慢性化脓性中耳炎患者病原菌分布及耐药性分析

Distribution and drug resistance of pathogenic bacteria in patients with chronic suppurative otitis media

目的分析慢性化脓性中耳炎患者病原菌分布及耐药性。方法纳入106例慢性化脓性中耳炎患者研究(2019.01~2020.09),对其分泌物标本进行病原菌分离、培养、菌种鉴定、抗菌药物药敏分析。结果(1)检出率:106例患者检出病原菌100例,占比94.34%,其中革兰阳性菌60株(60.00%)、革兰阴性菌30(30.00%)株、真菌10(10.00%)株。(2)主要菌种:革兰阳性菌以金黄色葡萄球菌为主,共30株(30.00%);表皮葡萄球菌、头状葡萄球菌次之,依次为13株(13.00%)、13株(13.00%)。革兰阴性菌以铜绿假单孢杆菌为主,共18(18.00%)株;奇异变形菌次之,共8株(8.00%)。真菌以黑曲霉菌为主,共4(4.00%)株。(3)耐药情况:金黄色葡萄球菌、表皮葡萄球菌、头状葡萄球菌等革兰阳性菌对利奈唑胺、万古霉素、呋喃妥因敏感性高达100.00%,不具有耐药性;铜绿假单孢杆菌、奇异变形菌等革兰阴性菌对美罗培南、阿米卡星、亚胺培南、哌拉西林敏感性高达100.00%,不具有耐药性。结论金黄色葡萄球菌、表皮葡萄糖杆菌、头状葡萄球菌、铜绿假单孢杆菌等为慢性化脓性中耳炎患者主要病原菌,不同病原菌对抗菌药物耐受性不同,在治疗时可根据致病菌种选择合适的抗菌药物进行治疗,提高治疗有效性。

Objective To analyze the distribution and drug resistance of pathogenic bacteria in patients with chronic suppurative otitis media.Methods A study of 106 patients with chronic suppurative otitis media(2019.01~2020.09)was included,and the secretion specimens were isolated,cultured,identified,and analyzed for antimicrobial drug sensitivity.Results(1)Detection rate:100 pathogenic bacteria were detected in 106 patients,accounting for 94.34%,including 60 gram-positive bacteria(60.00%),30 gram-negative bacteria(30.00%),and 10 fungi(10.00)%)strains.(2)Main strains:Staphylococcus aureus is the main gram-positive bacteria,with 30 strains(30.00%);Staphylococcus epidermidis and Staphylococcus capitis are followed,followed by 13 strains(13.00%)and 13 strains(13.00%).Gram-negative bacteria were mainly Pseudomonas aeruginosa,with 18(18.00%)strains;Proteus mirabilis came in second,with 8 strains(8.00%).The main fungus is Aspergillus niger,with 4(4.00%)strains in total.(3)Drug resistance:Staphylococcus aureus,Staphylococcus epidermidis,Staphylococcus capitis and other gram-positive bacteria have a sensitivity of up to 100.00%to linezolid,vancomycin,and nitrofurantoin,and they are not resistant;aeruginosa Gram-negative bacteria such as Bacillus sp.Conclusion Staphylococcus aureus,Gluconobacter epidermidis,Staphylococcus capitis,Pseudomonas aeruginosa,etc.are the main pathogens in patients with chronic suppurative otitis media.Different pathogens have different tolerance to antibacterial drugs.The treatment can be based on the pathogen species Choose suitable antibacterial drugs for treatment to improve the effectiveness of treatment.