慢性化脓性中耳炎患者耳道分泌物病原菌及其耐药性

Distribution of pathogen and its drug resistance in ear canal secretions from patients with chronic pyogenic otitis media

目的 探讨宁波地区慢性化脓性中耳炎患者耳道分泌物病原菌感染特点及其药敏试验结果。方法 选取2021年1月-2022年8月宁波市中医院收治的宁波地区160例慢性化脓性中耳炎患者作为研究对象。统计患者耳道分泌物病原菌感染特点,主要病原菌药敏试验结果。结果 160例慢性化脓性中耳炎患者共检出149株病原菌,检出率为93.13%,革兰阳性菌、革兰阴性菌及真菌占比分别为50.34%、35.57%及14.09%,主要为金黄色葡萄球菌、铜绿假单胞菌;金黄色葡萄球菌对青霉素、克林霉素、红霉素及阿莫西林的耐药率较高;表皮葡萄球菌对红霉素、青霉素、阿莫西林及克林霉素的耐药率较高;铜绿假单胞菌对青霉素、氨苄西林、头孢西丁、红霉素、头孢噻肟、庆大霉素、氯霉素的耐药率较高;近平滑假丝酵母及曲霉菌主要对酮康唑、氟康唑耐药。结论 宁波地区慢性化脓性中耳炎患者病原菌以金黄色葡萄球菌、表皮葡萄球菌、铜绿假单胞菌为主,在进行临床治疗时可根据药敏试验结果,针对不同致病菌感染的患者制定有针对性的抗菌药物治疗方案。

OBJECTIVE To investigate the characteristics of pathogenic bacteria infection and the results of drug sensitivity test in patients with chronic suppurative otitis media in Ningbo.METHODS A total of 160 patients with chronic suppurative otitis media in Ningbo from Jan 2021 to Aug 2022 were recruited.The characteristics of pathogenic bacterial infection in patients′ear canal secretions and the drug sensitivity of major pathogenic bacteria were analyzed.RESULTS A total of 149 strains of pathogenic bacteria were detected in 160 patients with chronic suppurative otitis media,with the detection rate of 93.13%.The proportion of gram-positive bacteria,gram-negative bacteria and fungi was 50.34%,35.57%and 14.09%,respectively.The proportion of gram-negative bacteria and gram-negative bacteria was relatively high,mainly Staphylococcus aureus and Pseudomonas aeruginosa.S.aureus had high rates of drug resistance to penicillin,clindamycin,erythromycin and amoxicillin;Staphylococcus epidermidis had high drug resistance rates to erythromycin,penicillin,amoxicillin and clindamycin.P.aeruginosa had high drug resistance rates to penicillin,ampicillin,cefoxitin,erythromycin,cefotaxime,gentamycin and chloramphenicol.Candida and Aspergillus were mainly drug-resistant to ketoconazole and fluconazole.CONCLUSION The pathogenic bacteria of chronic suppurative otitis media patients in Ningbo were mainly S.aureus,S.epidermidis and P.aeruginosa.In clinical treatment,according to the results of drug sensitivity test,targeted antibacterial drug treatment programs can be formulated for patients with different pathogenic bacteria infection.