儿童化脓性中耳炎病原菌及耐药性分析.docVIP

儿童化脓性中耳炎病原菌及耐药性分析 　　摘要：目的 研究儿童化脓性中耳炎主要致病菌的种类及耐药情况，为临床诊断和治疗提供依据。方法 对化脓性中耳炎患儿的中耳分泌物进行细菌分离培养鉴定及药物敏感试验。结果 227例标本中201例标本检出病原菌，检出率为88．5％，其中有8例标本检出2株病原菌，共分离出209株病原菌。病原菌主要是革兰氏阳性球菌164株（78.5%），其中金黄色葡萄球菌116株(55.5%)。金黄色葡萄球菌对青霉素G、氨苄西林、红霉素和克林霉素耐药率很高, 对利福平、阿莫西林/克拉维酸、环丙沙星、左氧氟沙星、头孢唑啉耐药率低，未发现对万古霉素、奎奴普丁/达福普汀、利奈唑胺耐药的菌株。结论 儿童化脓性中耳炎的主要致病菌是金黄色葡萄球菌。临床医生应根据药敏结果合理使用抗生素。 　　关键词：中耳炎；病原菌；药物敏感试验 　　Children Otitis Media Pathogens and Drug Resistance Analysis 　　CHEN Xiao-yan 　　(Linyi City Maternity and Child Health Hospital，Linyin 276000,Shandong,China) 　　Abstract：Objective To find the major types of pathogens in suppurative otitis media in children and analyze the drug resistance to provide a reference for rational clinical use of biotics. MethodsThe middle ear secretions from children with suppurative otitis media were cultured and the main pathogenic bacteria were isolated, and the susceptibility to antibiotics were carried out.Results209 pathogens were isolated from 201 specimens in a total of 227 samples. The positive detection rate was 88.5%. There were 8 cases in which two pathogens were isolated. 164 cases of Gram-positive cocci were isolated (78.5%), of which 116 Staphylococcus aureus were detected (55.5%).Staphylococcus aureus strains showed high resistance rate to penicillin G, ampicillin, erythromycin and clindamycin and low resistance rate to rifampin, amoxicillin / clavulanic acid, ciprofloxacin, levofloxacin, cefazolin and no resistance tovancomycin, quinupristin / dalfopristin, linezolid. ConclusionThe major bacterium stains in suppurative otitis media of chilidren was staphylococcus aureus. The rational use of antibiotics should be ensured according to the antibiotics susceptibility results. 　　Key words：Otitis media;Pathogens;Susceptibility results 　　对中耳炎分泌物作病原学研究,有助于掌握当前引起中耳炎的病原菌分布和药物抗菌谱规律,为无条件进行培养和药物敏感试验,或在检验结果出来之前,作为临床经验用药的参考依据。为此我们对2013年1月～9月在我院就诊的227例化脓性中耳炎患者的标本进行了分析,现将结果报道如下。 　　1资料与方法 　　1.1一般资料227份标本来源于2013年1月～9月临沂市儿童医院的耳鼻喉科，患者年龄0~14岁。 　　1.2标本采集标本采集先用75%酒精棉球清洁外耳道口,再用灭菌试管内的无菌