静止期慢性化脓性中耳炎的细菌培养与药敏试验结果分析

发布时间：2019-03-12 17:21

【摘要】：目的:了解静止期慢性化脓性中耳炎患者中耳腔的细菌分布及其耐药性特征,以指导Ⅰ型鼓室成形术后的临床合理用药。方法:取广东省人民医院诊断为慢性化脓性中耳炎静止期,均已干耳1个月以上的148例住院患者的中耳鼓室黏膜表面分泌物,行细菌培养及药敏试验,分析检测结果。结果:共培养出16种细菌,主要为金黄色葡萄球菌、铜绿假单胞菌、山羊葡萄球菌等;细菌培养阳性率为33.1%,其中革兰阳性菌为69.4%,革兰阴性菌为30.6%。药物敏感试验显示对革兰阳性菌抗菌活性较高的抗生素是万古霉素、利奈唑胺、替考拉宁、利福平等;对革兰阴性菌抗菌活性较高的抗生素是哌拉西林(他唑巴坦)、头孢哌酮(舒巴坦)等。结论:拟行Ⅰ型鼓室成形术的患者术前虽已干耳,但仍存在潜在的致病菌,术前细菌培养及药敏试验可以指导术后临床用药,防治感染。
[Abstract]:Aim: to investigate the distribution and drug resistance of bacteria in the middle ear cavity of patients with chronic suppurative otitis media at rest stage so as to guide the rational use of drugs after tympanoplasty. Methods: 148 inpatients with chronic suppurative otitis media diagnosed as chronic suppurative otitis media in Guangdong people's Hospital for more than one month were collected. Bacterial culture and drug sensitivity test were performed on the surface of tympanic mucosa of 148 inpatients with chronic suppurative otitis media, and the results were analyzed. Results: there were 16 kinds of bacteria, mainly Staphylococcus aureus, Pseudomonas aeruginosa and Staphylococcus goat, the positive rate of bacterial culture was 33.1%, of which 69.4% were gram-positive bacteria and 30.6% were gram-negative bacteria. Drug sensitivity test showed that the antibiotics with higher antibacterial activity against Gram-positive bacteria were vancomycin, ribazolamine, teicolanin and rifampicin. The antibiotics with high antibacterial activity against gram-negative bacteria were piperacillin (tazobactam), cefoperazone (sulbactam) and so on. Conclusion: the patients who plan to undergo tympanoplasty of type I have dry ears before operation, but there are still potential pathogenic bacteria. Pre-operation bacterial culture and drug sensitivity test can guide the clinical use of drugs after operation and prevent and cure infection.
【作者单位】：深圳市龙岗区第二人民医院耳鼻咽喉科;广东省人民医院耳鼻咽喉-头颈外科;
【分类号】：R764.21

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