151例化脓性中耳炎患者分泌物培养及药敏分析

Secretion culture and drug susceptibility analysis in 151 patients with suppurative otitis media

目的:了解化脓性中耳炎患者耳分泌物病原菌分布及其对抗菌药物的敏感性,为临床正确诊断和针对性治疗提供依据。方法:取151例化脓性中耳炎患者耳分泌物进行培养,并对培养出的病原菌进行鉴定和药敏试验,同时取20份健康人耳分泌物做对照。结果:151例分泌物培养中,病原菌111例,检出率73.5%;共培养出病原菌116株,其中5份标本为两种病原菌混合感染;检出革兰阳性菌52株(44.8%),革兰阴性菌50株(43.1%),真菌14株(12.1%)。主要病原菌为金黄色葡萄球菌47株(40.5%),铜绿假单胞菌26株(22.4%),常见革兰阳性菌、革兰阴性菌对临床常用喹诺酮类药物敏感性大于90%。20份健康人耳分泌物培养出12株表皮葡萄球菌。结论:金黄色葡萄球菌、铜绿假单胞菌是化脓性中耳炎常见病原菌,对临床常用喹诺酮类药物保持高敏感性。常规药物治疗效果不好的患者需注意耐药菌及真菌感染可能,要及时进行病原菌鉴定及药敏。表皮葡萄球菌是耳道正常细菌,不应作为病原菌进行常规治疗。

Objective ：To see the pathogenic bacteria distribution of patients with suppurative otitis media and their sensi- tivity to antimicrobial agents, so as to provide theoretical basis for clinical diagnosis and targeted treatment. Methods ： Ear secre- tions of 151 patients with suppurative otitis media were cultured and etiological identification and susceptibility were conducted on cultured pathogenic bacteria. At the same time, ear secretions of 20 healthy persons were taken as controls. Results ： All 111 cases of pathogenic bacteria were culture from 151 cases of secretion ,with the detection rate of 73% ;116 strains of pathogenic bacteria were cultured out and 5 samples of them were mixed infection of two kinds of pathogenic bacteria;52 strains （44.8%） of gram - positive bacterium,50 strains （43.1%） of gram - negative bacteria and 14 strains （ 12.1% ） of fungus were detec- ted out. The main pathogenic bacteria included 47 strains （40.5%） of staphylococcus aureus,26 strains （22.4%） of seudo- monas aeruginosa. The sensitivity of common gram - positive bacterium, gram - negative bacteria to clinical common carbostyril was over 90%. From ear secretions of 20 healthy persons, 12 strains of staphylococcus epidermidis were cultured out. Conclu- sion：Staphylococcus aureus and pseudomonas aeruginosa are common pathogenic bacteria in suppurative otitis media and they have high sensitivity to clinical commonly used quinolones. Patients who are not sensitive to regular drugs should pay attention to drug- resistant bacteria and fungus infection and conduct pathogenic bacteria identification and drug susceptibility timely. Staphylococcus epidermidis is normal bacteria in the ear and it should not be treated as a pathogen.