Transtracheal Aspiration Bacteriological Studies of Elderly Pneumonia Cases

To evaluate the causative organisms of pneumonia in the elderly, we studied the organisms in aspirates obtained by transtracheal aspiration (TTA) in 120 pneumonia cases. The transtracheal aspirates were bacteriologically positive in 105 cases (88%). Comparing the organisms obtained by TTA with sputu...

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Published inNihon Kyōbu Shikkan Gakkai zasshi Vol. 26; no. 11; pp. 1170 - 1176
Main Authors Kato, Masahito, Yamamoto, Kazuhide, Takeuchi, Toshihiko, Adachi, Satoru, Suzuki, Kanzo, Yamamoto, Toshiyuki, Ariga, Kenji
Format Journal Article
LanguageJapanese
Published Japan The Japanese Respiratory Society 01.11.1988
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ISSN0301-1542
1883-471X
DOI10.11389/jjrs1963.26.11_1170

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Abstract To evaluate the causative organisms of pneumonia in the elderly, we studied the organisms in aspirates obtained by transtracheal aspiration (TTA) in 120 pneumonia cases. The transtracheal aspirates were bacteriologically positive in 105 cases (88%). Comparing the organisms obtained by TTA with sputum from another 73 cases with pneumonia, S. pneumoniae, H. influenzae and K. pneumoniae were detected more in TTA than in sputum. Comparing the species isolated from TTA according to the situation of onset, S. aureus (31%), P. aeruginosa (31%), and K. pneumoniae (21%) were recovered in 61 nosocomial pneumonia case and S. pneumoniae (29%), and H. influenzae (15%) were recovered in pneumonia occurring in nursing homes. From the detection of normal flora in the oral cavity from TTA, we suspect that these were responsible for some participation in aspiration pneumonia in the elderly. Concerning the relationship between the Gram stain interpretation and recovered organisms on the plate from TTA, gram-positive cocci and gram-negative rods corresponded to the Gram stain interpretation in more than 85%. From these results we realize that TTA is a useful method obtain the causative organisms of pneumonia in the elderly, and Gram's stain is a useful technique for deciding on the initiation of antibiotic therapy.
AbstractList To evaluate the causative organisms of pneumonia in the elderly, we studied the organisms in aspirates obtained by transtracheal aspiration (TTA) in 120 pneumonia cases. The transtracheal aspirates were bacteriologically positive in 105 cases (88%). Comparing the organisms obtained by TTA with sputum from another 73 cases with pneumonia, S. pneumoniae, H. influenzae and K. pneumoniae were detected more in TTA than in sputum. Comparing the species isolated from TTA according to the situation of onset, S. aureus (31%), P. aeruginosa (31%), and K. pneumoniae (21%) were recovered in 61 nosocomial pneumonia case and S. pneumoniae (29%), and H. influenzae (15%) were recovered in pneumonia occurring in nursing homes. From the detection of normal flora in the oral cavity from TTA, we suspect that these were responsible for some participation in aspiration pneumonia in the elderly. Concerning the relationship between the Gram stain interpretation and recovered organisms on the plate from TTA, gram-positive cocci and gram-negative rods corresponded to the Gram stain interpretation in more than 85%. From these results we realize that TTA is a useful method obtain the causative organisms of pneumonia in the elderly, and Gram's stain is a useful technique for deciding on the initiation of antibiotic therapy.
Author Kato, Masahito
Suzuki, Kanzo
Yamamoto, Toshiyuki
Adachi, Satoru
Ariga, Kenji
Takeuchi, Toshihiko
Yamamoto, Kazuhide
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  fullname: Adachi, Satoru
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  fullname: Suzuki, Kanzo
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  fullname: Ariga, Kenji
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References 1) 谷本普一, 岡野弘: 呼吸器感染症における問題点 ―経気管吸引法を中心に―. 臨床と細菌, 2: 289, 1975.
12) 谷本普一, 蝶名林直彦, 鈴木幹三, 中田紘一郎, 岡野弘: 肺炎. 内科, 47: 191, 1981.
