Nasopharynx as a microbiologic reservoir in chronic suppurative otitis media: preliminary study

ObjectivesThe present study was designed to identify the correlations of bacterial strains of the middle ear and the nasopharynx in chronic suppurative otitis media (CSOM) patients who were scheduled for operations.MethodsSixty-three patients with CSOM were enrolled in the study. Culture specimens were collected from the middle ear and nasopharynx of patients who were admitted for operation. Samples collections were performed 3 times; from the middle ear and nasophaynx at the admission day, from the middle ear during the operation, and from the external auditory canal post-operatively. Bacteria were identified by gram staining and biochemical tests. The correspondence rate of organisms which simultaneously exist in the middle ear and the nasopharynx was measured.ResultsSixty-eight organisms were isolated from the middle ear and 57 organisms from the nasopharynx among 63 patients. Of 68 bacteria identified in middle ear, 26.52% (18 bacteria) corresponded with those of nasopharynx. MRSA had the high correspondence rate, and of 18 methicillin-resistant Staphylococcus aureus (MRSA) isolated from middle ear, 33.3% (6 bacteria) corresponded with nasophaynx. Meanwhile, 3 organisms of MRSA were detected from the external auditory canal post-operatively, although they were only found in nasopharynx pre-operatively.ConclusionThe current trend of middle ear swab alone for bacterial detection would be insufficient to identify the potent MRSA and impede early antibiotic intervention for the effective middle ear surgery. Therefore, it is necessary to perform nasopharynx cultures together with conventional middle ear culture to control potent risk for infection pre-operatively.     

鼻用糖皮质激素治疗兔急性细菌性上颌窦炎的细菌培养观察

目的探讨鼻用糖皮质激素喷雾剂布地奈德(budesonide)对兔急性细菌性上颌窦炎的细菌学的影响。方法健康成年新西兰白兔48只,采用鼻腔置入Merocel高分子膨胀海绵并注入肺炎链球菌的方法建立急性细菌性上颌窦炎模型,10 d后取出鼻腔膨胀海绵,随机分成抗生素治疗组(A组)、抗生素加鼻用激素治疗组(B组)、鼻用激素治疗组(C组)及对照组(D组),每组各12只。分别于治疗2周及4周后每组各处死6只动物,获取上颌窦腔分泌物作普通细菌培养。结果细菌培养结果显示治疗2周后,虽然A、B组上颌窦分泌物细菌培养阳性率低于C、D组,但组间差异无统计学意义(P>0.05)。治疗4周后,A、B组细菌培养阳性率明显低于C、D组,差异有统计学意义(P<0.05),A、B组间差异无统计学意义(P>0.05)。结论鼻用糖皮质激素合并抗生素治疗兔急性细菌性上颌窦炎时,未见影响抗生素的抗菌效果。     

5 year analysis of bacteriology culture in a tropical burns ICU

Introduction

Infection is a major cause of morbidity and mortality in burns patients.

Methodology

A retrospective review of all 94 patients admitted to a regional burns ICU from 2004 to 2009 was performed. All the patients’ data and records of all culture isolates from a computerized hospital wide database were studied. Epidemiology of the patients, bacteriology information including yield and correlation of bacteremia with positive cultures from other sites were examined. In addition, the relationship between burns excision surgeries to bacteremia was analyzed.

Results

402 tissue cultures, 238 wound swab cultures, 269 endotracheal cultures, 125 urine cultures, 236 tip of monitoring line cultures and 474 blood cultures were studied. Acinetobacter baumannii was the most prevalent bacteria for all culture methods. Within 24 h of bacteremia, the tissue, line tips, endotracheal and wound swab cultures had yielded very similar pathogens (>70% of the time) to those from the blood stream. Furthermore 60% of all bacteremic episodes occur within 48 h of the surgery.

Conclusion

In ICUs where multidrug resistant pathogens are endemic, the choice of appropriate antimicrobial empiric cover should be guided by the intensity of colonization with these organisms as indicated by the cultures from various sites.     

2003～2011年我院烧伤科患者细菌学调查及耐药性分析

目的调查分析2003～2011年我院烧伤科患者主要菌群的构成及其耐药性。方法将2003～2011年我院烧伤科患者送检的痰、血液、尿液、创面分泌物进行菌株分离,并调查分析。结果共检出病原菌200株,其中革兰阴性菌130株(65.0%),以铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌为主;革兰阳性菌70株(35.0%),以金黄色葡萄球菌为主。病原菌对常用抗菌药物耐药严重,且呈多重耐药性。结论烧伤科患者感染及多重耐药严重,加强耐药性监测,及时了解病原菌的种类及耐药性变化,有利于指导临床合理用药。     

Bacteriological and physicochemical quality of drinking water and hygiene-sanitation practices of the consumers in bahir dar city, ethiopia

Background

Lack of safe drinking water, basic sanitation, and hygienic practices are associated with high morbidity and mortality from excreta related diseases. The aims of this study were to determine the bacteriological and physico-chemical quality of drinking water and investigate the hygiene and sanitation practices of the consumers in Bahir Dar City, Ethiopia.

