下呼吸道感染患者支气管肺泡灌洗液和鼻咽拭子病原菌鉴定的比较研究

Bacteria from bronchoalveolar lavage fluid and nasopharyngeal swab from patients with suspected chronic lower respiratory tract infection

目的:分析疑似慢性下呼吸道感染(LRTI)患者支气管肺泡灌洗液(BALF)和鼻咽拭子(NPS)样本的病原菌的特征。方法:选择2016年4月-2018年4月在延安大学附属医院就诊的206例疑似慢性细菌性LRTI患者,采集检测BALF和NPS,记录相关的临床指标并进行统计分析。结果:分别在疑似慢性LRTI患者的28.9%、49.2%和48.0%的BALF培养基和50.4%、46.7%和57.6%的NPS培养基中检测到肺炎链球菌、流感嗜血杆菌和卡他莫拉菌。BALF和NPS样本中含有肺炎链球菌、流感嗜血杆菌、卡他莫拉菌的一致性分别为24.1%、33.3%和15.5%。结论:疑似慢性LRTI患者的BALF和NPS中检出的主要细菌为肺炎链球菌、流感嗜血杆菌和卡他莫拉菌,但两者一致性较低,表明NPS不能准确鉴定患者的病因。

Objective: To evaluate the pathogenic bacteria from bronchoalveolar lavage fluid(BALF) and nasopharyngeal swab(NPS) samples in patients suspected of chronic bacterial lower respiratory tract infection(LRTI), and to identify the characteristics of major pathogenic bacteria. Methods: 206 patients with suspected chronic bacterial LRTI who were admitted to our hospital from April 2016 to April 2018 were selected. BALF and NPS samples were collected and tested. Relevant clinical indicators were recorded and statistically analyzed. Results: Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis were detected in the BALF samples of 28.9%, 49.2% and 48.0% patients suspected of chronic bacterial LRTI, and in the NPS samples of 50.4%, 46.7% and 57.6%, respectively. The consistency of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis respectively in BALF and NPS samples was 24.1%, 33.3% and 15.5%. Conclusion: Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis are the main bacteria detected in BALF and NPS samples, but the consistency between the two methods is low, which indicates that NPS cannot exactly identify the etiology of suspected chronic bacterial LRTI.