慢性化脓性中耳炎分泌物的病原学研究

目的研究慢性化脓性中耳炎(CSOM)主要病原菌的种类及对抗生素的耐药情况.方法对135例CSOM患者的中耳脓性分泌物进行细菌培养,对分离的病原菌进行药物敏感试验.结果分离出病原菌119株,以金黄色葡萄球菌(45株)为主,其次是棒状杆菌(17株)和真菌(13株).金黄色葡萄球菌对青霉素、庆大霉素、奈替米星耐药率高,分别为94%、64%、61%,对喹诺酮类、利福平、万古霉素、磺胺类敏感性高.棒状杆菌对青霉素、氯洁霉素、磺胺类、苯唑西林耐药率高,分别为54%、60%、40%、40%,对庆大霉素、环丙沙星、利福平、万古霉素、复方氨苄西林敏感性高.结论金黄色葡萄球菌、棒状杆菌和真菌是CSOM的主要病原菌.革兰阳性球菌和革兰阴性杆菌对青霉素类抗生素耐药性均高,对喹诺酮类、利福平、万古霉素均敏感.

An investigation on the distribution of common pathogens in the secretion of chronic suppurative otitis media

Objective To investigate the distribution of common pathogens in the secret-ion of chronic suppurative otitis media(CSOM) and their status of antibiotics-resisting. Methods 135 cases with CSOM were included in this study.Their secreting samples were taken and bacteria culturing was done among all of them to separate the common kinds of pathogen.Meanwhile drug-sensitive tests were done for all the samples. Results Among the 119 strains of germ separated from the secretion fo CSOM,the most commonly seen ones were staphylococcus aureus(45 strains),and the others in an order from high to low were corynebacterium(17 strains)and fungus(13 strains).In the drug-sensitive tests,it was shown that staphylococcus aureus was highly resistive to penicillin(94%),gentamycin(64%) and netilmicin(61%) and was sensitive to quinolones,rifampicin,vancomycin and sulfanilamide.On the other hand,corynebacterium was resistive to penicillin(54%),clindamycin(60%),sulfanilamide(40%) and oxacillin(40%),and sensitive to gentamycin,cinroflaxacin,ripampicin,vancomycin and co-ampicillin. Conclusions The main pathogens in CSOM include staphylococcus oureus,coryneha-cterium and fangus.Among these germs, G+cocci and G-bacilli are all more resistive to penicillin and more sensitive to quinolones,ripampicin and vancomycin.