CAJ | 학술논문

目的：探讨儿童中耳感染病原菌的构成及耐药性。方法收集中耳炎患儿的耳脓分泌物，以全自动细菌鉴定仪VITEK32进行细菌鉴定和药敏实验，并结合K-B药敏实验法，根据临床试验室标准化委员会标准进行结果判读。结果2010年1月至2012年12月共收到2个月~14岁中耳炎患儿耳脓分泌物425份，分离病原菌347株，检出阳性率81.65%。细菌检出率93.37%（324/347），真菌检出率6.63%（23/347）。分离细菌主要为肺炎链球菌（40.92%，142/347），金黄色葡萄球菌（33.43%，116/347）和流感嗜血杆菌（7.78%，27/347）；肺炎链球菌相对集中分布在1~3岁幼儿，分离率为47.09%，不同年龄段间各细菌分离率差异无统计学意义（P>0.05）。2010年、2011年和2012年耳脓分泌物耐甲氧西林金黄色葡萄球菌（MRSA）分离率分别为11.11%（5/45）、18.75%（9/48）和30.43%（7/23），差异无统计学意义（χ2=3.86，P=0.145）；对青霉素耐药的肺炎链球菌（PRSP）分别为9.26%、3.92%和27.03%，各年份之间差异有统计学意义（χ2=11.47，P=0.003）。结论根据儿童耳脓分泌物的病原菌分离培养和药敏实验结果合理选用抗生素，可能有助于降低细菌耐药，提高儿童中耳炎治愈率。
목적：탐토인동중이감염병원균적구성급내약성。방법수집중이염환인적이농분비물，이전자동세균감정의VITEK32진행세균감정화약민실험，병결합K-B약민실험법，근거림상시험실표준화위원회표준진행결과판독。결과2010년1월지2012년12월공수도2개월~14세중이염환인이농분비물425빈，분리병원균347주，검출양성솔81.65%。세균검출솔93.37%（324/347），진균검출솔6.63%（23/347）。분리세균주요위폐염련구균（40.92%，142/347），금황색포도구균（33.43%，116/347）화류감기혈간균（7.78%，27/347）；폐염련구균상대집중분포재1~3세유인，분리솔위47.09%，불동년령단간각세균분리솔차이무통계학의의（P>0.05）。2010년、2011년화2012년이농분비물내갑양서림금황색포도구균（MRSA）분리솔분별위11.11%（5/45）、18.75%（9/48）화30.43%（7/23），차이무통계학의의（χ2=3.86，P=0.145）；대청매소내약적폐염련구균（PRSP）분별위9.26%、3.92%화27.03%，각년빈지간차이유통계학의의（χ2=11.47，P=0.003）。결론근거인동이농분비물적병원균분리배양화약민실험결과합리선용항생소，가능유조우강저세균내약，제고인동중이염치유솔。
Objectives To analyze pathogen distribution and antimicrobial resistance of bacilli among children with otitis media. Methods Pathogenic bacteria was isolated from children with suppurative otitis media. The VITEK32 was used for iden-tification. The bacterial susceptibility testing was done by Kirby-Bauer method. According to CLSI standard the antimicrobial susceptibility was determined. Results From Jan 2010 to Dec 2012, 425 children with suppurative otitis media were examined. 347 strains were isolated, of which the detectable rate was 81.65%. The detectable rate of bacteria and fungus was 93.37%(324/347) and 6.63%(23/347), respectively. Among bacteria, the detectable rate of streptococcus pneumoniae was 40.92%(142/347) and staphylococcus aureus was 33.43%(116/347). The detectable rate of haemophilus influenza was 7.78%(27/347). The preva-lence of streptococcus pneumoniae is high in children aged 1-3years, with detectable rate at 47.09%. There was no statistical dif-ference among different age groups. The prevalence of methicillin-resistant staphylococcus aureus (MRSA) in middle ear secre-tion was 1.11%(5/45), 18.75%(9/48)and 30.43%(7/23)in 2010, 2011 and 2012 respectively, with no statistical difference (χ2=3.86, P=0.145). The prevalence of penicillin-resistant streptococcus pneumoniae (PRSP) in middle ear secretion was 9.26%, 3.92%and 27.03%in 2010, 2011 and 2012 respectively, with statistical difference (χ2=11.47, P=0.003). Conclusions Choosing correct therapy according to the result of middle ear secretion culture and antibiotics sensitive test can increase the recovery rate of otitismedia.