胆脂瘤型和非胆脂瘤型慢性化脓性中耳炎手术前后病原菌分布及耐药性

发布时间：2018-03-31 18:09

本文选题：胆脂瘤　切入点：慢性化脓性中耳炎　出处：《中华医院感染学杂志》2017年03期

【摘要】：目的探讨胆脂瘤型和非胆脂瘤型慢性化脓性中耳炎手术前后病原菌分布及主要病原菌的耐药性。方法选择浙江中医药大学附属温州中西医结合医院耳鼻咽喉科2008年1月-2015年12月慢性化脓性中耳炎患者170例为研究对象,将其分为A组(胆脂瘤90例)和B组(非胆脂瘤80例),对两组患者术前、术中、术后分泌物或组织进行病原菌培养和药敏试验。结果术前、术中和术后A组患者共培养出真菌10株、革兰阳性菌60株、革兰阴性菌74株,B组患者共培养出真菌6株,革兰阳性菌59株,革兰阴性菌29株;A组患者术前和术中病原菌培养阳性率比较差异无统计学意义,B组术前病原菌培养阳性率高于术中,差异有统计学意义(P0.05),术前A组和B组病原菌培养阳性率比较差异无统计学意义,术后A组病原菌培养阳性率高于B组,差异有统计学意义(P0.05);84株金黄色葡萄球菌对万古霉素、呋喃妥因、利奈唑胺、替加环素均100.0%敏感,对红霉素、青霉素G耐药率比较高为75.0%和86.9%,55株铜绿假单胞菌对头孢吡肟和阿米卡星敏感,对头孢曲松、头孢替坦、氨苄西林、头孢呋辛、头孢唑林、磺胺甲VA唑/甲氧苄啶、呋喃妥因耐药率为100.0%。结论慢性化脓性中耳炎术前和术中检出病原菌不完全相同,胆脂瘤患者病原菌检出率较高,不同病原菌药敏试验结果不同。
[Abstract]:Objective to investigate the distribution of pathogens and drug resistance of chronic suppurative otitis media before and after operation in cholesteatoma and non-cholesteatoma. Methods 2008 Otolaryngology, Department of Otorhinolaryngology, Wenzhou Integrated Chinese and Western Medicine Hospital affiliated to Zhejiang University of traditional Chinese Medicine was selected. 170 cases of chronic suppurative otitis media from January to December 2015 were studied. They were divided into two groups: group A (90 cases of cholesteatoma) and group B (80 cases of non-cholesteatoma). A total of 10 fungi, 60 Gram-positive bacteria, 74 Gram-negative bacteria, 6 Gram-positive bacteria and 59 Gram-positive bacteria were cultured in group A during and after operation. There was no significant difference between the positive rate of pathogens culture before and during operation in group A (29 strains of Gram-negative bacteria). The positive rate of bacterial culture before operation in group B was higher than that in group B. The positive rate of pathogenic bacteria culture in group A was higher than that in group B after operation, and the difference was statistically significant in 84 strains of Staphylococcus aureus against vancomycin. Furantoin, linazolamine, tegacycline were sensitive to erythromycin, penicillin G, and 55 strains of Pseudomonas aeruginosa were sensitive to cefepime and amikacin, and were sensitive to ceftriaxone, ceftitan, ampicillin. The resistant rates of cefuroxime, cefazolin, sulfamethazol / trimethoprim and furantoin were 100.00.Conclusion the pathogens detected before and during chronic suppurative otitis media are not identical, and the positive rate of pathogenic bacteria in cholesteatoma patients is higher than that in patients with cholesteatoma. The drug sensitivity test results of different pathogens were different.
【作者单位】：浙江中医药大学附属温州中西医结合医院耳鼻咽喉科;
【基金】：浙江省医药卫生一般研究计划(2014KYB164)
【分类号】：R764.9

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