Methods

A cross sectional prospective study was conducted in Bahir Dar City from October–December, 2009. Water samples were collected from 35 private taps and 35 household water containers for bacteriological analysis. The turbidity, pH, temperature and turbidity were measured immediately after collection. Finally, the hygiene-sanitation practices of the consumers were surveyed using interview.

Results

Twenty seven (77.1%) of the household water samples had high total coliforms counts. Twenty (57.1%) household water samples and 9 (25.7%) of the tap water samples had no residual free chlorine. Sixteen (45.7%) household water samples had very high risk score to thermotolerant coliforms. Eight (22.9%) tap water samples had low risk score for total coliforms whereas 21(60%) tap water had very low risk score for thermotolerant coliforms. Twelve (34.3%) of the consumers collect water without contact with their hand and 9(25.7%) wash their hands with soap after visiting toilet.

Conclusion

Water supplies at tap and household water containers were contaminated with bacteria. Poor sanitation, low level of hygiene, uncontrolled treatment parameters are the causes for contamination. Control of physico-chemical parameters and promoting good hygiene and sanitation are recommended.     

慢性鼻窦炎手术前后分泌物细菌学对比研究及临床意义

目的对慢性鼻窦炎手术前后细菌学特性进行对比,探讨术后复发感染的可能原因,并对慢性鼻窦炎病程中细菌作用进行研究。方法内镜引导下,对接受功能性内窥镜鼻窦外科（FESS）手术的患者作分泌物需氧菌和厌氧菌培养;并在术后随访中对有复发感染表现的患者进行再次培养,将两次培养结果进行对比。结果术前细菌培养阳性率为60％,复发患者再次进行的细菌培养阳性率为100％,两次结果对比,差异有显著性（P〈0．01）。两次培养结果中,有24．14％的患者与术前感染菌株相同,有75．86％的患者表现为不同的感染菌株。术后再发感染中厌氧菌比例降低,但差异无显著性。结论FESS术后感染多为新发菌株的感染或定殖。但在个别病例中,细菌感染可能在充分治疗后仍迁延存在。     

急性加重期慢性阻塞性肺疾病患者的 细菌学构成及其与肺功能的关系

目的 探讨急性加重期慢性阻塞性肺疾病（acute exacerbation of chronic obstructive pulmonary disease, AECOPD）患者的细菌学构成及其与肺功能的关系。方法 回顾性分析2019年1月至2020年12月海南医学院第二附属医院呼吸内科收治的356例AECOPD患者的临床资料,统计痰培养、肺功能结果,根据肺功能分级分成Ⅱ、Ⅲ、Ⅳ级,分析细菌学与肺功能的相关性。结果 356例AECOPD患者中培养出细菌133株：鲍曼不动杆菌32株、铜绿假单胞菌31株、肺炎克雷伯杆菌25株、肺炎链球菌11株、金黄色葡萄球菌2株。肺功能Ⅱ、Ⅲ、Ⅳ级患者痰培养细菌阳性率分别为20.93%、35.14%、42.62%。肺功能Ⅳ级患者革兰阴性菌的感染率较Ⅱ级高,差异有统计学意义（P<0.05）,革兰阳性菌与肺功能差异无统计学意义（P>0.05）。结论 AECOPD患者的痰细菌学培养主要是革兰阴性菌,依次为鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯杆菌,还有少量革兰阳性菌。AECOPD患者肺功能越差越容易感染致病菌,肺功能Ⅳ级患者感染鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯杆菌概率更高。     

静脉输液瓶口消毒加药后放置时间的细菌学研究

目的监测静脉输液瓶口常规配药后放置不同时间段微生物的污染情况,探讨配药后30min内接上液体时不再重新消毒瓶口的可行性。方法取210瓶100ml无菌生理盐水,分7组进行常规配药,30瓶/组。分别于消毒后、消毒配药后5,10,15,20,25,30min,7个不同时间段对瓶口进行微生物采样计数;同时进行治疗室空气培养。结果210瓶无菌生理盐水瓶口中有25个被微生物污染,其中微生物主要为G+杆菌、微球菌、类酵母样菌、凝固酶阴性葡萄球菌。不同时间段内所污染的瓶口数及各瓶口微生物污染菌落计数经!2检验(P>0.05)差异无统计学意义。结论常规配药后,如30min内接上液体,可不必再重新消毒瓶口。     

嗜水气单胞菌及其对人的致病性

嗜水气单胞菌在自然界广泛分布,是一种典型的人-畜-鱼共患病病原菌,人类可因致病性嗜水气单胞菌感染而发生腹泻、食物中毒、继发感染。由于嗜水气单胞菌菌落易与肠杆菌科细菌特别是大肠杆菌混淆,氧化酶试验阳性是其特征,常规检测非常必要。蛋白酶阳性可确定该菌为致病性嗜水气单胞菌,另外还可用PCR检测Aer基因来区别致病性嗜水气单胞菌和非致病性嗜水气单胞菌。目前,国外已将嗜水气单胞菌纳入腹泻病原菌的检测范围,是食品卫生检测的对象。因此,建议在食品、饮用水检测指标中增加嗜水气单胞菌作为细菌学指标,并将其纳入食物中毒诊断标准中。