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目的明确慢性化脓性中耳炎(CSOM)患者的病原学及药敏学特点。方法对140例CSOM患者的耳分泌物进行细菌培养鉴定及药敏试验。结果 140例CSOM患者标本中病原菌培养阳性116例(82.9%),共培养出病原菌180株。G-菌84株(46.7%),其中铜绿假单胞菌40株,大肠埃希菌14株,肺炎克雷伯菌12株,鲍氏不动杆菌6株;G+菌79株(43.9%)和真菌19株(10.6%)。其中分离的铜绿假单胞菌对亚胺培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、头孢他啶和阿米卡星的耐药率<30%;肺炎克雷伯菌、大肠埃希菌和鲍氏不动杆菌对亚胺培南、头孢哌酮/舒巴坦和哌拉西林/他唑巴坦的耐药率<35%。79株G+菌中主要以金黄色葡萄球菌和表皮葡萄球菌为主,耐药性严重,对万古霉素和替考拉宁的敏感率均为100%。结论铜绿假单胞菌和金黄色葡萄球菌是CSOM患者的主要病原菌,存在较严重的耐药现象,进行细菌培养和药物敏感性分析,对合理选用抗菌药物治疗CSOM患者具有重要意义。
Objective To clarify the etiology and susceptibility of patients with chronic suppurative otitis media (CSOM). Methods Ear secretions of 140 CSOM patients were identified by bacterial culture and susceptibility testing. Results A total of 116 pathogenic bacteria (82.9%) were collected from 140 CSOM patients and 180 pathogenic bacteria were co-cultivated. There were 84 strains of G-bacteria (46.7%), including 40 strains of Pseudomonas aeruginosa, 14 strains of Escherichia coli, 12 strains of Klebsiella pneumoniae and 6 strains of Acinetobacter baumannii; 79 strains (43.9%) of G + And 19 strains of fungi (10.6%). Among them, the resistant rate of Pseudomonas aeruginosa isolated to imipenem, cefoperazone / sulbactam, piperacillin / tazobactam, ceftazidime and amikacin was less than 30%; Klebsiella pneumoniae The resistance rate of Escherichia coli and Acinetobacter baumannii to imipenem, cefoperazone / sulbactam and piperacillin / tazobactam was <35%. 79 strains of G + bacteria mainly Staphylococcus aureus and Staphylococcus epidermidis, the drug-resistant, the sensitivity of vancomycin and teicoplanin were 100%. Conclusions Pseudomonas aeruginosa and Staphylococcus aureus are the main pathogenic bacteria in CSOM patients. There is a serious resistance phenomenon. Bacterial culture and drug susceptibility analysis are of great significance to rational use of antibacterial drugs in the treatment of patients with CSOM.