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目的探讨慢性化脓性中耳炎(chronic suppurative otitis media,CSOM)患者主要致病菌及其药敏试验情况。方法选取我院2014年1月~2016年10月五官科收治的121例CSOM患者为研究对象,对所有病例外耳道分泌物进行采集,并进行细菌培养及药敏试验。对结果进行汇总、分析。结果本组病例共培养得到病原菌107株,其中革兰氏阳性菌57株(53.27%),革兰氏阴性菌44株(41.21%),真菌6株(5.61%)。其中金黄色葡萄球菌与表皮葡萄球菌对青霉素及红霉素的耐药性>80%,对复方新诺明的耐药性>50%;铜绿假单胞菌与肺炎克雷伯菌对氨苄西林、头孢曲松耐药性>90%,以上常见致病菌对左氧氟沙星、莫西沙星的敏感性较高。结论 CSOM患者分泌物的常见病原菌为金黄色葡萄球菌、表皮葡萄球菌、肺炎链球菌及铜绿假单胞菌,治疗上需根据具体的药敏实验结果选择敏感抗生素治疗。
Objective To investigate the main pathogens and their susceptibility testing in patients with chronic suppurative otitis media (CSOM). Methods A total of 121 CSOM patients admitted to our hospital from January 2014 to October 2016 were enrolled in this study. Extractants of external auditory meatus were collected from all cases and bacterial culture and drug sensitivity test were performed. The results of the summary, analysis. Results 107 strains of pathogens were co-cultivated in this group, of which 57 were Gram-positive bacteria (53.27%), 44 (41.21%) were Gram-negative bacteria and 6 (5.61%) were fungi. Staphylococcus aureus and Staphylococcus epidermidis resistant to penicillin and erythromycin> 80%, the resistance to cotrimoxazole> 50%; Pseudomonas aeruginosa and Klebsiella pneumoniae ampicillin , Ceftriaxone resistance> 90%, the above common pathogenic bacteria levofloxacin, moxifloxacin higher sensitivity. Conclusions The common pathogens of secretions of CSOM patients are Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae and Pseudomonas aeruginosa. The treatment should be based on the specific antibiotic susceptibility test result.