粤北地区学龄前儿童急性化脓性中耳炎病原菌及药敏分析  

Pathogenic bacteria and drug sensitivity analysis of acute suppurative otitis media in preschool children in Yuebei area

作　　者：张金平[1] 叶雪萌[1] 罗许勇[1] 谢记发 罗君[2] 黄若葵[1] ZHANG Jin-ping;YE Xue-meng;LUO Xu-yong;XIE Ji-fa;LUO Jun;HUANG Ruo-kui(Department of Otolaryngology,Yuebei People's Hospital;Clinical Laboratory,Yuebei People's Hospital,Shaoguan,Guangdong 512026)

机构地区：[1]粤北人民医院耳鼻喉科 [2]粤北人民医院检验科,广东韶关512026

出　　处：《赣南医学院学报》2021年第6期603-607,共5页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：韶关市科技计划项目(2018sn111)。

摘　　要：目的:研究粤北地区学龄前儿童急性化脓性中耳炎的病原菌分布及药敏分析,指导临床合理用药。方法:收集2015年1月至2019年12月就诊于我院耳鼻喉科228例学龄前儿童急性化脓性中耳炎的临床资料,按年龄分为0~1岁组、>1~3岁组、>3~6岁,按就诊时间分为4个季度。取患耳的分泌物,进行病原菌分离鉴定及药物敏感性分析。结果:(1)228例患儿病原菌检出率84.21%,常见致病菌分别为金黄色葡萄球菌(47.4%)、肺炎链球菌(32.81%)、铜绿假单胞菌(5.73%)。(2)金黄色葡萄球菌是>3~6岁组最常见的致病菌,与其他2组比较,差异有统计学意义(P<0.05),与肺炎链球菌在同组相比,差异也有统计学意义(P<0.05)。而肺炎链球菌则是>1~3岁组最常见致病菌,与其他2组比较,差异有统计学意义(P<0.05),但与金黄色葡萄球菌在同组相比差异无统计学意义(P>0.05)。(3)第3季度急性化脓性中耳炎(acute suppurative otitis media,ASOM)患者明显下降,金黄色葡萄球菌和肺炎链球菌在4个季度中分布差异均无统计学意义(P>0.05)。金黄色葡萄球菌在第3季度感染率明显较肺炎链球菌高,差异有统计学意义(P<0.05)。不同致病菌对抗菌药物的敏感性不同,金黄色葡萄球菌和肺炎链球菌对利奈唑胺、莫西沙星、万古霉素及左旋氧氟沙星均敏感性高,对红霉素、青霉素G均敏感性低。结论:不同年龄段及不同就诊时间粤北地区儿童ASOM的致病菌分布存在一定差异,临床医师应根据本地区的致病菌分布特点选择有效的药物治疗,条件允许时应进行细菌培养,选择敏感的抗生素治疗。Objective:To study the distribution and drug sensitivity analysis of acute suppurative otitis media in preschool children in Yuebei area for guidance of rationalclinical drug use.Methods:The clinical data of 228 preschool children with acute suppurative otitis media were collected from January 2015 to December 2019 in Yuebei people’s hospital.According to the age,they were divided into 0-1 year old group,>1-3 years old group,>3-6 years old.It was divided into four quarters according to the time of treatment.The secretions of the affected ears were isolated and identified by pathogenic bacteria and drug sensitivity analysis.Results:(1)The detection rate of pathogenic bacteria in this group was 84.21%,and the common were staphylococcus aureus(SA,47.4%),streptococcus pneumoniae(SP,32.81%)and pseudomonas aeruginosa(5.73%).(2)SA was the most common pathogen in the>3-6 years old group,which was statistically different from the other two groups(P<0.05),and also statistically significant compared with SP in the same group(P<0.05).SP was the most common pathogen in the>1-3 year old group,which was statistically different from the other two groups(P<0.05),but there was no significant difference compared with SA in the same group(P>0.05).(3)ASOM patients significantly decreased in the third quarter.There was no significant difference in the distribution of SA and SP in 4 quarters(P>0.05).SA infection rate was significantly higher in the third quarter than that of SP(P<0.05).The sensitivity of different pathogenic bacteria to antimicrobial agents was different.Linazolamide,moxifloxacin,vancomycin and levofloxacin were highly sensitive to SA and SP,and they were highly resistant to erythromycin and penicillin G.Conclusion:According to the distribution characteristics of pathogenic bacteria in children’s ASOM in Yuebei area,clinicians should choose effective drug therapy according to the distribution characteristics of pathogenic bacteria in this area.When conditions permit,bacteria should be cultured and sensitive antibio

关 键 词：中耳炎 学龄前儿童 细菌培养 药敏试验 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]