儿童急性化脓性中耳炎病原菌及药敏分析  

Pathogenic Bacteria Distribution and Antimicrobial Susceptibility of Children with Acute Otitis Media

作　　者：郝丽丽[1] 王智楠[1] 张振[2] 李隽[1] 夏忠芳[1] 

机构地区：[1]武汉市儿童医院耳鼻咽喉科,武汉430016 [2]武汉市儿童医院检验科

出　　处：《听力学及言语疾病杂志》2015年第6期593-596,共4页Journal of Audiology and Speech Pathology

基　　金：湖北省自然科学基金面上项目(2014CKB511)资助

摘　　要：目的 探讨儿童急性化脓性中耳炎的病原菌分布及主要病原菌的药敏。方法 回顾性分析武汉市儿童医院2012年1月1日-2014年12月31日诊治的146例急性化脓性中耳炎患儿的临床资料,分析患儿中耳脓性分泌物的病原菌培养及药敏结果。结果 1146例患儿中,109例（74.66%）中耳脓性分泌物检出菌株,肺炎链球菌（streptococcus pneumoniae,SP）检出例数最多（64/109,58.72%）,金黄色葡萄球菌（staphylococcus aureus,SA）次之（19/109,17.43%）;2SP对万古霉素、左氧氟沙星、氯霉素较敏感（分别为100%,100%,95.08%）,对青霉素、阿莫西林、头孢噻肟中度敏感（分别为35.08%,49.1%,59.65%）,对红霉素、克林霉素、复方新诺明耐药性高;SA对万古霉素、四环素、阿米卡星敏感性高（分别为100%,100%,94.7%）,对阿莫西林克拉维酸钾、头孢西丁、苯唑西林中度敏感（分别为68.4%,64.7%,68.4%）,对青霉素及氨苄西林的耐药率100%,;3≤1岁组（61例）、〉1-3岁组（44例）、〉3岁组（41例）的SP检出例数分别为31例（50.82%）、25例（56.82%）、8例（19.51%）;≤1岁组、〉1-3岁组的SP检出率显著高于〉3岁组（χ^2=14.073,P=0.001）;42012（53例）、2013（45例）、2014年（48例）SP的检出例数分别为16例（30.19%）、22例（48.89%）、26例（54.17%）,检出率逐年增高（χ^2=6.557,P=0.038）。不同年份SP对抗菌药物的敏感度差异无统计学意义（P〉0.05）,但耐药率有逐年降低的趋势。结论 SP是本组对象中小于3岁的急性化脓性中耳炎患儿的主要致病菌,近3年该菌检出率逐年增高,其对抗菌药物敏感性较稳定。Objective To analyze pathogenic bacteria distribution and antimicrobial susceptibility in children with acute otitis media（AOM）.Methods Otorrhea samples from 146 episodes of AOM were cultured.The antimicrobial susceptibility of the main pathogenic bacteria was determined.The results were analyzed by SPSS19.0.Results 1）The strains of bacteria were isolated from 109 children with the positive rate of 74.66%.Streptococcus pneumoniae（SP）was the major bacteria（64episodes,58.72%）,followed by staphlococcus aureus（SA）（19episodes,17.43%）.2）Sp was all sensitive to vancomycin,levofloxacin,moderate to penicillin,amoxicillin,cefotaxime,and highly resistent to erythromycin and clindamycin.Staphlococcus aureus were all sensitive to vancomycin,tetracycline,and Amy card,and moderate to amoxicillin clavulanic acid potassium,cefoxitin,and oxacillin,all resistent to penicillin and ampicillin.3）The strains of SP in age≤1year,〉1-3years,and 〉3years respectively were 31（50.82%）,25（56.82%）,8（19.51%）.There were significant differences between them（χ^2=14.073,P=0.001）.4）The strains of SP in 2012,2013,2014 respectively were 16（30.19%）,22（48.89%）,26（54.17%）,There were significant differences between them（χ^2=6.557,P=0.038）.The antimicrobial susceptibility of SP had no significant differences among 2012,2013,2014,but a yearly resistance decreasing trend was seen.Conclusion SP wasthe main bacterial contributor for AOM in Wuhan children.SP detection rate increases every year,mainly in children less than 3years old.The antimicrobial susceptibility is stable.

关 键 词：急性中耳炎 化脓性 儿童 药物敏感性 肺炎链球菌 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]