THE PATTERN OF BACTERIAL INFECTION IN BRONCHIAL DISEASES IN AUSTRALIA: A SEROLOGICAL AND BACTERIOLOGICAL SURVEY

Abstract

Specific precipitins to H. influenzæ, pneumococcus, Staph. aureus, Ps. aeruginosa and enterobacteria were assayed in the serum of Sydney patients with chronic respiratory diseases and 134 healthy controls. Hæmophilus precipitins were detected in 5% of the controls, in 66% of 90 chronic bronchitic patients, 37% of 54 patients having chronic bronchitis with asthma, 4% of 115 asthmatics and 66% of 45 subjects with chronic bronchial suppuration. Pneumococcal precipitin was detected in 22%, 55%, 39%, 29% and 35% of the same groups, respectively. Staphylococcal antibody was not detected with any greater frequency in the patient groups than in the control. Precipitins to enterobacteria and pseudomonas were detected rarely, and then only in patients with chronic suppuration who had K. ozænas or the uncommon mucoid pseudomonas in the sputum at the time. Cultures from 1,324 purulent sputum specimens in a routine laboratory over a three‐year period were analysed retrospectively. H. influenzae was isolated from 12·8% and pneumococci, Staph. aureus, pseudomonas and enterobacteria from 4·3%, 2·7%, 9·7% and 15·6%, respectively. The discrepancy between sputum culture results and the serum precipitin survey demonstrated the fallacy of necessarily relying on sputum cultures in the management of bronchial infections in Australia where H. influenzæ and the pneumococcus were virtually the sole pathogens.