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August 1978

Pharyngeal Colonization by Gram-Negative Bacilli in Aspiration-Prone Persons

Author Affiliations

From the Medical Service, Dallas Veterans Administration Hospital (Drs Mackowiak, Jones, and Smith, and Mr Martin), and the Department of Internal Medicine, Southwestern Medical School, University of Texas Health Science Center, Dallas (Drs Mackowiak, Jones, and Smith). Dr Jones is now with the Veterans Administration Hospital, Portland, Ore.

Arch Intern Med. 1978;138(8):1224-1227. doi:10.1001/archinte.1978.03630330024009

We compared the prevalence of Gram-negative bacilli in the pharyngeal flora of two groups of patients with a known predilection for Gram-negative bacillary pneumonia (chronic alcoholics and diabetics), two other groups of aspiration-prone persons with no known predilection for Gram-negative bacillary pneumonia (epileptics and narcotic addicts), and normal control subjects. Quantitative cultures of saline gargles showed pharyngeal Gram-negative bacilli to be significantly (P <.05) more prevalent among alcoholics (35%) and diabetics (36%) but not epileptics (17%) or addicts (20%) than controls (18%). Counts of 100 Gram-negative bacilli per milliliter were also significantly more common in alcoholics (14%) and diabetics (24%) than controls (5%, P <.05). Enterobacter sp, Klebsiella pneumoniae, and Escherichia coli were the most common Gram-negative bacilli isolated. Increased colonization by Gram-negative bacilli might be a factor contributing to the propensity of alcoholics and diabetics for Gram-negative pneumonia.

(Arch Intern Med 138:1224-1227, 1978)