慢性鼻-鼻窦炎患儿鼻腔灌洗液病原学检测与分析

Pathogen detection in and analysis of nasal lavage fluid from children with chronic rhinosinusitis

目的慢性鼻-鼻窦炎(CRS)患儿鼻腔灌洗液病原菌构成情况,为CRS的诊治提供依据。方法选取耳鼻咽喉科住院及门诊病例,CRS患儿为观察组,非CRS患儿为对照组。对两组患儿鼻腔灌洗液进行细菌培养和鉴定,对分离的病原菌进行药敏试验。结果住院及门诊病例共计112例,观察组54例,对照组58例。观察组病原菌阳性率为81.48%(44/54),对照组为75.86%(44/58),差异无统计学意义(χ2=1.200,P=0.549>0.05)。观察组患儿共分离病原菌84株,对照组74株,两组患儿分离菌主要为凝固酶阴性葡萄球菌、草绿色链球菌和奈瑟氏球菌。观察组和对照组分别分离革兰阳性菌38株和43株,对青霉素G、左氧氟沙星、阿奇霉素、阿米卡星、头孢他啶、加替沙星、头孢噻肟的耐药率分别为31.58%、28.95%、23.68%、23.68%、21.05%、13.16%、10.53%和16.28%、11.63%、11.63%、6.98%、4.65%和0%;观察组和对照组分别分离革兰阴性菌46株和31株,对青霉素G、左氧氟沙星、阿米卡星、哌拉西林的耐药率分别为34.87%、32.61%、32.61%、30.43%和16.13%、9.68%、3.23%和2.63%。观察组分离菌耐药率高于对照组。结论 CRS患儿与非CRS患儿均以凝固酶阴性葡萄球菌、草绿色链球菌和奈瑟球菌为鼻腔主要固定菌群,CRS患儿鼻腔细菌种类相对更多。

Objective To determine the role of bacteria in chronic rhinosinusitis （CRS） and provide evidence for diagno- sis and treatment of CRS. Methods A total of 112 pediatric inpatients and outpatients were selected： 54 patients with CRS served as the experimental group and 58 patients without CRS served as the control group. Pathogens were detected in nasal lavage fluid from members of both groups and the results were compared. Results There was no significant difference between the two groups in terms of gender or age （P〉0.05）. Nasal lavage fluid from the experimental group tested positive for bacteria at a rate of 81.48% （44/54） and nasal lavage fluid from the control group tested positive for bacteria at a rate of 75.86% （44/58）, but the difference in positivity was not statistically significant （P〉0.05）. There was no statistical difference between the two groups in terms of the distribution of bacteria （P〉0. 05）. Eighty-four strains of pathogens were isolated from the experimental group and 74 strains were isolated from the control group. The main bacteria isolated from both groups were coagulase-negative Staphylococcus spp. , Streptococcus viridans, and Neis- seria spp. , but more species of bacteria were isolated from the experimental group than from the control group. Conclu- sion There was no difference in the rate at which pathogens were isolated from patients with CRS and patients without CRS. The immobile bacteria noted were mainly coagulase-negative Staphylococcus spp. , Streptococcus viridans, and Neisseria spp. There were more species of nasal bacteria in patients with CRS.