.7%(5株),G球菌占13.6%(3株),G杆菌占50%(11株),其中铜绿假单胞茵分离率最高,占22.7%(5株),真菌占13.7%(3株)。32份痰标本经间接免疫荧光法检测呼吸道7种病毒,全部为阴性。对这32份痰标本进行细胞培养病毒分离,其中1份标本为副流感病毒Ⅲ型阳性,余均为阴性。痰细菌培养阳性率为50.0%,痰病毒检测阳性率为3.1%,细菌和病毒混合感染阳性率为3.1%。结论AECOPD的病原茵以G菌为主,其中铜绿假单胞茵分离率最高。AECOPD的诱导痰病毒检出率较低。
Objective To study the conditions of microbiological infection of lower respiratory tract in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods Thirty two samples of induced sputum were cultured from 32 AECOPD patients. Potential pathogenic bacteria were regarded as significant only if they reached a growth of ≥10^7CFU/ml indicating the presence of bacterial exacerbation of COPD. And such common 7 kinds of viruses as influenza A, influenza B, parainfluenza I, parainfluenza Ⅱ, parainfluenza Ⅲ, respiratory syncytial virus （RSV） and adenovirus were examined at the same time by indirect immtmofluorescence assay and virus isolation from culture. Results A total of 40 trains of bacteria were isolated. The growth of 22 trains from 16 AECOPD patients was more than or equal to 10^7CFU/ml. Mixed infection was identified in 8 AECOPD patients. Single infection was identified in 8 AECOPD patients. Gram-positive cocci occupied 22.7% （5 strains） . Gram-negative cocci occupied 13.6% （3 strains） . Gram-negative rods occupied 50% （11 strains） , with 22.7% （5 strains） of Pseudomonas aeruginosa being the highest. Fungi occupied 13.7% （3 strains） . Among 32 sputum samples none of the 7 kinds of viruses were detected by indirect immunofluorescence assay, in the viral culture undertaken only 1 sample had positive finding for parainfluenza Ⅲ, and the other samples were negative. The positive findings of pathogenic bacteria culture in sputum from AECOPD patients were occupied 50%, and the positive findings of viral culture were 3.1%. Mixed infection of pathogenic bacteria and viruses was 3.1%. Conclusion Gram-negative bacteria are the main pathogenic bacteria for AECOPD, and pseudomonas aeruginosa is the most common. The rate of positive findings for 7 kinds of common viruses in samples of induced sputum is lower.
出处
《中国全科医学》
CAS
CSCD
北大核心
2009年第21期1942-1944,共3页
Chinese General Practice
关键词
肺疾病
慢性阻塞性
病原菌
病毒
Pulmonary disease, chronic obstructive
Pathogenic microorganism
Virus
