鼻内镜下直接采取上颌窦内分泌物的细菌学及药敏分析

Bacteriological Study and Susceptibility Test Analysis of the Abscess in Maxillary Sinus Directly through Nasal Endoscopic Surgery

目的研究慢性上颌窦炎的细菌分布及药物敏感性,指导临床治疗。方法术中采集68例慢性上颌窦炎患者鼻窦内的分泌物进行需氧菌培养并进行药敏试验。结果 68例中46例培养出11种计51株细菌,以表皮葡萄球菌、金黄色葡萄球菌、肺炎链球菌、流感嗜血杆菌的比例为高,对亚氨培南、阿莫西林克拉维酸钾、头孢曲松敏感性较高,以庆大霉素、链霉素、四环素耐药株菌最高。结论慢性上颌窦炎耐药菌株现象严重,选用抗生素应以药敏试验为依据,无条件做药敏试验的应首选阿莫西林克拉维酸钾、头孢曲松等。

Objective To understand the bacterial distribution and susceptibility to antibiotics in maxillary sinus, and to guide the clinical treatment. Methods Sixty-eight cases had been operated by functional endoscopic sinus surgery, and the secretion of maxillary sinus was cultured for bacteriological study and susceptibility test of antibiotics. Results Among 46 of 68 specimens, 51 strains （11 species） of bacterics were detected. The main detected bacterics were staphylococcus epidermidis, staphylococcus aureus, streptococcus pneumoniae, hemophilies influenzae and so on, and that bacterics were hyper-susceptibility for imipenem, amoxicillin and clavulanate potassium, ceftriaxone, the drug-resistant bacterics among the detected bacterics were insensitive to gentamycin, streptomycin and streptomycin. Conclusion The study shows that seriously drug-resistant bacterics were cultured by specimens of chronic maxillary sinusitis, and the antibiotics are used according to the result of bacteria cultures and susceptibility to antibiotics, while moxicillin and clavulanate potassium, ceftriaxone are as the first choice without the result of bacteria cultures and susceptibility to antibiotics.