116例耳道流脓患者耳道分泌物病原菌培养及药敏分析

Pathogen culture and drug sensitivity analysis of ear canal secretions in 116 patients with ear canal pus

目的 分析成年人耳道流脓患者耳道分泌物中主要病原菌分布及耐药情况,为合理选择用药提供依据。方法 选取2022年3~11月到北京市第一中西医结合医院耳鼻咽喉科门诊就诊的耳道流脓患者116例(116耳),取耳道分泌物进行病原菌分离培养鉴定和药敏试验。结果 116例分泌物标本中,革兰阳性菌86株(74.14%),革兰阴性菌13株(11.21%),真菌17株(14.66%)。最常见的致病菌是金黄色葡萄球菌78株(67.24%),铜绿假单胞菌10株(8.62%)和丝状真菌11株(9.48%),86株革兰阳性菌中,耐甲氧西林金黄色葡萄球菌阳性菌有59株(68.60%)。金黄色葡萄球菌耐药率最高的是青霉素,耐药率高达91.03%;在铜绿假单胞菌耐药率分析中,头孢唑林、氨苄西林耐药率高达100%;丝状真菌的耐药率分析中,两性霉素B最敏感耐药率为0,氟康唑耐药率为45.45%。鼓膜未穿孔组和鼓膜穿孔组患者的致病菌感染构成比差异无统计学意义(P>0.05)。结论 耳道流脓患者的分泌物常见致病菌是金黄色葡萄球菌、铜绿假单胞菌及丝状真菌。临床上常用的抗菌药物具有较高的耐药性,及早进行致病菌培养及药敏鉴定,对指导临床用药的选择、提高治愈率、减少耐药的形成具有重要意义。

OBJECTIVE To analyze the distribution and drug resistance of the main pathogenic bacteria in the ear canal secretions of adult patients with ear canal abscess,and to provide a basis for rational drug use.METHODS From March 2022 to November 2022,116 patients(116 ears)with ear canal empyema were selected from the outpatient department of otolaryngology in Beijing First Hospital of Integrated Chinese and Western Medicine.The ear canal secretions were taken for pathogen isolation,culture,identification and drug sensitivity test.RESULTS Among the 116 secretion specimens,86 strains(74.14%)were Gram-positive bacteria,13 strains(11.21%)were Gram-negative bacteria,and 17 strains(14.66%)were fungi.The most common pathogenic bacteria were 78 strains of Staphylococcus aureus(67.24%),10 strains of Pseudomonas aeruginosa(8.62%)and 11 strains of filamentous fungi(9.48%).Among the 86 Gram-positive bacteria,59 strains(68.60%)were methicillin resistant staphylococcus aureus positive.The highest resistance rate of Staphylococcus aureus was penicillin,and the resistance rate was as high as 91.03%.In the analysis of the resistance rate of Pseudomonas aeruginosa,the resistance rate of cefazolin and ampicillin was as high as 100%.In the analysis of the resistance rate of filamentous fungi,the most sensitive resistance rate of amphotericin B was zero,and the resistance rate of fluconazole was 45.45%.There was no significant difference in the constituent ratio of pathogenic bacteria infection between the tympanic membrane non-perforation group and the tympanic membrane perforation group(P>0.05).CONCLUSION The common pathogenic bacteria in the secretion of patients with ear canal pus are Staphylococcus aureus,Pseudomonas aeruginosa and filamentous fungi.Antibiotics commonly used in clinic have high drug resistance.Early pathogen culture and drug sensitivity identification are of great significance for guiding the selection of clinical medication,improving the cure rate and reducing the formation of drug resistance.