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目的:探讨不同年龄人群化脓性中耳炎的细菌谱,及其对临床常用药物的敏感情况。方法:对张家口地区2001～2003年间不同年龄组(<14岁:儿童组;≥14岁:非儿童组)化脓性中耳炎患者的中耳分泌物进行细菌培养,每份标本分别接种巧克力色平板和血琼脂平板,置5%CO2环境,37℃孵育24～48h。采用KirbyBauer纸片琼脂扩散法测定分离致病菌对临床常用抗生素的敏感性。结果:儿童组142例中,129例培养阳性,检出率为90.85%,共检出病原菌140株。主要病原菌为流感嗜血杆菌、金黄色葡萄球菌和肺炎链球菌,分别占检出菌的24.29%、21.43%和17.88%。非儿童组253例中,213例培养阳性,检出率为84.15%,共检出病原菌245株。主要病原菌是表皮葡萄球菌、铜绿假单胞菌和假丝酵母菌,分别占检出菌的18.78%、17.55%和16.33%。引起儿童组人群感染的140株病原菌除对氨苄青霉素有较低的敏感性(64.29%)外,对所测试的其他10种抗生素敏感性均在94.00%以上。引起非儿童组人群感染的205株病原菌除对环丙沙星有较高的敏感性(90.73%)外,对其他抗生素都表现出了一定的耐药性,尤其对青霉素G、氨苄青霉素、庆大霉素敏感性仅为5.68%、0.98%、49.76%。两组人群对所测试的11种抗生素的敏感性均有统计学意义(均P<0.05)。结论:引起不同年龄组化脓性中耳炎的病原菌不一样,对药物的敏感性差异也显著,临床用药治疗时要全面考虑。
Objective: To investigate the bacterial spectrum of suppurative otitis media in different age groups and its sensitivity to commonly used clinical drugs. Methods: The middle ear secretions from patients with suppurative otitis media from 2001 to 2003 in different age groups (<14 years old: children group; ≥14 years: non-children group) were cultured in bacteria in Zhangjiakou district. Each sample was inoculated with chocolate color plate and Blood agar plate, set 5% CO2 environment, incubated at 37 ℃ for 24 ~ 48h. The KirbyBauer paper agar diffusion method was used to determine the sensitivity of isolates to commonly used antibiotics. Results: Of the 142 children in the group, 129 were positive for culture, with a detection rate of 90.85%. A total of 140 pathogenic bacteria were detected. The main pathogens were Haemophilus influenzae, Staphylococcus aureus and Streptococcus pneumoniae, accounting for 24.29%, 21.43% and 17.88% respectively of the detected bacteria. Among 253 non-children group, 213 cases were positive for culture, with a detection rate of 84.15%. A total of 245 pathogenic bacteria were detected. The main pathogens were Staphylococcus epidermidis, Pseudomonas aeruginosa and Candida albicans, which accounted for 18.78%, 17.55% and 16.33% of the detected bacteria respectively. The 140 pathogens causing infection in the children group were more than 94.00% for the other 10 antibiotics tested, except for the low sensitivity to ampicillin (64.29%). In addition to the 205 strains of pathogens causing non-children group infection in addition to ciprofloxacin has a higher sensitivity (90.73%), other antibiotics have shown some resistance, especially for penicillin G, ampicillin, Qing The sensitivity of gentamicin was only 5.68%, 0.98% and 49.76%. The sensitivity of the two groups to the 11 antibiotics tested were statistically significant (all P <0.05). Conclusion: The pathogenic bacteria causing suppurative otitis media of different age groups are different, and the difference of the sensitivity to drugs is also significant. The treatment of clinical medicine should be fully considered.