呼吸道感染患者的微生态研究

目的：了解健康人群的咽部菌群密集度和多样性，优势菌群的构成，呼吸道感染时咽部菌群变化及抗生素治疗后咽部菌群种类和数量的变化趋势。方法：采集健康人、呼吸道感染未治疗及经5d三代头孢菌素治疗后患者的咽拭标本各30例，进行需氧菌及厌氧菌的分离纯化、染色镜检及定性鉴定。结果：呼吸道感染未治疗组及经抗生素治疗组患者的咽部需氧菌密度与健康组比较差异有显著性（P〈0．05），未治疗组与健康组厌氧菌密度比较差异无显著性（P〉0．05），经抗生素治疗组患者的厌氧菌密度明显高于健康组，差异有显著性（P〈0．01）；经抗生素治疗组患者需氧菌及厌氧菌密度皆增高，同时导致呼吸道感染的致病菌和条件致病菌的检出率明显提高。如大肠杆菌、肺炎克雷伯菌亚种、嗜麦芽窄食单胞菌、鲍曼不动杆菌等细菌。结论：早期呼吸道感染仅是咽部需氧菌菌群的轻度失调和紊乱，厌氧菌菌群基本保持平衡；呼吸道感染患者经5d广谱抗生素治疗后，其咽部需氧菌及厌氧菌菌群的紊乱和失调则较为严重；甚至会选择出引起呼吸道感染的致病菌和条件致病菌。

Study on the Micro-ecology of Patients with Respiratory Tract Infection

Objective： To understand the healthy population of pharyngeal flora density and diversity, dominant microflora composition, respiratory tract infection, pharyngeal microflora changes and after antibiotic therapy in oropharyngeal flora species and the number of change trend. Methods： Nasopharyngeal swab specimens were collected from 30 healthy individuals, 30 eases with respiratory tract infection without treatment and 30 cases after treatment with broad-spectrum antibiotic. Aerobic anaerobic bacteria sep- aration and purification, staining and ATB identification were used. Results： The difference of pharyngeal aerobic bacteria density in respiratory tract infection in untreated and treated patients and healthy group was statistically significant （P 〈 0. 05 ）, and the difference of anaerobic bacteria density between untreated group and healthy group was not significant （ P 〉 0. 05 ）, anaerobic bacteria density in treated group was higher than that in healthy group, there was significant difference （P 〈 0. 01 ）. Anaerobic and aerobic density was increased in treated group, at the same time respiratory tract infection pathogens and opportunistic pathogen detection rate increased obviously, such as Pseudomonas fluorescens and Staphylococcus aureus, Bauman Acinetobacter bacterial. Conclusions： Early respiratory infections are only respiratory pharyngeal aerobic microflora of mild disorders, anaerobic microflora in the basic balance. Respiratory tract infection after 5 days of broad-spectrum antibiotic therapy, the pharyngeal aerobic microflora and anaerobic microflora disorders are relatively serious, even cause respiratory tract infections of conditional pathogenic bacteria.