8) Pecora, D. V. & Brook, R.: A method of securing uncontaminated tracheal secretions for bacterial examination. J. Thoracic. Surg., 37: 653, 1959.
13) Kalinske, R. W., Parker, R. H., Brandt, D. & Hoeprich, P. D.: Diagnostic usefulness and safety of transtracheal aspiration N. Engl. J. Med., 276: 604, 1967.
19) 谷本普一: 気道菌叢, 成人 ―経気管吸引法による呼吸器疾患の常在菌叢の検討―. 感染症誌, 56: 515, 1982.
10) Davidson, M., Tempest, B. & Palmer, D. L.: Bacteriologic diagnosis of acute pneumonia. Comparison of sputum, transtracheal aspirates, and lung aspirates. J. A. M. A., 235: 158, 1976.
14) 木田厚瑞: 老年者の肺炎. Indications in Antibiotic Therapy, 1: 3, 1986.
6) 鈴木幹三, 岸本明比古, 山本俊幸, 滝沢正子, 山本素子, 吉友和夫, 加藤錠一, 加藤政仁, 武内俊彦: 高齢者咽頭菌叢に関する研究. 感染症学雑誌, 58: 304, 1984.
20) Spencer, C. D. & Beaty, H. N.: Complications of transtracheal aspiration. N. Engl. J. Med., 286: 304, 1972.
7) Valenti, W. M., Trudell, R. G., Bentley, D. W.: Factors predisposing to oropharyngeal colonization with gram negative bacilli in the aged. N. Engl. J. Med., 298: 1108, 1978.
16) 鈴木幹三, 山本和英, 足立暁, 山本俊幸: 吸収遅延性肺炎. 化学療法の領域, 3: 194, 1987.
11) Editorail: Transtracheal aspiration. Lancet, I: 1151, 1974.
15) 浦山京子, 島田馨: 高齢者の肺感染症診断. 現代医療, 15: 1661, 1983.
18) 岡野弘, 荒井信吾, 蒲田英明, 谷本普一, 広森すみ子: 経皮的気管内吸引法に基づき呼吸器感染症患者から分離される細菌の由来部位に関する数量的評価の試み. 日胸疾会誌, 15: 634, 1977.
3) 永坂博彦, 加藤政仁, 菅栄, 南条邦夫, 森幸三, 加藤錠一, 北浦三郎, 宮治真, 山本俊幸, 武内俊彦, 新美達司, 中野小枝子, 前田甲子郎: 高齢者肺炎の臨床病理学的検討. 日胸, 40: 603, 1981.
5) 山本俊幸, 鈴木幹三: 高齢者の呼吸器感染症. カレントテラピー, 4: 181, 1986.
2) 小酒井望, 阿部裕, 林康之, 古川俊之: 微生物検査. 臨床検査術全書, 7, 1979, p. 161.
4) 鈴木幹三, 岸本明比古, 山本俊幸, 足立暁, 山本和英, 白井智之: 高齢者肺炎の臨床病理学的研究. 日胸疾会誌, 24: 1078, 1986.
9) 沢木政好, 三上理一郎, 国松幹和, 三笠桂一, 成田亘啓, 播金収: 慢性下気道感染症における細菌感染の実態 ―経時的経気管吸引法 (TTA) 施行例の検討から―. 感染症誌, 59: 389, 1985.
17) 小栗豊子: 感染症の迅速診断, 検体からの直接検出法, グラム染色の重要性. Medicament News, 1179: 14, 1987.
References_xml – reference: 13) Kalinske, R. W., Parker, R. H., Brandt, D. & Hoeprich, P. D.: Diagnostic usefulness and safety of transtracheal aspiration N. Engl. J. Med., 276: 604, 1967.
– reference: 3) 永坂博彦, 加藤政仁, 菅栄, 南条邦夫, 森幸三, 加藤錠一, 北浦三郎, 宮治真, 山本俊幸, 武内俊彦, 新美達司, 中野小枝子, 前田甲子郎: 高齢者肺炎の臨床病理学的検討. 日胸, 40: 603, 1981.
