不同年龄阶段真菌性鼻窦炎患者病原菌分布特点及耐药情况分析

Distribution of pathogenic bacteria and drug resistance in patients with fungal sinusitis at different ages

目的探讨不同年龄阶段真菌性鼻窦炎患者病原菌分布特点以及耐药情况。方法选取2013年1月至2018年12月于该院耳鼻喉科诊治的680例真菌性鼻窦炎患者作为研究对象,并根据患者年龄进行分组,年龄<40岁者共210例(A组),年龄为40~<65岁者共223例(B组),年龄≥65岁者共247例(C组),对3组患者的病原菌分布情况进行分析,并对3组不同年龄段真菌性鼻窦炎患者的合理用药情况进行分析。结果3组患者金黄色葡萄球菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、产气肠杆菌、阴沟肠杆菌以及脆弱类杆菌检出率差异有统计学意义(P<0.05)。病原菌对亚胺培南-西司他丁钠均未存在耐药情况,对哌拉西林他唑巴坦、莫西沙星、头孢哌酮舒巴坦的耐药率较低,对青霉素、甲硝唑以及头孢曲松的耐药率较高。结论中青年真菌性鼻窦炎患者感染病原菌主要为大肠埃希菌,老年患者则以感染金黄色葡萄球菌以及革兰阴性菌为主,可采用哌拉西林他唑巴坦、莫西沙星以及头孢哌酮舒巴坦对患者进行治疗。

Objective To study the distribution of pathogenic bacteria and drug resistance in patients with fungal sinusitis at different ages.Methods A total of 680 patients with fungal sinusitis who were admitted to the department of otorhinolaryngology in our hospital from January 2013 to December 2018 were selected as study subjects and grouped according to the age of the patients,of which 210 cases were less than 40 years old with fungal sinusitis were group A,223 cases between 40 and 65 years were group B,and 247 cases over 65 years were group C.The distributions of pathogens in the three groups of patients were compared,and the drug resistance of patients with fungal sinusitis at three age groups was analyzed.Results There were statistically significant differences of detection rates in Staphylococcus aureus,Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,Enterobacter aerogenes,Enterobacter cloacae,and Bacteroides fragile in three groups(P<0.05).The pathogenic bacteria were not resistant to imipenem-cilastatin.The resistance rates of piperacillin-tazobactam,moxifloxacin,and cefoperazone-sulbactam were relatively lower.In addition,the resistance rates of penicillin,metronidazole,and ceftriaxone were relatively higher.Conclusion The pathogenic bacteria of young and middle-aged patients with fungal sinusitis are mainly Escherichia coli,and the elderly patients are mainly Staphylococcus aureus and Gram-negative bacteria.Piperacillin tazobactam,moxifloxacin,and cefoperazone can be used in the treatment of patients with fungal sinusitis.