我国慢性化脓性中耳炎患者的病原学及其动态变化分析

发布时间：2019-05-24 13:21

【摘要】：目的了解我国近年来慢性化脓性中耳炎(chronic suppurative otitis media,CSOM)患者的病原菌谱分布及动态变化趋势,为临床合理用药提供指导。方法通过检索相关期刊论文(CNKI)、万方数据库、维普数据库(VIP)及中国生物医学文献数据库(CBM)从1991年1月~2015年5月发表的所有有关CSOM细菌培养的描述性临床研究中文献,共筛选出50篇文献纳入本次研究,累积研究CSOM患者7462例(7521耳)。根据文献资料的中位年限平均分为4组:1990-1995年组、1996-2001年组、2002-2007年组及2008-2013年组。对各组细菌培养病原菌检出率、真菌检出率、前4种细菌所占比例及革兰阳性(G~+)菌与革兰阴性(G~-)菌比例进行动态分析。结果细菌培养病原菌总检出率86.21%,真菌检出率5.25%。细菌以金黄色葡萄球菌、凝固酶阴性葡萄球菌、铜绿假单胞菌及变形杆菌4种细菌为主;真菌以念珠菌及曲霉菌为主。随着时间推移,细菌培养病原菌检出率逐渐降低;真菌检出率逐渐增高;前4种细菌中以金黄色葡萄球菌排名首位,凝固酶阴性葡萄球菌的比例有逐渐增加的趋势;G~+菌与G~-菌比例分别逐渐增加和下降。结论我国CSOM患者病原菌谱中以金黄色葡萄球菌、凝固酶阴性葡萄球菌、铜绿假单胞菌及变形杆菌为主要病原菌;随着时间推移,细菌培养病原菌检出率逐渐降低,真菌检出率、G~+菌检出比例及凝固酶阴性葡萄球菌的检出率有增高趋势。
[Abstract]:Objective to investigate the distribution and dynamic trend of pathogenic bacteria in patients with chronic suppurative otitis media (chronic suppurative otitis media,CSOM) in recent years, and to provide guidance for rational drug use in clinic. Methods the Chinese periodical full-text database (CNKI), Wanfang database was searched. From January 1991 to May 2015, (VIP) and (CBM), a Chinese biomedical literature database, selected a total of 50 literatures from all descriptive clinical studies on CSOM bacterial culture published from January 1991 to May 2015 for inclusion in this study. 7462 patients (7521 ears) with CSOM were enrolled in the cumulative study. According to the median years of literature, they were divided into 4 groups: 1990-1995 group, 1996-2001 group, 2002-2007 group and 2008-2013 group. The detection rate of pathogenic bacteria, the detection rate of fungi, the proportion of the first four bacteria and the ratio of Gram-negative bacteria to Gram-negative bacteria in each group were analyzed dynamically. Results the total detection rate of pathogenic bacteria and fungi was 86.21% and 5.25% respectively. Staphylococcus aureus, coagulase negative Staphylococcus, Pseudomonas aeruginosa and Proteus were the main bacteria, and candida and aspergillus were the main fungi. With the passage of time, the detection rate of pathogenic bacteria in bacterial culture decreased gradually, and the detection rate of fungi increased gradually. Staphylococcus aureus ranked first among the first four kinds of bacteria, and the proportion of coagulase negative Staphylococcus increased gradually. The ratio of G ~ bacteria to G / G bacteria increased and decreased gradually. Conclusion Staphylococcus aureus, coagulase negative Staphylococcus, Pseudomonas aeruginosa and Proteus are the main pathogens in the pathogen spectrum of CSOM patients in China. With the passage of time, the detection rate of pathogenic bacteria in bacterial culture decreased gradually, while the detection rate of fungi, the proportion of G ~ bacteria and the detection rate of coagulase-negative staphylococci tended to increase.
【作者单位】：中南大学湘雅医院耳鼻咽喉头颈外科;
【基金】：“973”国家重大科学研究计划项目(2014CB943003) 国家自然科学青年科学基金项目(81300819,81400468) 国家自然科学基金面上项目(81170912) 教育部博士点基金(20110162110007) “湘雅医院-北大未名临床与康复研究基金”项目(xywm2015Ⅱ10)
【分类号】：R764.21

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