婴幼儿泪囊炎致病菌分布和药物敏感性分析

Pathogens distribution and drug sensitivity of infantile dacryocystitis

目的探讨婴幼儿泪囊炎致病菌和耐药性，为临床合理用药提供依据。方法实验研究。2004年8月至2008年8月在沈阳市儿童医院参照《全国临床检验操作规程》的检验程序搜集230例婴幼儿泪囊炎患儿（年龄范围2d至10个月，平均为90d）的挤压泪囊部反流的脓汁标本做细菌培养及药物敏感试验，针对结果分析各年份致病菌菌株的检出率变化，被送检婴幼儿泪囊炎致病菌菌种种类，婴幼儿泪囊炎的主要致病菌，婴幼儿泪囊炎的致病菌平均检出率，大多数致病菌对何种药物敏感，何种药物耐药。结果婴幼儿泪囊炎的致病菌平均检出率为87．0％（200例）。各年份致病菌菌株的检出率变化无明显差异，被送检婴幼儿泪囊炎致病菌菌种种类繁多。革兰阳性球菌构成婴幼儿泪囊炎的主要致病菌，占74．5％（149例），其中凝固酶阴性葡萄球菌占20．5％（41例）。其次是金黄色葡萄球菌占11．0％（22例）；还包含极少见的致病菌菌种。大多数致病菌对妥布霉素、环丙沙星、左氧氟沙星敏感。在革兰阳性球菌中，凝固酶阴性葡萄球菌、金黄色葡萄球菌对妥布霉素、左氧氟沙星最为敏感。革兰阴性杆菌对妥布霉素、氯霉素最为敏感，敏感率均达96．67％（均29例）；对红霉素和青霉素的敏感率最低，耐药率分别达66．67％（20例）和80．00％（24例）。结论凝固酶阴性葡萄球菌已成为婴幼儿泪囊炎的主要致病菌。

Objective To investigate the pathogens and drug tolerance of infantile dacryocystitis in order to provide evidence for clinical drug use. Methods 230 cases of infant dacryocystitis （ aged from 2 to 10 months, average 90 days） were analyzed for bacterial culture and drug sensitivity tests. These tests were performed following National Guide to Clinical Laboratory Procedures. Based on the results, analyzed the difference of pathogens in different year, the pathogens kind of dacryocystitis, main pathogens of infantile dacryocystitis, average isolation rate of pathogens and sensitive or resistance drug for pathogens. Results Average detecting rate was 87. 0% （200 cases）. There is no difference for detecting rate in each year. The pathogens were predominantly gram-positive coccus 74.5% （149 cases）, coagulase-negative staphylococcus 20.5% （41 cases） and staphylococcus aureus 11.0% （22 eases）. Majority of these bacteria were sensitive to tobramycin, ciprofloxacin and levofloxacin. Gram-positive coccus was sensitive to tobramycin and levofloxacin. For gram-negative rod, tobramycin and chloromycetin were most sensitive drug. The sensitivity rates were 96. 67% （29 cases）. The resistant rates to erythromycin and penicillin were 66.67% （20 cases） and 80. 00% （24 cases ）. Conclusion Coagulase-negative staphylococcus was the main pathogen of infantile dacryocystitis.