15年耳部感染性疾病分离病原菌及药物敏感度分析  

Microbiological isolates and antibiotic susceptibilities in aural inflammatory disease:a 15-year review

作　　者：刘春红 丁百兴 吉建 王朱健 陈惠雯 曹文俊 LIU Chunhong;DING Baixing;JI Jian;WANG Zhujian;CHEN Huiwen;CAO Wenjun(Department of Clinical Laboratory,Eye&ENT Hospital,Fudan University,Shanghai 200031,China;Institute of Antibiotics,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院检验科,上海200031 [2]复旦大学附属华山医院抗生素研究所,上海200040

出　　处：《中国眼耳鼻喉科杂志》2022年第3期269-272,275,共5页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的探讨耳部分离病原菌的类型和药物敏感特征。方法收集复旦大学附属眼耳鼻喉科医院2005年1月~2019年12月临床诊断为耳部感染性疾病患者中耳及外耳分泌物标本中分离出的病原菌,分析病原菌的菌谱及药敏变化,利用SPSS 13.0统计学软件进行分析。结果共分离出病原菌2097株,39.0%(818株)为革兰阳性菌,24.7%(519株)为革兰阴性菌,36.2%(760株)为真菌。金黄色葡萄球菌和铜绿假单胞菌为最常见病原菌。革兰阳性菌对万古霉素的敏感度为100%;对其他药物的敏感度分别为:利福平97.6%、复方新诺明84.5%、氯霉素79.2%、左氧氟沙星57.0%、环丙沙星47.5%。革兰阴性菌对美罗培南的敏感度为96.1%;对其他药物的敏感度分别为:阿米卡星91.9%、头孢他啶87.3%、妥布霉素59.1%、环丙沙星46.5%。2005~2019年耳部分离的病原菌对头孢他啶和哌拉西林的敏感度有升高趋势,而对左氧氟沙星的敏感度有降低趋势,变化具有统计学意义。结论金黄色葡萄球菌和铜绿假单胞菌是耳部分离的常见病原菌。革兰阳性菌对万古霉素和复方新诺明的敏感度高;革兰阴性菌对美罗培南和阿米卡星的敏感度高。2005~2019年耳部分离的病原菌对头孢他啶和哌拉西林的敏感度有升高趋势,而对左氧氟沙星的敏感度有降低趋势。Objective To investigate the microbiological spectrum and antibiotic sensitivities of the pathogens that cause culture-proven aural inflammatory disease.Methods Data of 2097 culture-proven isolates collected between January 2004 and December 2019 were reviewed retrospectively.The specimens were cultured for bacteria,fungi and antibiotic susceptibility test.Statistical analyses were performed using theχ^(2) test for trends.Results Among these isolates,39.0%were gram-positive organisms(818 cases),24.7%were gram-negative organisms(519 cases),and 36.2%were fungi(760 cases).The predominant pathogens were Staphylococcus aureus and Pseudomonas aeruginosa.The antibiotic susceptibilities of gram-positive bacteria were as follows:vancomycin(100%),rifampicin 97.6%,trimethoprim-sulfamethoxazole(TMPSMX,84.5%),chloramphenicol(79.2%),levofloxacin(57.0%)and ciprofloxacin(47.5%).The antibiotic susceptibilities of gram-negative isolates were as follows:meropenem(96.1%),amikacin(91.9%),ceftazidime(87.3%),tobramycin(59.1%)and ciprofloxacin(46.5%).Over the 15-year study,there were significant changes in the antibiotic susceptibilities to the following three antibiotics:levofloxacin,ceftazidime and piperacillin.Conclusions Over the 15-year study period,most isolates were Staphylococcus aureus and Pseudomonas aeruginosa.Vancomycin and TMP-SMX remains the most appropriate empirical antibiotic for grampositive bacteria.Gram-negative bacteria appeared to be most susceptible to meropenem and amikacin.The susceptibility of isolates to two antibiotics,including ceftazidime and piperacillin increased over time,whereas the susceptibility to levofloxacin decreased over time.

关 键 词：耳部感染性疾病 病原菌 药物敏感特征 

分 类 号：R446.5[医药卫生—诊断学] R764[医药卫生—临床医学]