静止期慢性化脓性中耳炎的细菌培养与药敏试验结果分析

目的：了解静止期慢性化脓性中耳炎患者中耳腔的细菌分布及其耐药性特征，以指导I型鼓室成形术后的临床合理用药。方法：取广东省人民医院诊断为慢性化脓性中耳炎静止期，均已干耳1个月以上的148例住院患者的中耳鼓室黏膜表面分泌物，行细菌培养及药敏试验，分析检测结果。结果：共培养出16种细菌，主要为金黄色葡萄球菌、铜绿假单胞菌、山羊葡萄球菌等；细菌培养阳性率为33．1％，其中革兰阳性菌为69．4％，革兰阴性菌为30．6％。药物敏感试验显示对革兰阳性菌抗菌活性较高的抗生素是万古霉素、利奈唑胺、替考拉宁、利福平等；对革兰阴性菌抗菌活性较高的抗生素是哌拉西林（他唑巴坦）、头孢哌酮（舒巴坦）等。结论：拟行I型鼓室成形术的患者术前虽已干耳，但仍存在潜在的致病菌，术前细菌培养及药敏试验可以指导术后临床用药，防治感染。

Analysis of bacteriology of drug sensitivity in the inactive stage of chronic suppurative otitis media

Objective：Detecting the sensitivities of bacterium in the inactive stage of chronic suppurative otitis media,to guide a clinical rational drug use after the typeⅠtympanoplasty.Method：Collecting 148hospitalized patients from Guangdong General Hospital diagnosed as inactive stage of chronic suppurative otitis media,who had been dry ear for more than 1months.Analyse the results of drug sensitivity on the mucosa surfaces of the middle ear.Result：There are 16species of bacterium,including Staphylococcus aureus,Pseudomonas aeruginosa,Enterobacter cloacae etc.Total positive rate of bacteria was 33.1%,the detectable rate of gram-positive bacteria was69.4%,gram-negative bacteria was 30.6%.Drug sensitive test demonstrated that vancomycin,linezolid,teicoplanin,rifampicin etc were effective in gram positive bacteria,piperacillin/tazobactam,cefoperazone/sulbactam etc were effective in gram-negative bacteria.Conclusion：Patients with dry ears,who were going to take typeⅠtympanoplasty,still had potential pathogens.Bacterial cultivation and drug sensitive test before operation can guide the clinical medication and prevent infection.