海南地区慢性化脓性中耳炎患者术前病原菌培养结果分析  

Analysis of Pathogenic Bacteria Culture Results of External Auditory Canal Secretion in Preoperative Patients with Chronic Suppurative Otitis Media in Hainan

作　　者：李新建[1,2] 刘明波 刘军[1,3] 韩维举 LI Xinjian;LIU Mingbo;LIU jun;HAN Weiju(Department of Otolaryngology Head and Neck Surgery,Hainan Hospital of Chinese PLA General Hospital,Sanya 572000;The Clinical Medical Research Center for Otolaryngology Head and Neck Surgery of Hainan Provincial,Sanya 572000;Department of Otolaryngology Head and Neck Surgery,Chinese PLA General Hospital,Beijing 100853)

机构地区：[1]解放军总医院海南医院耳鼻咽喉头颈外科,三亚572000 [2]海南省耳鼻咽喉头颈疾病临床医学研究中心,三亚572000 [3]中国人民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》2020年第3期494-497,共4页Chinese Journal of Otology

摘　　要：目的了解海南地区慢性化脓性中耳炎(chronic suppurative otitis media,CSOM)患者手术前耳道或鼓室病原菌分布情况,并通过药敏结果筛选出有效抗生素,以帮助临床选择合理的抗生素进行手术预防感染。方法选取在我院治疗的128例慢性化脓性中耳炎手术患者为研究对象,采取研究对象的深外耳道或鼓室耳拭子进行细菌、真菌培养和药敏试验。结果128例患者中19例患者无细菌生长,共培养出145珠细菌或真菌,其中凝固酶阴性葡萄球菌(55株37.93%)、革兰阳性杆菌(21株14.48%)以及真菌(29珠20%)为外耳道正常菌群,属条件致病菌,培养出的病原菌共检出40株,占27.59%,主要前三位病原菌为:金黄色葡萄球菌(7株4.83%)(敏感抗生素:莫西沙星、左氧氟沙星、喹努普汀/达福普汀、亚胺培南、替加环素、苯唑西林),铜绿假单胞菌(7株4.83%)(敏感抗生素:环丙沙星、左氧氟沙星、庆大霉素、妥布霉素、阿米卡星、喹努普汀/达福普汀、亚胺培南),头状葡萄球菌(5株3.45%)(敏感抗生素:莫西沙星、苯唑西林、亚胺培南、喹努普汀/达福普汀、替加环素。结论由此可得出经验性手术预防性用药:苯唑西林、左氧氟沙星(成人)、莫西沙星(成人)。本研究结果揭示了海南地区慢性化脓性中耳炎手术患者术前耳道或鼓室的常见病原菌,筛选出的抗生素为临床工作合理用药提供了参考依据。Objective To investigate the distribution of pathogenic bacteria in external auditory canal secretions of patients with chronic suppurative otitis media(CSOM)in Hainan before operation,and to screen out effective antibiotics through drug sensitivity results,so as to help the clinical selection of reasonable antibiotics for operation to prevent infection.Methods 128 patients with chronic suppurative otitis media who were treated on in our hospital were selected as the research objects.The external auditory canal secretions of the research subjects were cultured for bacteria,fungi and drug sensitivity tests.Results Among the 128 patients,19 patients had no bacterial growth and 145 beads of bacteria or fungi were cultured.Coagulase-negative Staphylococcus(55 strains 37.93%)、Gram-positive Bacillus(21 strains 14.48%)and fungi(29 strains 20%)were normal bacteria in the external auditory canal.40 strains of pathogenic bacteria were detected,accounting for 27.59%.The main pathogenic bacteria were Staphylococcus aureus(7 strains 4.83%)(Moxifloxacin,Levofloxacin,Quinoputin/Dafoputin,Imipenem,Tegacycline,Oxacillin),Pseudomonas aeruginosa(7 strains 4.83%)(Ciprofloxacin,Levofloxacin,Gentamicin,Tobramycin,Amikacin,Quinoputin/Dafoputin,Imipenem),Staphylococcus cephalococcus(5 strains 3.45%)(Moxifloxacin,Oxacillin,Imipenem,Quinoputin/dafoputin,Tegacycline).Conclusion From this,we can conclude that the prophylactic drugs for empirical surgery are:oxacillin,levofloxacin(adult),moxifloxacin(adult).The results of this study revealed the common pathogenic bacteria in the ear canal or tympanum of the patients with chronic suppurative otitis media in Hainan area before operation,and the selected antibiotics provided a reference for the rational use of drugs in clinical work.

关 键 词：中耳炎 微生物培养 药敏 合理用药 

分 类 号：R764[医药卫生—耳鼻咽喉科]