2012-2020年苏州地区儿童中耳炎感染病原菌分布及其耐药率变化  

Distribution of pathogenic bacteria infected on children with otitis media in SuZhou from 2012 to 2020 and change in corresponding drug resistance

作　　者：何萍[1] 房锐颖 黄莉莉[1] 郑秀秀 陶云珍[1] He Ping;Fang Ruiying;Huang Lili;Zheng Xiuxiu;Tao Yunzhen(Department of Clinical Laboratory, Children's Hospital of Soochow University, Suzhou 215003, China)

机构地区：[1]苏州大学附属儿童医院检验科,江苏苏州215003

出　　处：《临床荟萃》2022年第4期343-348,共6页Clinical Focus

摘　　要：目的分析苏州地区儿童中耳炎感染流行病学特征和病原菌的分布及其耐药率的变化情况。方法收集2012年1月-2020年12月连续9年因中耳炎在苏州大学附属儿童医院耳鼻喉科就诊的患儿,对患儿的中耳耳脓分泌物进行细菌培养,分析其主要病原菌在不同季节、不同年龄段的分布情况,并动态分析其耐药率的变化特点。结果1312例患儿的中耳耳脓分泌物共分离出病原菌970例,总阳性率为73.9%。常见的病原菌为肺炎链球菌、金黄色葡萄球菌和流感嗜血杆菌。2012-2014年肺炎链球菌,金黄色葡萄球菌和流感嗜血杆菌阳性率分别为31.7%,23.1%和4.4%;2015-2017年肺炎链球菌,金黄色葡萄球菌和流感嗜血杆菌阳性率分别为32.7%,30.4%和4.5%;2018-2020年肺炎链球菌,金黄色葡萄球菌和流感嗜血杆菌阳性率分别为28.5%,24.7%和5.5%。2015-2017年金黄色葡萄球菌阳性率高于2012-2014年及2018-2020年金黄色葡萄球菌阳性率(均P<0.05);各时间段肺炎链球菌和流感嗜血杆菌阳性率差异无统计学意义(均P>0.05)。2012-2014年、2015-2017年和2018-2020年耳脓分泌物耐甲氧西林金黄色葡萄球菌(MRSA)阳性率分别为30.8%、27.2%和46.2%;2018-2020年MRSA检出率高于2015-2017年及2012-2014年(均P<0.05)。肺炎链球菌在不同年龄段检出率不同,>5岁检出率最低(均P<0.05);金黄色葡萄球菌在不同年龄段检出率不同,>5岁及≤6个月年龄段检出率较高(均P<0.05);流感嗜血杆菌在各年龄段检出率不同,>5岁年龄段检出率最高(均P<0.05)。肺炎链球菌在各季节的检出率不同,以夏季检出率最低;金黄色葡萄球菌在各季节的检出率不同,以春、夏季检出率较高,分别为39.6%、45.5%;流感嗜血杆菌在各季节的检出率不同,春季检出率最高,秋季检出率最低。肺炎链球菌未发现对万古霉素和左氧氟沙星的耐药株;对红霉素、复方新诺明高度耐药,耐药率在93.5%以上;2012-2020年对青霉素耐Objective To analyze the epidemiological characteristics of otitis media infection in children in Suzhou,distribution of pathogenic bacteria and change in the drug resistance rate.Methods Children with otitis media from the Department of Otolaryngology,Children's Hospital of Soochow University for 9 consecutive years from January 2012 to December 2020 were collected,the bacterial culture was implemented on the pus secretion from children's middle ear,the distributions of primary pathogenic bacteria in different seasons and age groups,and the characteristics of change in drug resistance rate of such children were dynamically analyzed.Results A total of 970 pathogenic bacteria were isolated from the middle ear pus secretions of 1312 children with an overall positive rate of 73.9%.Common pathogens were Streptococcus pneumoniae,Staphylococcus aureus and Haemophilus influenzae,the positive rate of which were 31.7%,23.1%and 4.4%,respectively during the period from 2012 to 2014,the positive rate of such indexes during the period from 2015 to 2017 was 32.7%,30.4%and 4.5%,respectively,and the positive rate of such indexes during the period from 2018 to 2020 was 28.5%,24.7%and 5.5%,respectively.The positive rate of Staphylococcus aureus during the period from 2015 to 2017 was higher than that during the period from 2012 to 2014 and such period from 2018 to 2020(all P<0.05);the difference in the positive rate of Streptococcus pneumoniae and Haemophilus influenzae during the time periods wasn't statistically significant(all P>0.05).The positive rate of methicillin-resistant Staphylococcus aureus(MRSA)in ear pus secretions during the periods from 2012 to 2014,from 2015 to 2017 and from 2018 to 2020 was 30.8%,27.2%and 46.2%,respectively;the detectable rate of MRSA during the period from 2018 to 2020 was higher than that during the periods from 2015 to 2017 and from 2012 to 2014(all P<0.05).The detectable rate of Streptococcus pneumoniae in subjects from different age groups varied,and the detectable rate of Streptococcus pneum

关 键 词：中耳炎 细菌 儿童 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]