– reference: 19) 谷本普一: 気道菌叢, 成人 ―経気管吸引法による呼吸器疾患の常在菌叢の検討―. 感染症誌, 56: 515, 1982.
– reference: 20) Spencer, C. D. & Beaty, H. N.: Complications of transtracheal aspiration. N. Engl. J. Med., 286: 304, 1972.
– reference: 11) Editorail: Transtracheal aspiration. Lancet, I: 1151, 1974.
– reference: 4) 鈴木幹三, 岸本明比古, 山本俊幸, 足立暁, 山本和英, 白井智之: 高齢者肺炎の臨床病理学的研究. 日胸疾会誌, 24: 1078, 1986.
– reference: 18) 岡野弘, 荒井信吾, 蒲田英明, 谷本普一, 広森すみ子: 経皮的気管内吸引法に基づき呼吸器感染症患者から分離される細菌の由来部位に関する数量的評価の試み. 日胸疾会誌, 15: 634, 1977.
– reference: 7) Valenti, W. M., Trudell, R. G., Bentley, D. W.: Factors predisposing to oropharyngeal colonization with gram negative bacilli in the aged. N. Engl. J. Med., 298: 1108, 1978.
– reference: 17) 小栗豊子: 感染症の迅速診断, 検体からの直接検出法, グラム染色の重要性. Medicament News, 1179: 14, 1987.
– reference: 10) Davidson, M., Tempest, B. & Palmer, D. L.: Bacteriologic diagnosis of acute pneumonia. Comparison of sputum, transtracheal aspirates, and lung aspirates. J. A. M. A., 235: 158, 1976.
– reference: 5) 山本俊幸, 鈴木幹三: 高齢者の呼吸器感染症. カレントテラピー, 4: 181, 1986.
– reference: 1) 谷本普一, 岡野弘: 呼吸器感染症における問題点 ―経気管吸引法を中心に―. 臨床と細菌, 2: 289, 1975.
– reference: 2) 小酒井望, 阿部裕, 林康之, 古川俊之: 微生物検査. 臨床検査術全書, 7, 1979, p. 161.
– reference: 12) 谷本普一, 蝶名林直彦, 鈴木幹三, 中田紘一郎, 岡野弘: 肺炎. 内科, 47: 191, 1981.
– reference: 15) 浦山京子, 島田馨: 高齢者の肺感染症診断. 現代医療, 15: 1661, 1983.
– reference: 14) 木田厚瑞: 老年者の肺炎. Indications in Antibiotic Therapy, 1: 3, 1986.
– reference: 16) 鈴木幹三, 山本和英, 足立暁, 山本俊幸: 吸収遅延性肺炎. 化学療法の領域, 3: 194, 1987.
– reference: 8) Pecora, D. V. & Brook, R.: A method of securing uncontaminated tracheal secretions for bacterial examination. J. Thoracic. Surg., 37: 653, 1959.
– reference: 9) 沢木政好, 三上理一郎, 国松幹和, 三笠桂一, 成田亘啓, 播金収: 慢性下気道感染症における細菌感染の実態 ―経時的経気管吸引法 (TTA) 施行例の検討から―. 感染症誌, 59: 389, 1985.
– reference: 6) 鈴木幹三, 岸本明比古, 山本俊幸, 滝沢正子, 山本素子, 吉友和夫, 加藤錠一, 加藤政仁, 武内俊彦: 高齢者咽頭菌叢に関する研究. 感染症学雑誌, 58: 304, 1984.
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Snippet To evaluate the causative organisms of pneumonia in the elderly, we studied the organisms in aspirates obtained by transtracheal aspiration (TTA) in 120...
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SubjectTerms Aged
Aged, 80 and over
Bacteria - isolation & purification
Elderly subjects
Female
Gram's stain
Humans
Male
Pneumonia
Pneumonia - microbiology
Sputum - microbiology
Suction - methods
Transtracheal aspiration (TTA)
Title Transtracheal Aspiration Bacteriological Studies of Elderly Pneumonia Cases
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