扁桃体隐窝内分泌物细菌谱及药敏分析  

Bacterial spectrum and drug sensitivity analysis of secretions from the tonsillar crypts

作　　者：伍瑜 王梦舒 方兴[1,2,3,4] 徐婧 黄东海[1,2,3,4] WU Yu;WANG Meng-shu;FANG Xing;XU Jing;HUANG Dong-hai(Xiangya Hospital,Central South University,Changsha,Hunan 410008,China;不详)

机构地区：[1]中南大学湘雅医院耳鼻喉头颈外科,湖南长沙410008 [2]耳鼻咽喉科重大疾病研究湖南省重点实验室,湖南长沙410008 [3]湖南省咽喉嗓音疾病临床医学研究中心,湖南长沙410008 [4]国家老年疾病临床医学研究中心(湘雅医院),湖南长沙410008

出　　处：《中华医院感染学杂志》2023年第16期2478-2483,共6页Chinese Journal of Nosocomiology

基　　金：中国博士后面上项目(2022M723557);长沙市自然科学基金(kq2208390);湘雅医院青年基金(2022Q08);中南大学研究生创新项目(2022ZZTS0907)。

摘　　要：目的 分析扁桃体隐窝内微生物谱、药敏情况及其相关影响因素,以期指导抗菌药物的合理应用。方法 收集扁桃体隐窝冲洗液,行直接涂片革兰染色镜检、分泌物需氧培养鉴定及药敏试验、真菌培养及鉴定,并对结果进行统计及多因素分析。结果 188例患者培养出阴性者30例、正常咽喉杂菌者36例、条件致病菌者122例;其中,培养出单一菌种者103例、培养出两种菌种者19例、培养出真菌者共3例;药敏发现金黄色葡萄球菌耐药抗菌药物为青霉素等、敏感抗菌药物为磺胺甲噁唑/甲氧苄啶等;肺炎链球菌多数对于氨苄西林耐药;Logistic回归分析显示,患者条件致病菌感染、球菌或杆菌感染和性别、年龄、吸烟、病史长短、疾病类型无显著相关,与饮酒有显著相关;且不同疾病类型、年龄分组、病史长短分组之间条件致病菌感染率均无统计学差异。结论 扁桃体隐窝内菌群以条件致病菌感染为主,多为金黄色葡萄球菌,其对青霉素耐药,但对磺胺甲噁唑/甲氧苄啶等敏感,其次为肺炎克雷伯菌和化脓性链球菌,其多数对于大环内酯类抗菌药物耐药,但对头孢类敏感;真菌极少见。条件致病菌感染与饮酒有相关性。OBJECTIVE To analyze the microbiological spectrum and drug sensitivity in the tonsillar crypts and their related influencing factors,so as to guide the rational application of antibiotics.METHODS Tonsillar crypts washings were collected and subjected to direct smear gram staining microscopy,identification of secretion aerobic culture and drug sensitivity test,fungal culture and identification,and the results were also subjected to statistical and multi-factor analysis.RESULTS Among the 188 patients,30 cases had negative cultures,36 cases had normal throat bacteria,and 122 cases had opportunistic bacteria.Among them,103 cases were cultured for a single bacteria,19 cases were cultured for two strains,and 3 were cultured for fungi.The drug sensitivity results showed that the antibiotic-resistant antibiotics of Staphylococcus aureus were penicillin,and the sensitive antibiotics were sulfamethoxazole/methoprene.The majority of Streptococcus pneumoniae were resistant to ampicillin.Logistic regression analysis showed that there was no significant correlation between opportunistic pathogen infection and cocci infection and gender,age,smoking,length of medical history and disease type,but there was a significant correlation with alcohol consumption.There was no significant difference in the infection rate of opportunistic pathogens among different disease types,age groups and history length groups.CONCLUSION The bacterial spectrum in tonsillar crypts was dominated by opportunistic pathogens,mostly S.aureus,which was resistant to penicillin,but sensitive to sulfamethoxazole/methoprene,followed by Klebsiella pneumoniae and Streptococcus pyogenes,most of which were resistant to macrolides but sensitive to cephalosporin.Fungi were rare.There was a correlation between opportunistic pathogen infection and alcohol consumption.

关 键 词：扁桃体隐窝 分泌物 细菌谱 药敏分析 

分 类 号：R446[医药卫生—诊断学]