388例儿童扁桃体肥大细菌学分析  

Bacteriological analysis of 388 children with tonsil hypertrophy

作　　者：左路杰[1] 耿江桥[1] 赫莉 张爱英[1] 黄爱萍[1] 王丽[1] 刘莹莹 ZUO Lujie;GENG Jiangqiao;HE Li;ZHANG Aiying;HUANG Aiping;WANG Li;LIU Yingying(Department of Otolaryngology,Hebei Children's Hospital,Shijiazhuang,Hebei,050000,China)

机构地区：[1]河北省儿童医院耳鼻咽喉科,河北石家庄050000

出　　处：《中国耳鼻咽喉头颈外科》2023年第8期515-518,526,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的多因素研究分析儿童扁桃体肥大细菌学特点。方法选取河北省儿童医院耳鼻咽喉科手术治疗的扁桃体肥大患儿388例,术中留取扁桃体表面分泌物及扁桃体实体组织标本,行细菌培养及药敏试验,根据细菌培养条件致病菌检出情况,比较患儿在性别、年龄、孕周、喂养方式等多个相关因素间的差异并分析其药敏特点。结果扁桃体肥大患儿中条件致病菌检出率为32.47%(126/388),以金黄色葡萄球菌、流感嗜血杆菌及肺炎链球菌为主。伴鼻窦炎患儿条件致病菌检出率为43.52%(47/108),高于不伴鼻窦炎患儿条件致病菌检出率28.21%(79/280),差异比较有统计学意义(χ^(2)=8.325,P=0.004);伴腺样体肥大患儿条件致病菌检出率为35.26%(116/329),高于不伴腺样体肥大患儿的条件致病菌检出率16.95%(10/59),差异比较有统计学意义(χ^(2)=7.684,P=0.006)。在性别、年龄、孕周、喂养方式、家庭宠物、生活环境、病史长短等因素进行比较,组间差异无统计学意义(P>0.05),以上常见细菌对青霉素类、大环内酯类及磺胺类耐药明显。结论金黄色葡萄球菌、流感嗜血杆菌及肺炎链球菌为儿童扁桃体肥大的菌群分布中主要的条件致病菌,鼻窦炎及腺样体肥大是影响儿童扁桃体肥大菌群的重要因素。在儿童扁桃体肥大及其相关疾病诊治中,头孢类抗生素仍是用药首选。OBJECTIVE To explore the underlying bacterial pathogens in children with tonsil hypertrophy by multivariate analysis.METHODS A total of 388 children with tonsil hypertrophy scheduled for operation were chosen at randomly.The surface secretion of the tonsils and entity tissue removed by surgery were sent for bacterial culture and drug sensitivity test.The differences of children in sex,age,gestational age,feeding mode and other related factors according to the detection of pathogenic bacteria in bacterial culture conditions were compared,and the characteristics of drug sensitivity were analyzed.RESULTS The detection rate of conditioned pathogens in the children with tonsil hypertrophy was 32.47%(126/388).The main strains were strains of staphylococcus aureus,followed by strains of haemophilus influenzae and strains of streptococcus pneumoniae.The detection rate of opportunistic pathogens in children with sinusitis was 43.52%(47/108),which was higher than that of children without sinusitis 28.21%(79/280),and the difference was statistically significant(χ^(2)=8.325,P=0.004).The detection rate of opportunistic pathogens in children with adenoid hypertrophy was 35.26%(116/329),which was higher than that in children without adenoid hypertrophy 16.95%(10/59),and the difference was statistically significant(χ^(2)=7.684,P=0.006).There was no significant differences in sex,age,gestational age,feeding patterns,family pets,living environment,course of tonsil hypertrophy(P>0.05).These bacteria are obviously resistant to penicillins,macrolides and sulfonamides.CONCLUSION Staphylococcus aureus,haemophilus influenzae,andstreptococcus pneumoniae are three main kinds of conditional pathogenic bacteria of tonsil hypertrophy in children.Sinusitis and adenoid hypertrophy are important factors affecting the flora of tonsil hypertrophy in children.In the diagnosis and treatment of tonsil hypertrophy,cephalosporins are still the first choice.

关 键 词：儿童 细菌学 抗菌药 耐药性 扁桃体肥大 

分 类 号：R766[医药卫生—耳鼻咽喉科]