49例培养阳性的慢性鼻窦炎分泌物细菌分布及药物敏感性分析

Analysis of bacterial distribution and drug sensitivity of secretions from 49 culture-positive patients with chronic rhinosinusitis

目的探讨慢性鼻窦炎(CRS)患者鼻道黏膜分泌物细菌分布特点及药物敏感性试验,指导CRS患者抗生素的合理使用。方法鼻内镜下采集CRS鼻窦、鼻道黏膜分泌物进行细菌培养及药敏试验,均为单一细菌生长。结果培养阳性的49例标本中葡萄球菌42株,其中表皮葡萄球菌27例,占培养细菌总数的55.1%,金黄色葡萄球菌9例,占培养细菌总数的18.4%。药敏试验表明凝固酶阴性葡萄球菌对氨苄西林、苯唑西林、阿莫西林/克拉维酸、头孢曲松和环丙沙星耐药率均高达65%以上,金黄色葡萄球菌除对氨苄西林有较高的耐药率外,对其它常用的抗生素均具有较高的敏感性。葡萄球菌对大环内酯类抗生素具有较高的敏感性,未发现耐万古的葡萄球菌。结论葡萄球菌感染在CRS的致病中占有重要地位。CRS患者应进行常规细菌培养和药敏试验,抗生素的使用应以病原菌检测和药敏试验结果为基础。

Objective To investigate the bacteriological characteristics and the status of their antibiotics resistance among patients with chronic rhinosinusitis(CRS),and to guide the rational use of antibiotics in patients with CRS.Method Mucous secretions from the nasal sinuses and nasal passages of CRS were collected under nasal endoscopy for bacterial culture and drug susceptibility test.Result Among the 49 positive culture samples,there were 42 strains of staphylococcus,including 27 cases of staphylococcus epidermidis(55.1%)and 9 cases of staphylococcus aureus(18.4%).The drug sensitivity test showed that the drug resistance rate of coagulase negative staphylococcus to ampicillin,benzoxicillin,amoxicillin/clavulinic acid,ceftriaxone and ciprofloxacin was above 65%.Staphylococcus aureus has high drug resistance rate to ampicillin and high sensitivity to other commonly used antibiotics.Staphylococcus has a high sensitivity to acrolides,and no vivacian-resistant staphylococcus has been found.Conclusion Staphylococcal infection plays an important role in the pathogenesis of CRS.Patients with CRS should undergo routine bacterial culture and drug susceptibility test,and the use of antibiotics should be based on pathogen detection and drug susceptibility test results.