208例慢性鼻窦炎患者中鼻道细菌学监测及药敏试验结果分析  

Bacteriological study in the middle meatus with drug sensitive tests carried out among 208 cases of chronic rhino-sinusitis

作　　者：朱玲瑛[1] 康厚墉[1] 唐世雄[1] 张立涛[1] 傅波[1] 

机构地区：[1]浙江省宁波市第一医院耳鼻咽喉科,315010

出　　处：《中国中西医结合耳鼻咽喉科杂志》2008年第3期236-237,219,共3页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的研究慢性鼻窦炎患者的病原菌分布特征及其耐药性状。方法208例慢性鼻窦炎患者,鼻窦术前收集中鼻道分泌物,进行需氧菌培养、药物敏感试验及产β2内酰胺酶菌株(β2LPB)监测。结果共培养出17种细菌,主要为表皮葡萄球菌、大肠埃希菌等,培养阳性率为61.54%,其中革兰阳性菌占64.84%,革兰阴性菌为35.16%。药物敏感试验显示,对需氧菌抗菌活性较高的广谱抗生素有万古霉素、克林霉素、舒普深、碳青烯类。β2LPB检出率为61.38%。结论慢性鼻窦炎病程中的需氧菌感染以革兰氏阳性球菌为主,耐药现象严重。可考虑选用广谱耐β2内酰胺酶类抗生素。Objective To investigate the bacteriological characteristics and the status of their antibiotics resistance among patients with chronic rhino-sinusitis（CR） based on a clinical assay. Methods Included in this study were 208 cases with CR and going to undergo endoscopic surgical procedures for their nasosinous lesion, with their nasal secretion collected preoperatively from the middle meatus to do aerobe culture, bacterial isolation, drug sensitive tests and the detection of β2 lactamase-producing bacteria （β2LPB）. Results Seventeen strains of bacteria were isolated from the cultures, most frequently found being Staphylococcus epidermidis, Escherichia coli and so on, with a positive culture rate of 61.54%. In the positive cultures, gram-positive bacteria accounted for 64.84% and gram-negative bacteria accounted for 35.16% respectively. As shown from the antimicrobial sensitive test, such broad spectrum antibiotics as Imipenem, Cefotaxime and Amoicillin-claculanate were shown much more sensitive in vitro to these aerobic pathogens. Moreover, the positive detecting rate of β2LPB was 61.83% in all these isolated gram-positive bacteria. Conclusions The most frequently detectable bacterial strains of aerobic pathogens are gram-positive bacteria of Coccaceae among CR cases with infecting lesion, with a very marked antibioticsresistance from these pathogens. To cure these conditions, broad spectrum antibiotics containing β-lactamase inhibitor, such as Imioenem and Amoxicillin-claculanate, is recommended in case of bacteriological test being not finished yet.

关 键 词：慢性鼻窦炎 细菌学特征 药物敏感试验 

分 类 号：R765[医药卫生—耳鼻咽喉科] R446.5[医药卫生—临床医学]