听力学及言语疾病杂志
聽力學及言語疾病雜誌
은역학급언어질병잡지
Journal of Audiology and Speech Pathology
2015年
6期
593-596
,共4页
郝丽丽%王智楠%张振%李隽%夏忠芳
郝麗麗%王智楠%張振%李雋%夏忠芳
학려려%왕지남%장진%리준%하충방
急性中耳炎%化脓性%儿童%药物敏感性%肺炎链球菌
急性中耳炎%化膿性%兒童%藥物敏感性%肺炎鏈毬菌
급성중이염%화농성%인동%약물민감성%폐염련구균
Acute otitis media%Suppurative%Child%Antimicrobial susceptibility%Streptococcus pneumoniae
目的:探讨儿童急性化脓性中耳炎的病原菌分布及主要病原菌的药敏。方法回顾性分析武汉市儿童医院2012年1月1日~2014年12月31日诊治的146例急性化脓性中耳炎患儿的临床资料,分析患儿中耳脓性分泌物的病原菌培养及药敏结果。结果①146例患儿中,109例(74.66%)中耳脓性分泌物检出菌株,肺炎链球菌(streptococcus pneumoniae ,SP)检出例数最多(64/109,58.72%),金黄色葡萄球菌(staphylococcus aureus , S A )次之(19/109,17.43%);②S P对万古霉素、左氧氟沙星、氯霉素较敏感(分别为100%,100%,95.08%),对青霉素、阿莫西林、头孢噻肟中度敏感(分别为35.08%,49.1%,59.65%),对红霉素、克林霉素、复方新诺明耐药性高;S A对万古霉素、四环素、阿米卡星敏感性高(分别为100%,100%,94.7%),对阿莫西林克拉维酸钾、头孢西丁、苯唑西林中度敏感(分别为68.4%,64.7%,68.4%),对青霉素及氨苄西林的耐药率100%,;③≤1岁组(61例)、>1~3岁组(44例)、>3岁组(41例)的SP检出例数分别为31例(50.82%)、25例(56.82%)、8例(19.51%);≤1岁组、>1~3岁组的SP检出率显著高于>3岁组(χ2=14.073,P=0.001);④2012(53例)、2013(45例)、2014年(48例)SP的检出例数分别为16例(30.19%)、22例(48.89%)、26例(54.17%),检出率逐年增高(χ2=6.557,P=0.038)。不同年份SP对抗菌药物的敏感度差异无统计学意义(P>0.05),但耐药率有逐年降低的趋势。结论 SP是本组对象中小于3岁的急性化脓性中耳炎患儿的主要致病菌,近3年该菌检出率逐年增高,其对抗菌药物敏感性较稳定。
目的:探討兒童急性化膿性中耳炎的病原菌分佈及主要病原菌的藥敏。方法迴顧性分析武漢市兒童醫院2012年1月1日~2014年12月31日診治的146例急性化膿性中耳炎患兒的臨床資料,分析患兒中耳膿性分泌物的病原菌培養及藥敏結果。結果①146例患兒中,109例(74.66%)中耳膿性分泌物檢齣菌株,肺炎鏈毬菌(streptococcus pneumoniae ,SP)檢齣例數最多(64/109,58.72%),金黃色葡萄毬菌(staphylococcus aureus , S A )次之(19/109,17.43%);②S P對萬古黴素、左氧氟沙星、氯黴素較敏感(分彆為100%,100%,95.08%),對青黴素、阿莫西林、頭孢噻肟中度敏感(分彆為35.08%,49.1%,59.65%),對紅黴素、剋林黴素、複方新諾明耐藥性高;S A對萬古黴素、四環素、阿米卡星敏感性高(分彆為100%,100%,94.7%),對阿莫西林剋拉維痠鉀、頭孢西丁、苯唑西林中度敏感(分彆為68.4%,64.7%,68.4%),對青黴素及氨芐西林的耐藥率100%,;③≤1歲組(61例)、>1~3歲組(44例)、>3歲組(41例)的SP檢齣例數分彆為31例(50.82%)、25例(56.82%)、8例(19.51%);≤1歲組、>1~3歲組的SP檢齣率顯著高于>3歲組(χ2=14.073,P=0.001);④2012(53例)、2013(45例)、2014年(48例)SP的檢齣例數分彆為16例(30.19%)、22例(48.89%)、26例(54.17%),檢齣率逐年增高(χ2=6.557,P=0.038)。不同年份SP對抗菌藥物的敏感度差異無統計學意義(P>0.05),但耐藥率有逐年降低的趨勢。結論 SP是本組對象中小于3歲的急性化膿性中耳炎患兒的主要緻病菌,近3年該菌檢齣率逐年增高,其對抗菌藥物敏感性較穩定。
