成人急性化脓性中耳炎的病原菌构成及药敏分析

Pathogen composition and drug sensitivity analysis of adult acute suppurative otitis media

目的分析成人急性化脓性中耳炎的病原菌分布及药敏结果,指导临床精准治疗。方法对2020年10月~2021年10月我院门诊就诊的263例成人急性化脓性中耳炎行脓液培养,观察病原菌构成及药敏分析。结果263例患者阳性病例241例(91.63%),混合菌株感染6例(2.28%),培养菌株共247株(93.92%)。G+球菌109株(45.23%),主要菌金黄色葡萄球菌70株(29.05%),G-杆菌22株(9.13%),主要菌铜绿假单孢菌7株(2.9%);真菌106株(43.98%),主要菌曲霉菌94株(39%)。药敏结果:G+球菌对利奈唑胺、头孢西丁、万古霉素、头孢唑林及左氧氟沙星敏感,对青霉素、红霉素及克林霉素耐药;主要G-杆菌对亚胺培南、哌拉西林舒巴坦、美罗培南、左氧氟沙星、头孢哌酮舒巴坦、头孢吡肟及头孢他啶敏感,对头孢噻肟、头孢呋辛耐药。结论急化脓性中耳炎的致病菌以金黄色葡萄球菌、真菌及铜绿假单孢菌为主,且真菌感染居第二,应引起临床医生的高度重视,依据药敏分析结果针对性选择用药。

Objective Analyze the pathogenic bacteria distribution and drug sensitivity results of adult acute suppurative otitis media,and guide clinical precision treatment.Method From October 2020 to October 2021,263 adults with acute suppurative otitis media were treated with pus culture to observe the composition of pathogenic bacteria and drug sensitivity analysis.Result There were 241 positive cases(91.63%)of 263 patients,6 cases(2.28%)of mixed strain infection,and 247 strains(93.92%)of cultured strains.109 strains of G+cocci(45.23%),70 strains of Staphylococcus aureus(29.05%),22 strains of G-bacillus(9.13%),7 strains of Pseudomonas aeruginosa(2.9%),106 strains of fungi(43.98%),94 strains(39%)of the main bacteria Aspergillus.Drug sensitivity results:G+cocci are sensitive to linezolid,cefoxitin,vancomycin,cefazolin and levofloxacin,and are resistant to penicillin,erythromycin and clindamycin;the main G-bacteria are resistant to imipenem,Piperacillin and sulbactam,meropenem,levofloxacin,cefoperazone,sulbactam,cefepime and ceftazidime are sensitive and resistant to cefotaxime and cefuroxime.Conclusion The main pathogens of acute suppurative otitis media are Staphylococcus aureus,fungus and Pseudomonas aeruginosa,and fungal infection ranks second,Clinicians should pay great attention to it,and choose drugs based on the results of drug sensitivity analysis.