小儿化脓性中耳炎的病原学调查

A Survey of Etiology of Suppurative Otitis Media in Children

目的 调查小儿化脓性中耳炎的主要病原菌及其对抗生素的耐药情况。方法 对 5 2例化脓性中耳炎患儿的中耳分泌物进行细菌培养 ,每份标本分别用 5 %～ 7%羊血平板和自制改良巧克力平板分离 ,置烛缸培养。对获得的病原菌用K -B纸片琼脂扩散法行药物敏感试验。结果 分离出 46株致病菌 ,嗜血杆菌 (15株 )和金黄色葡萄球菌为主 ,嗜血杆菌对青霉素和复方新诺明的耐药率分别为 83.3%和 40 % ,以金黄色葡萄球菌为主的临床常见菌对氨苄青霉素和氧哌嗪青霉素的耐药率分别为 95 .5 %和 5 4.2 %。结论 嗜血杆菌和金黄色葡萄球菌是本地区小儿化脓性中耳炎的主要致病菌 ,两者对青霉素类抗生素的耐药率皆较高。

Objective For better understanding the main pathogen of suppurative otitis media in children and the condition of antibiotics resistance.Methods Secretion from otitis media were cultlured,and all separated by using 5%～7% sheep blood plate and self-made improved chocloated plate.Put them in candle vat for calture.Drug sensitive test by K-B disk agar diffusion method were done.Result Fourty-six strains of pathogens were isolated from middle ear secretion.The main pathogens were the haemophilus and aureus staphylococus,15 (32.6%) and 13 (28.2%) strains respectively.Among haemophilus 7 (46.7%) were haemophilus influenzae,8 (53.3%) haemophilus para-influenzae.The resistance rate for Penicillin and SMZco were 83.3% and 40% respectively.The resistance rate of aureus staphylococus for Ampicillin and Piperacillin were 95.5% and 54.2%.Conclusion haemophilus and aureus staphylococus are the main pathogen of suppurative otitis media in children.The resistance rate for Penicillin is high.To prevent the production of the resisting strain,clinicians need depend on the secretion culture and drug sensitive test for treatment but not only on the experience.