慢性鼻窦炎的需氧菌分析  

Investigation of aerobic bacteria in chronic sinusitis

作　　者：陈争明[1] 范静平[1] 颜泽敏[2] 吴建[1] 庞帅[2] 

机构地区：[1]第二军医大学长征医院耳鼻咽喉科,上海200003 [2]第二军医大学长征医院呼吸科,上海200003

出　　处：《中国耳鼻咽喉颅底外科杂志》2007年第6期432-435,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的分析慢性鼻窦炎的需氧菌分布及对常用抗生素敏感情况,为临床药物治疗慢性鼻窦炎提供依据。方法在鼻内镜手术中以无菌方式取215个慢性鼻窦炎的鼻窦内容物(实验组),进行需氧菌培养和常用抗生素的药敏试验,并与正常人群60例中鼻道分泌物(对照组)的细菌培养结果对比。结果实验组中检出单一细菌者占92%,2种细菌混合感染者占8%;对照组均检为单一细菌。实验组单菌感染的G+菌占54.7%,G-菌占45.3%;对照组G+菌占73.3%,G-菌占26.7%。蝶窦、筛窦以G+菌感染为主;额窦、上颌窦以G-菌感染为主。实验组需氧菌耐药情况严重。结论慢性鼻窦炎需氧菌感染以单一细菌为主,G+菌占大多数,但G-菌的肠道菌群感染比例较高。不同的鼻窦中需氧菌种类不同。慢性鼻窦炎需氧菌耐药性严重。临床围手术期应用抗生素治疗宜先进行细菌培养与药物敏感试验。Objective To study the distribution of aerobic bacteria in chronic sinusitis and their antimicrobial susceptibility and to provide reference to the antibiotic treatment for chronic sinusitis.Methods In nasal endoscopic surgery,the sinusal contents from 215 patients with chronic sinusitis were cultured aerobically.Secretion from middle meatus of 60 normal ones was selected as control.Their antimicrobial susceptibility was detected.Results In experimental group,one kind of bacteria was found in 92% of all cases,and two kinds of bacteria in 8%.In control group,one kind of bacteria was found in all cases.The prevalences of Gram-positive（G＋） bacteria were 54.7% and 73.3% in those with one kind of bacteria in experimental group and control group respectively.G＋ bacteria were predominant in sphenoid sinus and ethmoid sinuses while Gram-negative（G-） bacteria were predominant in frontal sinus and maxillary sinus.Drug resistance of aerobic bacteria was various in experimental group.Conclusion The pathogen of chronic sinusitis is mostly one kind of aerobic bacteria,mainly G＋ bacteria.Different sinuses have different types of aerobic bacteria.The drug resistance of aerobic bacteria in chronic sinusitis is various.Before antibiotic treatment,the antimicrobial susceptibility test should be performed.

关 键 词：慢性鼻窦炎 需氧菌 药物敏感试验 抗药性 

分 类 号：R765.41[医药卫生—耳鼻咽喉科] R917.795[医药卫生—临床医学]