気管支ファイバースコープによる気道内菌検索ならびに検索上の諸問題に関する研究

気管チューブ挿入時のチューブ汚染について

抄録

We are carrying on the basic and clinical investigations of transbronchial bacteriological culture studies using the flexible fiberoptic bronchoscope.
This time we would like to present some of the results of bacteriological culture studies with some of the asscciated problems through the transtracheal tube method. Sixty point five % of positive bacterial cultures were obtained from a total of 172 cases, consisting of 16 kinds of chest diseases.
In each disease in which we examined more than 10 cases, the higher positive bacterial culterial groups were, lung abscess 100%, chronic bronchitis 82%, tumor of the lung 80% and bronchiectasis 75%; on the other hand, lower positive bacterial culture groups were pulmonary tuberculosis, 16.7% and the cases examined for the purpose of excluding cancer, 33.3%.
Approximately 10 kinds of causative microbials were identified in the both groups. Secretions came from different diseases and different tracheobronchial areas showed their own microorganisms and different positive culture rates.
No microorganisms were cultured from clear serous and white tenaceous secretions, except those located on hyperemic mucosa and with stenotic or ectatic lumens; however, several kinds of microorganisms were cultured from yellowish, brownish and greenish secretions.
In reference to contamination within the lumen of the tracheal tube immediately after intubation, positive bacterial cultures were obtained from the swab-sponges at 12.5%, so the contamination rate of the channel of the fiberoptic bronchoscope caused by passing through the tracheal tube, will be under 12.5%, however comparative bacteriological identification between the secretions from the tracheal tube (sputum) and from the fiberscope channel should be done for diagnostic and therapeutic purpose.
“PRELEVEMENTS BRONCHIQUES AU MOYEN DU FIBROSCOPE: ETUDE BACTERIOLOGIQUE ET PROBLEMES DE CONTAMINATION DES CANULES ENDO-TRACHEALES APRES INTUBATION”
Nous voudrions presenter, dans le cadre d'une étude clinique et bactériologique, les résultats obtenus à partir de prélèvements endoscopiques par bronchofibroscope en essayant d'apprecier l'influence éventuelle du passage du fibroscope dans une canule d'intubation.
Sur un total de 172 prelevements concernant 16 affections broncho-pulmonaires différentes, les cultures furent positives dans 60.5% des cas-Eu ce qui concerne les maladies pour lesquelles plus de 10 cas furent réunis les pourcentages les puls éléves concernaient les abcès du poumon (100%), les bronchites chroniques (82%), les tumeures broncho-pulmonaires (80%) et les bronchectasies (75%); les plus bas: les cas examinés pour la exclusion de cancer (33.3%) et la tuberculose pulmonaire (16.7%).
Environ 10 espèces microbiennes furent identifiées. Suivant la maladie et le territoire concerné par le prélèvement, les souches différaient par le germe en cause et pourcentage de détection.