115例农村慢性鼻-鼻窦炎患者分泌物病原菌培养分析

发布时间：2018-08-31 18:34

【摘要】：目的:了解农村地区慢性鼻-鼻窦炎(CRS)的细菌分布、药物敏感性特征及抗生素使用对病原菌培养的影响。方法:选取115例居住在农村地区的CRS患者的鼻腔鼻窦分泌物,分别行需氧菌、厌氧菌培养及药物敏感试验。统计患者2周及近2个月内使用抗生素的情况。结果:115例标本中共检出37例17种致病菌,需氧菌阳性率为32.17%。表皮葡萄球菌为农村地区CRS中最常见的需氧菌。17例上颌窦标本厌氧菌培养无结果。115例患者中近2个月内使用抗生素者有90例(78.26%),近2周内使用抗生素者有73例(63.48%)。采用χ2检验发现在伴鼻息肉的CRS组中,细菌培养率高(P0.05),提示细菌性因素与鼻息肉生成有关联。CRS患者细菌培养阳性者对氧氟沙星、头孢噻肟、头孢他啶、头孢吡肟等敏感,而对青霉素G、氨苄西林、红霉素等有较高的耐药现象。结论:农村地区CRS细菌分布无特异性差异,CRS患者抗生素滥用及厌氧菌培养技术原因是导致培养阳性率低最主要的因素。合理使用抗菌药物应建立在细菌培养和药物敏感试验的基础上。
[Abstract]:Objective: to investigate the distribution of bacteria in chronic rhinosinusitis (CRS) in rural areas, the characteristics of drug sensitivity and the effect of antibiotic use on the culture of pathogenic bacteria. Methods: the nasal cavity and paranasal secretions were collected from 115 CRS patients living in rural areas, and the aerobic bacteria, anaerobes culture and drug sensitivity tests were performed respectively. The use of antibiotics in 2 weeks and 2 months was counted. Results A total of 37 cases (17 pathogenic bacteria) were detected in 115 specimens, and the positive rate of aerobic bacteria was 32.17%. Staphylococcus epidermidis (Staphylococcus epidermidis) was the most common aerobic bacteria in CRS in rural areas. 17 cases of anaerobes in maxillary sinuses showed no results. 90 cases (78.26%) were treated with antibiotics within 2 months and 73 cases (63.48%) were treated with antibiotics within 2 weeks. The results of 蠂 2 test showed that bacteria culture rate was high in CRS group with nasal polyps (P0.05), suggesting that bacterial factors were associated with nasal polyp formation. The positive cases were sensitive to ofloxacin, cefotaxime, ceftazidime, cefepime, etc. The drug resistance to penicillin G, ampicillin and erythromycin was higher. Conclusion: there is no specific difference in the distribution of CRS bacteria in rural areas. The reasons of antibiotic abuse and anaerobic culture technique are the main factors leading to the low positive rate of culture. Rational use of antimicrobial agents should be based on bacterial culture and drug sensitivity test.
【作者单位】：安徽医科大学附属省立医院耳鼻咽喉头颈外科;
【分类号】：R765

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