摘要
目的:掌握不同年龄段及不同季节珠三角地区儿童急性中耳炎(AOM)的病原菌分布及药敏情况。方法:442例经临床确诊为AOM且临床资料完整的患儿按年龄分为0～1岁组、>1～3岁组及>3岁组,同时按就诊季节分为1～3月份、4～6月份、7～9月份、10～12月份4个组。无菌操作取中耳脓液行细菌、真菌、支原体培养并进行药敏实验。结果:①442例患儿中,356例培养阳性,阳性率80.5%,病原菌以肺炎链球菌(39.2%),金黄色葡萄球菌(25.9%)和流感嗜血杆菌(7.4%)为主;②肺炎链球菌是0～1岁组(56.9%)和>1～3岁组(32.5%)的主要病原菌,分布差异有统计学意义(P<0.05)。>3岁组以金黄色葡萄球菌为主(40.5%),与其他2组比较均差异有统计学意义(均P<0.05);③按月份分组中,7～9月份组AOM患儿数明显下降。肺炎链球菌在各组中分布差异无统计学意义(P>0.05),1～3月份组则以金黄色葡萄球菌为主(P<0.05);④药物敏感试验显示,利奈唑烷、氧氟沙星等对肺炎链球菌、金黄色葡萄球菌敏感性较高,阿奇霉素对流感嗜血杆菌有良好的作用。结论:不同年龄段及不同季节珠三角地区儿童AOM致病性病原菌分布存在一定的差异。各地应该结合当地的环境、气候特点,准确掌握本地区AOM的菌群分布,以便合理治疗。
Objective：To investigate the pathogenic bacteria distribution and drug susceptibility in children with acute otitis media（AOM） in different age and different season in the Pearl River Delta region.Method：Four hundred and forty-two children diagnosed as AOM were divided into three groups by age factor and four groups by season factor.Midge ear pus collecting and culturing were used for bacteria and antimicrobial susceptibility test.Result：① Strains of bacteria were isolated from 356 children with the positive rate of 80.5%.Streptococcus pneumoniae（39.2%）,staphylococcus aureus（25.9%） and haemophilus influenzae（7.4%） were the most frequently isolated pathogens.②Streptococcus pneumoniae was the main pathogenic bacteria in 0-1 year group and 1-3 years group（P0.05）,staphylococcus aureus was the most frequently isolated pathogen in 3 years group（P0.05）;③In the season groups,the number of children with AOM decreased significantly in July-September group.There was no significant difference of streptococcus pneumoniae distribution among the four groups（P0.05）.Staphylococcus aureus was the main pathogen in January-March group（P0.05）;④Drug sensitivity shown that linezolid and ofloxacin were most sensitive to streptococcus pneumoniae and staphylococcus aureus,and macrolides had a good therapy effect to haemophilus influenzae.Conclusion：The pathogens distribution and drug susceptibility in children with AOM were varies in different age and different season.As a result,a treatment should be done based on the climate,environment,and pathogens distribution of a region.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2011年第19期884-887,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基金
珠三角地区婴幼儿急性化脓性中耳炎病原菌谱与耐药性监测研究广东省科技厅立项(No:粤科社字[2009]135号
No:93070)
广东珠江三角洲地区儿童中耳炎病原菌谱与耐药性监测研究IIR项目(No:CHN2008AI008)
关键词
中耳炎
儿童
年龄
季节
肺炎链球菌
金黄色葡萄球菌
otitis media
children
age
season
streptococcus pneumoniae
staphylococcus aureus
