儿童中耳感染病原菌分布与耐药性分析

发布时间：2018-05-03 11:09

本文选题：儿童 + 中耳炎　；参考：《中华医院感染学杂志》2015年17期

【摘要】：目的调查与分析儿童中耳感染病原菌分布及其耐药性,为合理使用抗菌药物提供参考依据。方法收集2011年1月-2013年5月收治的180例中耳炎患儿耳分泌物标本进行病原学检测及药敏试验;采用SPSS13.0统计软件对数据进行分析。结果 180例中耳感染患儿中125例耳分泌物标本中检出病原菌,阳性率为69.4%,其中10例为复合菌感染,占8.0%;在患儿的耳分泌物标本中共培养分离出病原菌135株,革兰阳性菌为95株占70.4%,革兰阴性菌为15株占11.1%,真菌25株占18.5%;各年龄段患儿的病原菌检出率的差异无统计学意义;婴儿期患儿或幼儿期患儿的肺炎链球菌分离率显著高于学龄前期患儿或学龄期患儿(P0.05);肺炎链球菌对红霉素、克林霉素、四环素、磺胺甲VA唑/甲氧苄啶及美罗培南的耐药率较高,80.0%,金黄色葡萄球菌对青霉素、克林霉素、红霉素的耐药率较高,45.0%,两种病原菌对左氧氟沙星、万古霉素、利奈唑胺均较敏感,耐药率10.0%。结论肺炎链球菌、金黄色葡萄球菌等革兰阳性球菌仍然是引发儿童中耳炎的主要病原菌,随着患儿年龄的增长,肺炎链球菌的感染率呈现下降的趋势,儿童中耳炎的主要病原菌对传统抗感染药物的耐药率均较高,而对万古霉素等新型抗感染药物较敏感。
[Abstract]:Objective to investigate and analyze the distribution of pathogenic bacteria and their drug resistance in children with middle ear infection, and to provide reference for rational use of antimicrobial agents. Methods from January 2011 to May 2013, 180 samples of ear secretions from children with otitis media were collected for pathogen detection and drug sensitivity test, and the data were analyzed by SPSS13.0 software. Results pathogenic bacteria were detected in 125 of 180 cases of middle ear infection, the positive rate was 69.4%, of which 10 cases were compound bacteria infection, accounting for 8.0%. 135 strains of pathogenic bacteria were isolated from the ear secretion samples of the children. There were 95 Gram-positive bacteria (70.4), 15 Gram-negative bacteria (11.1b) and 25 fungi (18.5B). The isolation rate of Streptococcus pneumoniae in infants or infants was significantly higher than that in pre-school children or school-age children (P0.05), and Streptococcus pneumoniae against erythromycin, clindamycin, tetracycline, tetracycline, erythromycin, clindamycin, tetracycline, The resistance rate of Staphylococcus aureus to penicillin, clindamycin and erythromycin was higher than that of Staphylococcus aureus to penicillin, clindamycin and erythromycin. The two pathogens were sensitive to levofloxacin, vancomycin and linazolamine. The drug resistance rate was 10.0%. Conclusion Streptococcus pneumoniae, Staphylococcus aureus and other gram-positive cocci are still the main pathogens causing otitis media in children. The infection rate of Streptococcus pneumoniae is decreasing with the increase of age. The main pathogens of otitis media in children were high resistance to traditional anti-infective drugs, but sensitive to vancomycin and other new anti-infective drugs.
【作者单位】：湖北民族学院附属民大医院耳鼻咽喉头颈外科;湖北民族学院附属民大医院微生物室;
【基金】：湖北省教育厅科研基金资助项目(B20101908)
【分类号】：R764.2;R446.5

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