シンポジウム ２ 高齢者の喉頭，下気道の生理と病態 Ｃ． 上気道と下気道における感染のかかわり 高齢者を中心に

Abstract

Causative organisms of lower respiratory tract infections have been changed because of the increase in number of the aged and the resistant strains. In the hospital for aged patients, two major pathogens, Staphylococcus aureus (S. aureus) andPseudomonas aeruginosa (P. aeruginosa) are specially seen in nosocomial pneumonia and bronchitis. In these patients, the two major ones were isolated from the oropharynx. Attachment ability ofBranhamella catarrhalis (B. catarrhalis) to oropharyngeal cells coincided with lower respiratory tract infections by this organism. Adherence of indigenous bacteria of the normal flora was found to be an important ecological determinant in the colonization of specific surfaces in human and their role in resistance to infection have already been emphasized. In healthy aged, their oropharynx is usually colonized with non-pathogenic organisms, but after the suffering from Influenza virus infection, their oropharynx will be sometimes attached by pathogenic bacteria.Oropharyngeal pathogens likeH. influenzae, S. pneumoniae, B. catarrhalis, S. aureus (MRSA) andP. aeruginosawere killed by 100-500 times diluted solution of 7% povidon iodine solution. Mereover the frequency of recurrence of respiratory infections by these bacteria were decreased by gargling of this solution 3-4 times/day.Control or adjustment of these bacteria in upper respiratory tract may become very important in the future.