摘要
目的从基因水平探讨长期住院的老年患者口腔内需氧致病定植细菌与医院获得性肺炎(HAP)病原菌的同源性。方法选择2012年1-12月老年住院患者62例,入组第1天采集患者咽拭子、龈上菌斑标本,收集HAP患者痰标本确定HAP病原菌;采用重复序列聚合酶链反应技术(rep-PCR)对口腔定植菌及HAP病原菌行同源性研究。结果需氧致病菌定植率咽部为56.45%,龈上菌斑为54.39%,其中革兰阴性杆菌占66.26%,革兰阳性球菌占33.74%,分离最多的细菌依次为铜绿假单胞菌、金黄色葡萄球菌、鲍氏不动杆菌;62例患者中49例住院期间发生HAP,发病率为79.03%,28例患者送检标本确定35株HAP病原菌;rep-PCR显示35株HAP病原菌中26株与口腔内定植菌具有100%同源性。结论长期住院的老年患者口腔内需氧致病菌定植率较高,尤其革兰阴性杆菌,分离最多的依次为铜绿假单胞菌、金黄色葡萄球菌、鲍氏不动杆菌;HAP病原菌与口腔定植菌具有较高同源性,口腔定植菌是HAP病原菌重要的贮存库。
OBJECTIVE To study the homology between the aerobic pathogenic bacteria colonized in oral cavity and the pathogens causing hospital-acquired pneumonia from the molecular level.METHODS A total of 62elderly patients who were hospitalized from Jan to Dec 2012were enrolled in the study,then the pharyngeal swab and dental plaque specimens were sampled on the first day of enrollment,the sputum specimens were collected from the patients with hospital-acquired pneumonia so as to determine the pathogens causing the hospital-acquired pneumonia,and the homology between the bacteria colonized in the oral cavity and the pathogens causing hospital-acquired pneumonia was studied with the use of repetitive polymerase-chain-reaction（rep-PCR）.RESULTS The colonization rate of aerobic pathogenic bacteria was 56.45%in the pharyngeal,54.39%in the dental plaque;the gram-negative bacilli accounted for 66.26%,the gram-positive cocci 33.74%;the Pseudomonas aeruginosa,Staphylococcus aureus,and Acinetobacter baumannii were the predominant species of pathogens.The hospital-acquired pneumonia occurred in 49of 62patients during the hospital stay with the incidence rate of 79.03%.Totally 35strains of confirmed pathogens causing the hospital-acquired pneumonia were isolated from the submitted specimens from 28patients.The rep-PCR indicated that 26of 35strains of pathogens causing the hospital-acquired pneumonia had100% homology with the bacteria colonized in the oral cavity.CONCLUSION The colonization rate of the aerobic pathogenic bacteria is high in the oral cavities of the elderly patients who have long-term of hospital stay,the gramnegative bacilli in particularly;the P.aeruginosa,S.aureus,and A.baumannii are dominant among the isolated pathogens.The pathogens causing the hospital-acquired pneumonia have high homology with the bacteria colonized in the oral cavities,which serve as an important reservoir for the pathogens causing the hospital-acquired pneumonia.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第14期3416-3418,共3页
Chinese Journal of Nosocomiology
基金
北京市卫生局青年科学研究基金资助项目(QN2009-005)
北京友谊医院科研启动基金项目(2011-27)
关键词
医院获得性肺炎
口腔
定植
同源性
Hospital-acquired pneumonia
Oral cavity
Colonization
Homology
