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目的研究慢性化脓性中耳炎(CSOM)主要病原菌的种类及对抗生素的耐药情况。方法对135例CSOM患者的中耳脓性分泌物进行细菌培养,对分离的病原菌进行药物敏感试验。结果分离出病原菌119株,以金黄色葡萄球菌(45株)为主,其次是棒状杆菌(17株)和真菌(13株)。金黄色葡萄球菌对青霉素、庆大霉素、奈替米星耐药率高,分别为94%、64%、61%,对喹诺酮类、利福平、万古霉素、磺胺类敏感性高。棒状杆菌对青霉素、氯洁霉素、磺胺类、苯唑西林耐药率高,分别为54%、60%、40%、40%,对庆大霉素、环丙沙星、利福平、万古霉素、复方氨苄西林敏感性高。结论金黄色葡萄球菌、棒状杆菌和真菌是CSOM的主要病原菌。革兰阳性球菌和革兰阴性杆菌对青霉素类抗生素耐药性均高,对喹诺酮类、利福平、万古霉素均敏感。
Objective To study the types of major pathogens in chronic suppurative otitis media (CSOM) and their resistance to antibiotics. Methods The middle ear purulent secretions from 135 patients with CSOM were cultured in vitro and the pathogenic bacteria were isolated for drug susceptibility testing. Results 119 pathogens were isolated, Staphylococcus aureus (45 strains), followed by Corynebacterium (17 strains) and fungi (13 strains). Staphylococcus aureus to penicillin, gentamicin, netilmicin resistance rate were 94%, 64%, 61%, quinolones, rifampin, vancomycin, sulfa high sensitivity. Corynebacterium penicillin, clindamycin, sulfonamides, oxacillin resistance rates were high, respectively 54%, 60%, 40%, 40% of gentamicin, ciprofloxacin, rifampicin, Vancomycin, compound ampicillin high sensitivity. Conclusion Staphylococcus aureus, coryneform bacteria and fungi are the main pathogens of CSOM. Gram-positive cocci and gram-negative bacilli are resistant to penicillin antibiotics and sensitive to quinolones, rifampicin and vancomycin.