分析慢性化脓性中耳炎分泌物的病原菌分布及耐药性  

Analysis of pathogen distribution and drug resistance of chronic suppurative otitis media discharge

作　　者：贾兰英 陈怀华[1] 欧阳治国[1] 蒋锦琴[2] JIA Lan ying;CHEN Huai hua;OUYANG Zhi guo;JIANG Jin qin(Yiwu Central Hospital, Yiwu, Zhejiang 322000, Chin)

机构地区：[1]义乌市中心医院,浙江义乌322000 [2]杭州医学院,浙江杭州310053

出　　处：《中国卫生检验杂志》2018年第8期922-924,共3页Chinese Journal of Health Laboratory Technology

基　　金：浙江省医学重点(创新)学科建设计划项目

摘　　要：目的探讨慢性化脓性中耳炎(CSOM)患者病原菌分布及对抗生素的耐药情况,以指导临床合理用药。方法对223例CSOM患者在确诊后24 h内采集鼓膜穿孔处或鼓室内分泌物进行细菌培养及鉴定,并对分离的主要病原菌进行药物敏感试验。结果细菌培养阳性178例,阳性率为79.8%;分离到病原菌209株,革兰阳性、阴性菌和真菌分别占50.7%、35.9%和13.4%;主要为金黄色葡萄球菌、表皮葡萄球菌和铜绿假单胞菌、变形杆菌。金黄色葡萄球菌和表皮葡萄球菌对万古霉素、利福平和利奈唑胺完全敏感,铜绿假单胞菌、变形杆菌对亚胺培南完全敏感,上述细菌对青霉素耐药率接近90%。结论金黄色葡萄球菌、表皮葡萄球菌、铜绿假单胞菌和变形杆菌是本地区引起CSOM的主要病原菌,临床用药应该根据药物敏感试验结果来选择。Objective To explore the distribution and antibiotic resistance of pathogenic bacteria in chronic suppurative otitis media（CSOM） for guiding clinical rational drug use. Methods Tympanic membrane perforation or intratympanic secretions were collected for bacterial culture and identification in 223 samples from CSOM patients within 24 hours after definite diagnosis. Drug sensitivity test was carried out in the main pathogens. Results The pathogens were isolated from the secretions specimens of 178 from 223 patients, and the isolation rate of pathogens was 79.8%. Totally 209 strains of pathogens were cultured, and Grampositive bacteria, Gramnegative bacteria, and Fungi accounted for 50.7%, 35.9%, 13.4%. The main pathogen bacteria were S. aureus, S. epidermidis, P. aeruginosa and Proteus species. S. aures and S. epidermidis were 100% sensitive to vancomycin, rifampicin and rina thiazole amine. P. aeruginosa and Proteus species were 100% sensitive to imipenem. All the 4 bacterium had nearly 90% resistance to penicillin. Conclusion S. aureus, S. epidermidis, P aeruginosa and Protells species are the main pathogenic bacteria causing CSOM in local area. Clinical medication should be based on the results of drug sensitivity tests.

关 键 词：慢性化脓性中耳炎 分泌物 细菌培养 药敏试验 

分 类 号：R446.5[医药卫生—诊断学]