1440例慢性咽炎患者病原菌分布及耐药性分析  

Analysis of distribution and drug resistance of pathogens in 1440 patients with chronic pharyngitis

作　　者：周立辉 聂静 高前进 周冬晓 乔卿华 ZHOU Lihui;NIE Jing;GAO Qianjing;ZHOU Dongxiao;QIAO Qinghua(Department of Otorhinolaryngology,Joint Logistic Support Force 989 Hospital,Luoyang,Henang,471031,China)

机构地区：[1]联勤保障部队第九八九医院耳鼻喉科,河南洛阳471031 [2]联勤保障部队第九八九医院检验输血科

出　　处：《中国中西医结合耳鼻咽喉科杂志》2025年第2期111-114,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的研究慢性咽炎患者病原菌分布以及耐药性特征,以期为临床治疗慢性咽炎提供可靠的用药指导。方法收集1440例慢性咽炎患者咽后壁分泌物进行细菌培养及药敏试验。结果共检出3271株菌株,其中病原菌2998株,排名前三位的菌株分别为α-溶血性链球菌、表皮葡萄球菌以及副流感嗜血菌,其所占构成比分别为24.58%,10.30%以及8.35%。药敏结果发现,主要的革兰阳性菌中,α-溶血性链球菌对红霉素、克林霉素、四环素耐药率较高,在50%以上,而对万古霉素、利奈唑胺、替考拉宁未显示出耐药性。表皮葡萄球菌对青霉素耐药率达85.76%,对万古霉素、利奈唑胺、替考拉宁未显示出耐药性。主要革兰阴性菌中,卡他莫拉菌的总体耐药率较低,其中对氨苄西林耐药率35.65%,四环素耐药率23.56%。副流感嗜血杆菌对氨苄西林耐药率达66.42%,复方磺胺甲噁唑耐药率达56.09%,而对氯霉素、头孢曲松及左氧氟沙星较为敏感。结论咽部菌群失衡,病原菌感染是慢性咽炎的主要发病因素,为了提高治疗效果,合理使用抗菌药物,应当在治疗前对患者咽部病原菌的耐药性进行分析,根据药敏性选择适当的抗生素。Objective To study the distribution and drug resistance of pathogens in patients with chronic pharyngitis,in order to provide reliable guidance for clinical treatment of chronic pharyngitis.Methods Bacterial culture and drug sensitivity test were carried out on secretions from posterior pharyngeal wall of 1440 patients with chronic pharyngitis.Results A total of 3271 strains were detected,among which 2998 strains were pathogenic.The top three strains wereα-hemolytic streptococcus,Staphylococcus epidermoides and Haemophilus paraininfluenzae,which accounted for 24.58%,10.30%and 8.35%respectively.The results of drug sensitivity test showed that,among the major gram-positive bacteria,the rate of drug resistance ofα-hemolytic streptococcus to erythromycin,clindamycin and stetracycline was more than 50%,but did not show resistance to vancomycin,linezolid and teicoplanin.The resistance rate of Staphylococcus epidermidis to penicillin was 85.76%,and there was no resistance to vancomycin,linezolid and teicolanin.In the main gram-negative bacteria,the overall drug resistance rate of moraxella catarrh was low,among which the resistance rate to ampicillin was 35.65%and tetracycline was 23.56%.The resistance rate of Hemophilus parainfluenzae to ampicillin was 66.42%,the resistance rate of compound sulfamethoxazole was 56.09%,and it was sensitive to chloramphenicol,ceftriaxone and levofloxacin.Conclusion The imbalance of pharyngeal flora and pathogen infection is the main pathogenic factor of chronic pharyngitis.In order to improve the therapeutic effect and rational use of antibacterial drugs,the drug resistance of pharyngeal pathogens should be analyzed before treatment,and appropriate antibiotics should be selected according to drug sensitivity.

关 键 词：慢性咽炎 病原菌 细菌培养 药敏试验 

分 类 号：R446.5[医药卫生—诊断学]