学龄前儿童中耳感染病原菌分布及耐药性分析

目的 研究引起学龄前儿童中耳感染的病原菌分布及耐药特征。方法 选取2012年1月—2015年12月就诊的中耳感染患儿,进行耳分泌物常规病原菌分离培养及药物敏感性试验。结果 分离出病原菌200株,包括革兰阳性球菌156株,占78.0%,主要包括肺炎链球菌、金黄色葡萄球菌等;革兰阴性杆菌38株,占19.0%,主要为铜绿假单胞菌;念珠菌6株,占3%。肺炎链球菌对红霉素、四环素、克林霉素、复方新诺明的耐药率高,对青霉素的耐药率低,金黄色葡萄球菌对青霉素的耐药率高,未见对万古霉素、利奈唑胺、达托霉素耐药的金黄色葡萄球菌。在常规监测的12种抗菌药物中,铜绿假单胞菌总体耐药性低,各抗菌药物的耐药率均32%。结论 学龄前儿童中耳感染的常见病原菌为肺炎链球菌、金黄色葡萄球菌、铜绿假单胞菌,不同细菌对不同抗菌药物的耐药性不同,合理用药是控制感染的关键。

Analysis of pathogenic bacteria distribution and drug resistance of otitis media in preschool children

Abastract:Objective To explore the pathogenic bacteria distribution and drug resistance of otitis media in preschool children.Methods Children with otitis media during January 2012 to December 2015 were selected. Ear discharge was taken for common pathogenic bacteria isolation and culture. The drug sensitivity was tested.Results In 200 strains of pathogenic bacteria isolated, 156 (78.0%) strains were Gram-positive cocci, mainly beingStreptococcus pneumoniae,Staphylococcus aureus; 38 (19.0%) strains were Gram-negative bacilli, mainly beingPseudomonas aeruginosa; 6 (3.0%) strains were monilia. Streptococcus pneumoniae had high rate of resistance to erythromycin, tetracycline, clindamycin and sulfamethoxazole, and low rate of resistance to penicillin.Staphylococcus aureus had high rate of resistance to penicillin, and had not found resistance to vancomycin, linezolid and daptomycin. In routine monitoring of 12 kinds of antimicrobial agents, the overall drug resistance of Pseudomonas aeruginosa was low, and the resistance rates of each antimicrobial agent was less than 32%.Conclusion The common pathogens of otitis media in preschool children wereStreptococcus pneumoniae,Staphylococcus aureus, and Pseudomonas aeruginosa. However, different bacteria had different drug resistance. Thus, rational use of antibacterial drugs is the key to control infections.