成人慢性化脓性中耳炎耳道分泌物病原菌分布及耐药性分析

目的 分析慢性化脓性中耳炎成人患者耳道分泌物中病原菌分布及耐药情况,为临床诊断与治疗提供参考。方法 选取2017年7月~2018年6月于我院确诊的慢性化脓性中耳炎患者300例,取耳道分泌物进行病原菌分离培养鉴定和药敏试验。结果 300份分泌物标本中病原菌检出率为82.33%(247/300)。共分离出268株病原菌,其中真菌112株(41.79%)、革兰阳性菌 107株(39.93%)、革兰阴性菌 49株(18.28%)。曲霉属(29.11%,78/268)、金黄色葡萄球菌(25.75%,69/268)和铜绿假单胞菌(9.33%,25/268)是慢性化脓性中耳炎患者外耳道分泌物中的常见病原菌。金黄色葡萄球菌及凝固酶阴性葡萄球菌对青霉素的耐药率最高,分别为72.46%和90.00%,而金黄色葡萄球菌对头孢西丁的耐药率达到27.54%;铜绿假单胞菌对左氧氟沙星的耐药率最高,达到52.00%。结论 广泛开展针对慢性化脓性中耳炎患者外耳道分泌物病原菌的培养鉴定及药敏试验,对指导临床选取合理的抗菌药物进行有效治疗具有重要意义。

Pathogens distribution and drug resistance analysis of secretions of adult patients with chronic suppurative otitis media

Objective To analyze the pathogens distribution and drug resistance of secretions of adult patients with chronic suppurative otitis media in order to direct the clinical diagnosis and treatment. Methods A total of 300 patients with chronic suppurative otitis media were collected from July 2017 to June 2018. The ear canal secretions were obtained for culture and identification of pathogen separation, and the result of drug susceptibility test was analyzed. Results The isolation rate of pathogens in 300 secretion specimens was 82.33% (247/300). A total of 268 strains of pathogens were isolated from the secretion specimens of patients with chronic suppurative otitis media, including 112 (41.79%) strains of fungi, 107 (39.93%) strains of gram-positive bacteria and 49 (18.28%) strains of gram-negative bacteria. Aspergillus (29.11%, 78/268), Staphylococcus aureus (25.75%, 69/268) and Pseudomonas aeruginosa (9.33%, 25/268) were the common species of pathogens. The drug resistance rates of Staphylococcus aureus and coagulase negative Staphylococci strains to penicillin were 72.46% and 90.00% respectively which were more than others, and the drug resistance rate of Staphylococcus aureus to cefoxitin was 27.54%. The drug resistance rate of Pseudomonas aeruginosa strains to levofloxacin was 52.00% which was more than others. Conclusions It is important to carry out the culture, identification and drug susceptibility test of pathogens for patients with chronic suppurative otitis media, which could guide the clinical to select antibiotics for effective treatment.