儿童耳分泌物培养的病原菌分布及耐药性分析

The distribution and drug resistance analysis of pathogens cultured from children's ear ssecretions

目的 探讨儿童耳分泌物培养的病原菌种类及其耐药性情况,为儿科临床治疗提供参考.方法 选取2022年4月-2024年1月鹤山市人民医院耳鼻喉科就诊的、年龄为0-14岁、外耳道或耳膜内有流脓的儿童耳炎患者87例为研究对象.采集患儿的耳道分泌物,利用血平板对其培养,生长的菌株利用梅里埃VITEKⅡ对其鉴定药敏.分析患儿的病原菌分布及其耐药情况.结果 87例患儿耳道分泌物,标本中,共培养出病原菌117株,其中,最常见的病原菌为革兰阳性菌(占74.36%)和革兰阴性菌(占25.64%);耐药性分析显示,链球菌、金黄色葡萄球菌对红霉素、青霉素、阿奇霉素的耐药性较高;大肠埃希菌对氨苄西林、头孢呋辛、氨曲南、复方磺胺甲噁唑的耐药性较高.结论 儿童耳部感染的病原菌主要为链球菌、金黄色葡萄球菌和大肠埃希菌,其对多种常用抗菌药物有着较强的耐药性,临床医生在制定治疗方案时应充分考虑到病原菌的种类及其耐药性,避免滥用抗生素,提高治疗效果.

Objective To explore the types of pathogens and their drug resistance in the culture of children's ear secretions,and to provide reference for clinical treatment in pediatrics.Methods A total of 87 children with otitis media aged 0-14 years who visited the Department of Otolaryngology of our hospital from April 2022 to January 2024 were selected as the research objects.Ear secretions of the patients were collected for culture on blood agar plates,and the grown strains were identified and drug sensitivity tested using the VITEK II system.The distribution of pathogens and their drug resistance in the patients were analyzed.Results Among the 87 specimens of ear secretions from the children,a total of 117 strains of pathogens were cultured,among which the most common pathogens were Gram-positive bacteria(74.36%)and Gram-negative bacteria(25.64%);drug resistance analysis showed that Streptococcus,Staphylococcus aureus had high resistance to erythromycin,penicillin,and azithromycin;Escherichia coli had high resistance to ampicillin,cefuroxime,amikacin,and sulfamethoxazole.Conclusion The main pathogens of children's ear infections are Streptococcus,Staphylococcus aureus.and Escherichia coli.They have strong resistance to many commonly used antibiotics.Clinicians should fully consider the types of pathogens and their drug resistance when formulating treatment plans to avoid antibiotic abuse and improve treatment outcomes.