慢性化脓性中耳炎细菌生物膜体外检测及耐药性研究  

Detection and drug resistance of biofilm-forming bacteria in chronic suppurative otitis media

作　　者：石磊[1] 玛依拉.吐地 张建中[1] 田刚[3] 王荣光[4] 

机构地区：[1]天津市公安医院耳鼻咽喉科,天津300042 [2]新疆喀什地区第一人民医院耳鼻咽喉科,新疆844000 [3]天津市公安医院检验科,天津300042 [4]解放军总医院耳鼻咽喉-头颈外科,北京100853

出　　处：《中华耳科学杂志》2008年第3期290-294,共5页Chinese Journal of Otology

摘　　要：目的研究慢性化脓性中耳炎细菌生物膜检测及耐药机制。方法刚果红培养法观察培养基不同条件下TSB(胰酪胨大豆肉汤),TSB-0.25%Glu(TSB-0.25%葡萄糖),TSB-2% Alc(TSB-2%无水乙醇),TSB-4% Alc,TSB-2% NaCl和TSB-4% NaCl生物膜生长情况,铜绿假单胞菌生物被膜分析采用银染法,K-B琼脂扩散法进行抗菌药敏试验。结果(1)刚果红培养法的培养基最佳配方为TSB-0.25% Glu,TSB-2%Alc,TSB-4%NaCl。革兰氏阳性菌中产生生物膜阳性率为48.4%,革兰氏阴性菌中产生生物膜阳性率为45%。铜绿假单胞菌生物膜产生阳性率最高;(2)有生物膜葡萄球菌对青霉素、红霉素、复方新诺明耐药,未发现耐万古霉素。有生物膜假单胞菌/变形杆菌对喹诺酮类、第三代头孢菌素和泰能(亚胺培南-西司他丁钠)敏感。结论临床治疗和细菌检验中应严格区分有无生物膜生长,对有生物膜细菌应选择抗生素的联合使用。Objective To investigate the detection and antibiotic resistance of biofilm-forming bacteria in chronic suppurative otitis media. Methods Biofilm-forming ability was determined by congo red agar plate method in 6 different medium conditions of ： Tryptone soy broth（TSB）, TSB-0.25% glucose, TSB-2% alcohol, TSB-4% alcohol, TSB-2% NaCl and TSB-4% NaCl. Drug resistance was tested by using the classical diffusion Kirby-Bauer method. Results （1） The optimal medium constituents were TSB-0.25% glucose, TSB-2% alcohol and TSB- 4% NaCl. Biofilm-forming G＋ and G- bacteria account for 48.4% and 45% of all the strains tested, respectively. （2） Biofilm-forming Staphylococcus was resistant to penicillin and erythromycin, but susceptible to vancomycin. Biofilm-forming Pseudomonas aeruginosa / Proteus were susceptible to quinolone, the third generation cephalosporin and tienam. Conclusion Biofilm-producing and non-biofilm-producing bacteria should be identified. Antibiotics combination therapy is effective for biofilm bacteria.

关 键 词：慢性化脓性中耳炎 细菌生物膜 耐药 

分 类 号：R764.21[医药卫生—耳鼻咽喉科] R37-33[医药卫生—临床医学]