临床儿科杂志
臨床兒科雜誌
림상인과잡지
2013年
7期
641-644
,共4页
中耳炎%病原体%耐药性%儿童
中耳炎%病原體%耐藥性%兒童
중이염%병원체%내약성%인동
otitis media%pathogen%antibiotic resistance%child
目的研究引起儿童中耳炎感染的病原菌分布和耐药性特征。方法收集门诊就诊的164例中耳炎患儿的耳分泌物标本，分离鉴定病原菌，并进行药敏试验。按照2012年临床实验室标准化委员会（CLSI）推荐的抗菌药物敏感性试验标准，并使用WHONET5.6软件分析药敏结果。结果164例中耳炎患儿中，121例的耳分泌物培养出病原菌，阳性率73.8%；其中复合菌感染者9例，占5.5%。共分离出病原菌130株，其中细菌占83.1%（108/130），真菌占16.9%（22/130）。细菌以肺炎链球菌最多，其次是金黄色葡萄球菌。真菌主要为念珠菌和曲霉菌。婴儿期和幼儿期患儿的肺炎链球菌检出率分别高于学龄前期和学龄期，差异有统计学意义（P<0.05）。对青霉素不敏感的肺炎链球菌76.0%，对甲氧西林耐药金黄色葡萄球菌14.3%。结论由于引起儿童中耳炎的病原菌不同，应对患儿耳分泌物进行细菌培养和药敏试验，并根据结果合理选用药物治疗。
目的研究引起兒童中耳炎感染的病原菌分佈和耐藥性特徵。方法收集門診就診的164例中耳炎患兒的耳分泌物標本，分離鑒定病原菌，併進行藥敏試驗。按照2012年臨床實驗室標準化委員會（CLSI）推薦的抗菌藥物敏感性試驗標準，併使用WHONET5.6軟件分析藥敏結果。結果164例中耳炎患兒中，121例的耳分泌物培養齣病原菌，暘性率73.8%；其中複閤菌感染者9例，佔5.5%。共分離齣病原菌130株，其中細菌佔83.1%（108/130），真菌佔16.9%（22/130）。細菌以肺炎鏈毬菌最多，其次是金黃色葡萄毬菌。真菌主要為唸珠菌和麯黴菌。嬰兒期和幼兒期患兒的肺炎鏈毬菌檢齣率分彆高于學齡前期和學齡期，差異有統計學意義（P<0.05）。對青黴素不敏感的肺炎鏈毬菌76.0%，對甲氧西林耐藥金黃色葡萄毬菌14.3%。結論由于引起兒童中耳炎的病原菌不同，應對患兒耳分泌物進行細菌培養和藥敏試驗，併根據結果閤理選用藥物治療。
목적연구인기인동중이염감염적병원균분포화내약성특정。방법수집문진취진적164례중이염환인적이분비물표본，분리감정병원균，병진행약민시험。안조2012년림상실험실표준화위원회（CLSI）추천적항균약물민감성시험표준，병사용WHONET5.6연건분석약민결과。결과164례중이염환인중，121례적이분비물배양출병원균，양성솔73.8%；기중복합균감염자9례，점5.5%。공분리출병원균130주，기중세균점83.1%（108/130），진균점16.9%（22/130）。세균이폐염련구균최다，기차시금황색포도구균。진균주요위념주균화곡매균。영인기화유인기환인적폐염련구균검출솔분별고우학령전기화학령기，차이유통계학의의（P<0.05）。대청매소불민감적폐염련구균76.0%，대갑양서림내약금황색포도구균14.3%。결론유우인기인동중이염적병원균불동，응대환인이분비물진행세균배양화약민시험，병근거결과합리선용약물치료。
Objectives To analyze the main pathogen of otitis media and antibiotics resistance of clinical bacterial isolates in pediatric patients. Methods Secretion specimens from 164 cases of otitis media were cultured. Antimicrobial susceptibility was determined. Results were analyzed according to the guidelines of Clinical and Laboratory Standard In-stitute (2012). WHONET 5.6 software was used to analyse the data. Results Pathogens were cultivated in 121 ear secretion specimens from 164 cases of otitis media and the positive rate was 73.8%. There were 9 cases of mixed bacterial infection, accounting for 5.5%. 130 strains of pathogens were isolated from middle ear secretion and the main pathogens were bacteria (83.1%) and fungus (16.9%). Among bacteria, 50 (46.3%) were Streptococcus pneumoniae and 21 (19.4%) Staphylococcus aureus. Among fungus, 17 (77.3%) were Candida spp and 5 (22.7%) Aspergillus spp. By age, the rates of infection caused by Streptococcus pneumoniae in infancy and early childhood were markedly higher than those in preschool and school-age, respectively (P<0.05). The no-susceptibility rate of Streptococcus pneumoniae to penicillin was 76.0%. The prevalence of meticillin-resistant Staphylococcus aureus (MRSA) was 14.3%. Conclusions Proper treatment depends on the secretion culture and drug sensitive test due to various pathogens of otitis media.
