小儿急性化脓性扁桃体炎和急性细菌性鼻窦炎的细菌学特点多中心研究

Multicenter study on the bacteriology characteristic of acute suppurative tonsillitis and acute bacterial sinusitis in children

目的探讨小儿急性化脓性扁桃体炎和急性细菌性鼻窦炎的细菌学特点,观察常用抗生素对分离的5种主要致病菌的敏感性。方法在14家研究机构分别用咽拭子采取急性化脓性扁桃体炎患儿扁桃体表面分泌物和在鼻内镜下对急性细菌性鼻窦炎用拭子采样中鼻道分泌物标本,并进行细菌培养、种属鉴定和常用抗生素最低抑菌浓度(MIC)测定。结果共计入组研究273例中,142例(53.2%)至少分离出一种菌株感染,其中扁桃体炎组136例中(47.1%)至少分离出一种菌株,主要为金黄色葡萄球菌、肺炎链球菌;鼻窦炎152例中78例(56.9%)至少有一种菌株感染,主要为流感嗜血杆菌、肺炎链球菌、卡他莫拉菌。在所有测定药物中(头孢妥仑、头孢克洛、头孢克肟、头孢地尼、头孢曲松、阿莫西林/克拉维酸、阿奇霉素、青霉素、苯唑西林和氨苄西林),头孢妥仑对5种主要致病菌的90%抑菌浓度(MIC90)和50%抑菌浓度(MIC50)均处于最低或次低水平,尤其是对肺炎链球菌。结论小儿急性化脓性扁桃体炎和急性细菌性鼻窦炎的细菌学特点不同。头孢妥仑匹酯对分离的5种主要致病菌最敏感。

ObjectiveTo investigate the bacteriology characteristics of acute suppurative tonsillitis and acute bacterial sinusitis in children.Method In 14 institutions pharyngeal and nasal swab- based samples of secretions in children with acute suppurative tonsillitis for acute bacterial were obtained and bacteria culture, species identification and the commonly-used MIC determination for antibiotics were conducted.Result A total of 273 cases of children were recruited in the study. 142 cases (53.2%) were isolated at least one bacteria strain. 136 tonsillitis group staphylococcus aureus and streptococcus pneumoniae were predominant. 152 patients with sinusitis, haemophilus influenzae and streptococcus pneumoniae were predominant bacteria. In the determination of all drugs, MIC90 and/or MIC50 of cephalosporins shimron for five pathogenic bacteria were at the low level, especially for streptococcus pneumoniae. ConclusionThere are some different characteristics of bacteriology in acute suppurative tonsillitis and acute bacterial sinusitis. Cephalosporins shimron is most effective for the separated 5 pathogenic bacteria.