儿童慢性分泌性中耳炎的细菌研究

发布时间：2018-07-26 07:52

【摘要】：目的:研究耳炎差异球菌(A.otitidis)、肺炎链球菌、流感嗜血杆菌、卡他莫拉菌在儿童慢性分泌性中耳炎(SOM)中耳积液中的检出率以及在鼻咽部中的繁殖情况,以探讨其对儿童SOM的意义。方法:采用传统细菌培养方法和PCR方法,观察4种细菌在中耳积液和鼻咽部中的检出率。结果:通过细菌培养,中耳积液中致病菌的检出率为3.6%,鼻咽部为54.0%,肺炎链球菌、流感嗜血杆菌、卡他莫拉菌的检出率分别为10.8%、27.0%、4.5%,对51例细菌培养为肺炎链球菌、流感嗜血杆菌、卡他莫拉菌的标本进行药敏,结果表明39例标本对β-内酰胺类抗生素敏感;通过PCR检测,在中耳积液和鼻咽部中同时检测到多种细菌的例数分别是6例和34例。肺炎链球菌、流感嗜血杆菌、卡他莫拉菌、A.otitidis在中耳积液中的检出率分别为5.4%、5.4%、3.6%和42.3%,在鼻咽部中分别是25.2%、27.0%、13.5%、34.2%。结论:1PCR方法比常规细菌培养方法能够更灵敏地检测出细菌;2儿童慢性SOM可能是由多种细菌混合感染引起的,而A.otitidis可能是儿童SOM最常见的致病菌;3对于SOM儿童,如果疾病初期使用抗生素,建议使用β-内酰胺类抗生素。
[Abstract]:Objective: to study the detectable rate of A.otitidis, Streptococcus pneumoniae, Haemophilus influenzae and Morrah carinii in the middle ear effusion of chronic secretory otitis media (SOM) in children and their reproduction in nasopharynx in order to explore the significance of SOM in children. Methods: the detection rate of 4 kinds of bacteria in middle ear effusion and nasopharynx were observed by traditional bacterial culture method and PCR method. Results: the positive rate of pathogenic bacteria in middle ear effusion was 3.6, and that in nasopharynx was 54.0. The positive rates of Streptococcus pneumoniae, Haemophilus influenzae and Mora carinii were 10.8 and 27.04.5.The bacteria were cultured as Streptococcus pneumoniae and Haemophilus influenzae respectively. The results showed that 39 samples were sensitive to 尾 -lactam antibiotics, 6 cases were detected in middle ear effusion and 34 cases in nasopharynx by PCR. The detectable rates of Streptococcus pneumoniae, Haemophilus influenzae and A. katamurium in middle ear effusion were 5.45.40.36% and 42.3%, respectively. Conclusion compared with the conventional bacterial culture method, the ratio 1 PCR method is more sensitive than the conventional bacterial culture method in the detection of chronic SOM, which may be caused by multiple bacterial co-infection, while A.otitidis may be the most common pathogen of SOM in children. 尾-lactam antibiotics are recommended if the disease is initially used.
【作者单位】：中国医科大学附属第一医院耳鼻咽喉科;武汉市第三医院耳鼻咽喉科;
【分类号】：R764.21

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