【摘要】 [目的]了解外耳道炎、慢性化脓性中耳炎及中耳胆脂瘤主要病原菌的分布及药物敏感性.[方法]取139例外耳道炎、慢性化脓性中耳炎及中耳胆脂瘤患者的184例外耳道分泌物标本,行细菌及真菌培养和药物敏感试验.[结果] 184例标本中87例(47.3%)病原菌培养阳性,细菌培养的139例标本中72例(51.8%)病原菌培养阳性,真菌培养的45例标本中15例(33.3%)病原菌培养阳性.细菌培养的病例中常见致病菌:在外耳道炎中金黄色葡萄球菌(38.5%)居首位,其次为铜绿假单胞菌(19.2%)、产气肠杆菌(15.4%);慢性中耳炎中金黄色葡萄球菌(47.4%)居首位,其次为肺炎克雷伯氏菌肺炎亚种(7.9%)、化脓链球菌(A群)(7.9%)、铜绿假单胞菌(7.9%)、表皮葡萄球菌(7.9%);中耳胆脂瘤中金黄色葡萄球菌(37.5%)居首位,其次为肺炎克雷伯氏菌肺炎亚种(25.0%)、铜绿假单胞菌(25.0%).金黄色葡萄球菌对阿莫西林克拉维酸钾、呋喃妥因、利福平、利奈唑胺、庆大霉素、替考拉宁、万古霉素敏感性高;铜绿假单胞菌对阿米卡星、氨曲南、环丙沙星、美洛培南、哌拉西林、庆大霉素、头孢吡肟、头孢哌酮舒巴坦、头孢他啶、亚胺培南、左旋氧氟沙星敏感.[结论]外耳道炎、慢性化脓性中耳炎及中耳胆脂瘤的病原菌以金黄色葡萄球菌为主,铜绿假单胞菌、肺炎克雷伯氏菌肺炎菌次之.不同病原菌对药物的敏感性及耐药性不同,均对临床常用抗生素存在耐药性.更多还原

【Abstract】 OBJECTIVE To explore the bacteriology of diffuse external otitis, chronicsuppurative otitis media and cholesteatoma of middle ear and examine antibiotic sensitivity of a certain isolated bacterium for guiding appropriate use of antibiotics. METHODS 184 samples of external acoustic meatus purulence were collected from 139 patients with external otitis, chronic suppurative otitis media and cholesteatoma of middle ear and cultured for bacteria, fungi and an antimicrobial susceptibility test. RESULTS 87 of the 184 samples(47.3%) were positive.Among the 139 samples with fungal growth, 72(51.8%) were positive. Among the 45 samples with bacteria growth, 15(33.3%) were positive. In the bacterial culture cases, staphylococcus aureus was the most common pathogenic bacteria(38.5%), followed by Pseudomonas aeruginosa(19.2%) and Enterobacter aerogenes(15.4%).In patients with chronic otitis media, Staphylococcus aureus was the most common pathogenic bacteria(47.4%), followed by Klebsiella pneumoniae subspecies(7.9%), Streptococcus pyogenes(group A)(7.9%), Pseudomonas aeruginosa(7.9%), and Staphylococcus epidermidis(7.9%).Among the patients with cholesteatoma of the middle ear, Staphylococcus aureus was the most common pathogenic bacteria(37.5%), Klebsiella pneumoniae subspecies(25.0%) and Pseudomonas aeruginosa(25.0%). Staphylococcus aureus showed high sensitivity to amoxicillin clavulanate potassium, furantoin, rifampicin, linezolid, gentamicin, tekoranin and vancomycin. The bacterium was sensitive to amikacin, amtronin, ciprofloxacin, meroppenem, piperacillin, gentamicin, cefepime, cefoperazone sulbactam, ceftazidime, imipenem and levofloxacin. CONCLUSION Staphylococcus aureus is the main pathogen of external otitis media, chronic suppurative otitis media and cholesteatoma of middle ear, followed by Pseudomonas aeruginosa and Klebsiella pneumoniae. Different pathogens have different level of sensitivity and drug resistance, and they have drug resistance to commonly used antibiotics in clinic.更多还原