慢性化脓性中耳炎的病原学及耐药状况

Etiology and drug resistance situation of chronic suppurative otitis media

目的:分析慢性化脓性中耳炎的病原学及耐药状况。方法:选取2014年4月至2016年2月收治的慢性化脓性中耳炎患者100例。收集所有患者的耳分泌物行细菌培养与药敏试验,并对致病菌及其药敏结果进行排序。结果:按照占比从高到低的顺序,100例患者致病菌分类如下:铜绿假单胞菌29.00%(29/100)、金黄色葡萄菌24.00%(24/100)、变形杆菌21.00%(21/100)、凝固酶阴性葡萄球菌13.00%(13/100)、肺炎链球菌8.00%(8/100)、混合感染2.00%(2/100)、大肠杆菌1.00%(1/100)、类白喉杆菌1.00%(1/100)、嗜麦芽假单胞菌1.00%(1/100)。其中铜绿假单胞菌的耐药性按照从高到低的顺序分别为头孢替坦、头孢唑啉、头孢曲松、头孢呋辛、环丙沙星、左旋氧氟沙星、庆大霉素、妥布霉素、亚胺培南、丁胺卡那霉素;金黄色葡萄菌的耐药性按照从高到低的顺序分别为氯洁霉素、红霉素、四环素、环丙沙星、庆大霉素、左旋氧氟沙星,对其余4种抗生素的耐药性均为0.00%(0/24)。变形杆菌的耐药性按照从高到低的顺序分别为呋喃妥因、左旋氧氟沙星、环丙沙星、头孢唑啉,对其余6种抗生素的耐药性均为0.00%(0/21)。结论:慢性化脓性中耳炎患者主要病原菌包括铜绿假单胞菌、金黄色葡萄菌、变形杆菌以及凝固酶阴性葡萄球菌等。对上述病原菌进行药敏试验可用于临床指导抗生素的应用。

Objective：To study the etiology and drug resistance situation of chronic suppurative otitis media. Methods ：100 cases of patients with chronic suppurative otitis media in our hospital from April 2014 to February 2016 were chosen. All the ear secretions collected were analyzed by bacterial culture and drug sensitive test, and the pathogenic bacteria and their drug susceptibility results were sorted. Results：According to the proportion order from high to low, bacterial pathogens classification in the 100 cases was as follows： pseudomonas aeruginosa 29.00 % （29/100） , staphylococcus bacteria 24.00 % （24/100）, bacillus proteus 21.00 % （21/100）, coagulase negative staphylococcus 13.00 % （ 13/100）, s. pneumoniae 8.00 % （8/100）, mixed infection 2.00 % （2/100）, escherichia coli 1% （ 1/100）, diphtheroids 1% （1/100） and pseudomonas maltophilia 1% （1/100）. The drug resistance of pseudomonas aeruginosa in the order from high to low respectively was cefotetan, cefazolin, ceftriaxone, cefuroxime, ciprofloxacin, ofloxacin, gentamicin, tobramycin, imipenem and amikacin. The drug resistance of staphylococcus bacteria in the order from high to low respectively was chlorine lincomycin, erythromycin, tetracycline, ciprofloxacin, gentamycin and ofloxacin, and the antibiotic resistance of the other four kinds was 0.00 % （0/24）. Proteus resistance in the order from high to low respectively were nitrofurantoin, ofloxacin, ciprofloxacin, cefazolin, and the antibiotic resistance of the left 6 kinds was 0.00 % （0/21 ）. Conclusion ： The main pathogens of chronic suppurative otitis media patients include pseudomonas aeruginosa, staphylococcus bacteria, bacillus proteus and coagulase negative staphylococcus, etc. The drug sensitive test on the above pathogenic bacteria can be used to guide clinical application of antibiotics.