목적:탐토인동급성화농성중이염적병원균분포급주요병원균적약민。방법회고성분석무한시인동의원2012년1월1일~2014년12월31일진치적146례급성화농성중이염환인적림상자료,분석환인중이농성분비물적병원균배양급약민결과。결과①146례환인중,109례(74.66%)중이농성분비물검출균주,폐염련구균(streptococcus pneumoniae ,SP)검출례수최다(64/109,58.72%),금황색포도구균(staphylococcus aureus , S A )차지(19/109,17.43%);②S P대만고매소、좌양불사성、록매소교민감(분별위100%,100%,95.08%),대청매소、아막서림、두포새우중도민감(분별위35.08%,49.1%,59.65%),대홍매소、극림매소、복방신낙명내약성고;S A대만고매소、사배소、아미잡성민감성고(분별위100%,100%,94.7%),대아막서림극랍유산갑、두포서정、분서서림중도민감(분별위68.4%,64.7%,68.4%),대청매소급안변서림적내약솔100%,;③≤1세조(61례)、>1~3세조(44례)、>3세조(41례)적SP검출례수분별위31례(50.82%)、25례(56.82%)、8례(19.51%);≤1세조、>1~3세조적SP검출솔현저고우>3세조(χ2=14.073,P=0.001);④2012(53례)、2013(45례)、2014년(48례)SP적검출례수분별위16례(30.19%)、22례(48.89%)、26례(54.17%),검출솔축년증고(χ2=6.557,P=0.038)。불동년빈SP대항균약물적민감도차이무통계학의의(P>0.05),단내약솔유축년강저적추세。결론 SP시본조대상중소우3세적급성화농성중이염환인적주요치병균,근3년해균검출솔축년증고,기대항균약물민감성교은정。
Objective To analyze pathogenic bacteria distribution and antimicrobial susceptibility in children with acute otitis media(AOM ) .Methods Otorrhea samples from 146 episodes of AOM were cultured .The antimi‐crobial susceptibility of the main pathogenic bacteria was determined .The results were analyzed by SPSS19 .0 .Re‐sults 1) The strains of bacteria were isolated from 109 children with the positive rate of 74 .66% .Streptococcus pneumoniae (SP ) was the major bacteria(64 episodes ,58 .72% ) ,followed by staphlococcus aureus(SA) (19 epi‐sodes ,17 .43% ) .2) Sp was all sensitive to vancomycin ,levofloxacin ,moderate to penicillin ,amoxicillin ,cefo‐taxime ,and highly resistent to erythromycin and clindamycin .Staphlococcus aureus were all sensitive to vancomy‐cin ,tetracycline ,and Amy card ,and moderate to amoxicillin clavulanic acid potassium ,cefoxitin ,and oxacillin ,all resistent to penicillin and ampicillin .3) The strains of SP in age≤1year ,>1 -3years ,and >3 years respectively were 31(50 .82% ) ,25(56 .82% ) ,8 (19 .51% ) .There were significant differences between them(χ2 =14 .073 ,P=0 .001) .4)The strains of SP in 2012 ,2013 ,2014 respectively were 16(30 .19% ) ,22(48 .89% ) ,26(54 .17% ) ,There were significant differences between them(χ2 =6 .557 ,P=0 .038) .The antimicrobial susceptibility of SP had no sig‐nificant differences among 2012 ,2013 ,2014 ,but a yearly resistance decreasing trend was seen .Conclusion SP was the main bacterial contributor for AOM in Wuhan children .SP detection rate increases every year ,mainly in chil‐dren less than 3 years old .T he antimicrobial susceptibility is stable .