重庆地区慢性化脓性中耳炎分泌物培养及药敏试验结果分析

Analysis of bacterial culture and drug sensitivity test in external auditory canal secretion of chronic suppurative otitis media in Chongqing area

摘要:

目的 分析重庆地区慢性化脓性中耳炎患者外耳道脓性分泌物细菌培养及药敏试验结果，为慢性化脓性中耳炎手术前后合理用药提供依据。方法 以2020年1月-2021年5月收集的106例慢性中耳炎患者为研究对象，取患耳脓性分泌物进行细菌培养和药敏试验。结果 106例患者中85例检测出病原菌，检出率80.19%，共检出病原菌107株。其中革兰阳性菌51株（47.66%），以金黄色葡萄球菌为主（19株，17.76%）；革兰阴性菌27株（25.23%），以铜绿假单胞杆菌为主（8株，7.48%）；真菌29株（27.10%），以酵母样真菌为主（12株，11.21%）。金黄色葡萄球菌的药敏试验结果表明：金黄色葡萄球菌对苯唑西林、喹奴普丁/达福普汀、利福平及万古霉素敏感性较高，达到100%；对红霉素、青霉素、克林霉素耐药性高。铜绿假单胞菌药敏试验结果显示：对头孢他定、头孢吡肟、亚胺培南、哌拉西林/他唑巴坦、阿米卡星、庆大霉素敏感性较高，达到100%；对氨苄西林、头孢唑琳、复方新诺明耐药性高。结论 重庆地区慢性中耳炎的主要致病菌为金黄色葡萄球菌、铜绿假单胞杆菌及酵母样真菌。重庆地区气候潮湿，真菌阳性率较高，在慢性化脓性中耳炎治疗中，应重视真菌感染。

Abstract:

Objective To analyze the results of bacterial culture and drug sensitivity test of purulent secretion of external auditory canal in patients with chronic suppurative otitis media in Chongqing, so as to provide the basis for rational perioperative drug use.Methods A total of 106 patients with chronic otitis media from Jan 2020 to May 2021 were selected as the research objects. The purulent secretion of the affected ear was taken for bacterial culture and drug sensitivity test.Results The pathogens were isolated from the specimens in 85 of the 106 patients with an isolation rate of 80.19%. Totally 107 strains of pathogens were cultured, including 51 (47.66%) strains of Gram-positive bacteria, mainly Staphylococcus aureus (19 strains, 17.76%), 27 (25.23%) strains of Gram-negative bacteria, mainly Pseudomonas aeruginosa (8 strains, 7.48%), and 29 (27.10%) strains of fungi, mainly yeast like fungi (12 strains, 11.21%). Staphylococcus aureus was highly susceptible to benzoxacillin, quinoloptin/daprotin, rifampin and vancomycin, with a sensitive rate of 100%, but highly resistant to erythromycin, penicillin and clindamycin. Pseudomonas aeruginosa was highly sensitive to ceftazidime, cefepime, imipenem, piperacillin/tazobactam, amikacin and gentamicin, with a sensitive rate of 100%, and highly resistant to ampicillin, cefazolin and compound sulfamethoxazole.Conclusions The main pathogens of chronic otitis media in Chongqing are Staphylococcus aureus, Pseudomonas aeruginosa and yeast like fungi. The climate in Chongqing is humid and the positive rate of fungi is high. Fungal infection should be paid attention to in the treatment of chronic suppurative otitis media.