桂西北地区小儿急性化脓性中耳炎病原菌分布及耐药性分析

Analysis on the pathogenic bacteria distribution and drug resistance of child acute suppurative otitis media in the northwest of Guangxi

目的:了解桂西北地区小儿急性化脓性中耳炎常见病原菌及其耐药情况,为临床治疗提供依据。方法:回顾性分析我院2005年3月～2010年12月256例小儿急性化脓性中耳炎患者耳脓性分泌物培养和药物敏感试验的结果。结果:262只耳共检出病原菌266株。革兰阳性球菌195株,占73.31%;革兰阴性杆菌64株,占24.06%;真菌7株,占2.63%。革兰阳性球菌对万古霉素尚未发现耐药菌株;对阿奇霉素和苯唑西林具有较高的敏感性;对复方新诺明、利福平和青霉素具有较高的耐药性。革兰阴性杆菌占比率最大的是肺炎克雷伯菌;敏感性较高的抗生素为亚胺培南、氨曲南以及哌拉西林/他唑巴坦。结论:桂西北地区小儿急性化脓性中耳炎常见病原菌为金黄色葡萄球菌、表皮葡萄球菌、溶血葡萄球菌和肺炎克雷伯菌等,治疗应根据药敏试验结果选用敏感性较高的抗生素以保证疗效。

Objective： To understand the pathogenic bacteria distribution and drug resistance of child acute suppurative otitis media in the northwest of Guangxi for a better treatment.Methods： The secretions of 256 samples with chronic suppurative otitis media in Hechi first municipal people＇s hospital from May 2005 to December 2010,which were collected for culture and drug sensitivity test were analyzed retrospectively.Results： 266 pathogenic bacterias were found in 262 ears,gram-positive bacteria was 195（73.31%）,gram-negative bacteria was 64（24.06%） and fungus was 7（2.63%）.Gram-positive bacteria didn＇t resist Vancomycin but resisted Paediatric Compound Sulfamethoxazole Tablets,Rifampicin and Penicillin greaterly.Gram-positive bacteria developed a greater sensitivity to Azithromycin and Oxacillin.Klebsiella pneumonia was the most in gram-negative bacteria.Imipenem,Aztreonam,Piperacillin/Tazobactam Sodium were of greater sensitivity.Conclusion： In child acute suppurative otitis media in the northwest of Guangxi,the vulgar pathogenic bacteria are usually Staphylococcus aureus and staphylococcus epidermidis,staphylococcus haemolyticus,klebsiella pneumonia and so on.According to the results of drug sensitivity test,antibiotics with greater sensitivity are chosen to treat child acute suppurative otitis media to assure the effectiveness of the treatment.