CAJ | 학술논문

目的：探讨机械通气患者口腔牙菌斑与呼吸机相关性肺炎(VAP)的关系。方法选择我院重症监护病房行机械通气后并发 VAP 的30例患者，同时取其口腔牙菌斑和肺泡灌洗液进行培养，并进行细菌鉴定和同源性分析。结果30例患者中有22例的牙菌斑能培养出需氧细菌，其中15例的牙菌斑培养出的需氧菌≥2种；17例患者的肺泡灌洗液能培养出需氧细菌。牙菌斑和肺泡灌洗液培养出的革兰阴性菌的比例均高于革兰阳性菌。17个肺泡灌洗液样本中有10个和自身牙菌斑所培养出来的细菌具有高度同源性。结论口腔牙菌斑与 VAP 的发生密切相关，可能是机械通气患者呼吸道病原体的一个重要来源。
목적：탐토궤계통기환자구강아균반여호흡궤상관성폐염(VAP)적관계。방법선택아원중증감호병방행궤계통기후병발 VAP 적30례환자，동시취기구강아균반화폐포관세액진행배양，병진행세균감정화동원성분석。결과30례환자중유22례적아균반능배양출수양세균，기중15례적아균반배양출적수양균≥2충；17례환자적폐포관세액능배양출수양세균。아균반화폐포관세액배양출적혁란음성균적비례균고우혁란양성균。17개폐포관세액양본중유10개화자신아균반소배양출래적세균구유고도동원성。결론구강아균반여 VAP 적발생밀절상관，가능시궤계통기환자호흡도병원체적일개중요래원。
Objective To investigate the relationship of dental plaque and ventilator associated pneumonia (VAP)in patients undergoing mechanical ventilation.Methods A total of 30 patients with VAP who were admitted into the intensive care unit of hospital were selected.Dental plaques and bronchoalveolar lavage fluids (BALF)samples from patients were cultured,the bacteria from the BALF and dental plaques were identified and homology analysis was determined by pulsed-field gel electrophoresis.Results Aerobic bacteria were cultured from 22 dental plaques of 30 patients,including 1 5 patients with equal to or greater than 2 kinds of bacteria;aerobic bacteria were cultured from 1 7 BALF samples.The proportion of gram-negative bacteria was higher than that of gram-positive bacteria isolating from both the dental plaques and BALF samples.Bacteria from 10 BALF samples showed highly homologous with those of dental plaques samples.Conclusion Dental plaques are closely related to VAP and may serve as important reservoir for respiratory pathogens in patients undergoing mechanical ventilation.