133例儿童化脓性中耳炎病原菌和药敏分析

Distribution and drug sensitivity of pathogens in 133 children with suppurative otitis media

目的探讨该地区儿童化脓性中耳炎的主要致病菌与耐药情况,指导临床合理用药。方法对133例儿童化脓性中耳炎的耳分泌物进行细菌培养鉴定与药物敏感试验。结果 133例耳脓液标本中共分离出致病菌110株,检出率为98.23%。其中肺炎链球菌56株,金黄色葡萄球菌26株(MRSA 3株),化脓链球菌11株,流感嗜血杆菌4株,其他13株。肺炎链球菌对头孢曲松、头孢噻肟、氯霉素、左氧氟沙星、万古霉素敏感,对克林霉素、四环素、复方磺胺甲噁唑、红霉素耐药。金黄色葡萄球菌中MRSA总检出率11.54%,产β-内酰胺酶总检出率84.61%,化脓链球菌对青霉素、氨苄西林、氨苄西林/舒巴坦、头孢噻肟、万古霉素均高度敏感,对红霉素耐药。结论该地区儿童化脓性中耳炎的主要致病菌是肺炎链球菌、金黄色葡萄球菌及化脓链球菌,临床应根据药敏试验结果合理使用抗菌药物。

Objective To guide proper clinical medication through analysing the main pathogen and the drug resistant situation of suppurative otitis media of the local children.Methods Making the bacterial culture and antibiotic susceptibility tests with the ear secretion collected randomly of 133 children with suppurative otitis media.Results Among the 133 cases,110pathogenic germs were separated totally,as the detectable rate was 98.23%,and Among them,56 streptococcus pneumoniae,26 staphylococcus aureus（3multi-drug resistant to oxacillin）,11 streptococcus pyogenes,4 Haemophilus influenza and 13 others.Streptococcus pneumoniae was susceptible of ceftriaxoneo,cefotaxime,chloramphenicol,levofloxacin,quinupristin/dalfopristin and vancomycin,while was resistant to clindamycin,tetracycline,sulfamethoxazole and erythromycin.11.54% of the total detectable rate of MRSA in Staphylococcus aureus,produce toβ-lactamase detection rate was 84.61%.Streptococcus pyogenes had a high resistance rate to erythrocin,while a low rate to the other antimicrobial.Conclusion The main pathogen of the local children suppurative otitis media are Streptococcus pneumonia,Staphylococcus aureus and Streptococcus pyogenes.The clinicians should use antibiotics reasonably according to the antimicrobial susceptibility results.