儿童中耳感染病原菌的构成及主要病原菌耐药性的监测

临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (2): 136-139.

儿童中耳感染病原菌的构成及主要病原菌耐药性的监测

何萍，季正华，徐俊，陶云珍，朱宏，王运中

苏州大学附属儿童医院检验科（江苏苏州　215003）

收稿日期:2013-08-25 出版日期:2014-02-15 发布日期:2014-02-15

Surveillance of pathogen distribution and antimicrobial resistance of bacilli among children with otitis media

HE Ping, JI Zhenghua，XU Jun, TAO Yunzhen, ZHU Hong , WANG Yunzhong

(Department of Clinical Laboratory, Children's Hospital Affiliated to Soochow University, Suzhou 215003, Jiangsu, China)

Received:2013-08-25 Online:2014-02-15 Published:2014-02-15

摘要/Abstract

摘要：

　目的　探讨儿童中耳感染病原菌的构成及耐药性。方法　收集中耳炎患儿的耳脓分泌物，以全自动细菌鉴定仪VITEK32进行细菌鉴定和药敏实验，并结合K-B药敏实验法，根据临床试验室标准化委员会标准进行结果判读。结果　2010年1月至2012年12月共收到2个月~14岁中耳炎患儿耳脓分泌物425份，分离病原菌347株，检出阳性率81.65%。细菌检出率93.37%（324/347），真菌检出率6.63%（23/347）。分离细菌主要为肺炎链球菌（40.92%，142/347），金黄色葡萄球菌（33.43%，116/347）和流感嗜血杆菌（7.78%，27/347）；肺炎链球菌相对集中分布在1~3岁幼儿，分离率为47.09%，不同年龄段间各细菌分离率差异无统计学意义（P>0.05）。2010年、2011年和2012年耳脓分泌物耐甲氧西林金黄色葡萄球菌（MRSA）分离率分别为11.11%（5/45）、18.75%（9/48）和30.43%（7/23），差异无统计学意义（χ²=3.86，P=0.145）；对青霉素耐药的肺炎链球菌（PRSP）分别为9.26%、3.92%和27.03%，各年份之间差异有统计学意义（χ²=11.47，P=0.003）。结论　根据儿童耳脓分泌物的病原菌分离培养和药敏实验结果合理选用抗生素，可能有助于降低细菌耐药，提高儿童中耳炎治愈率。

Abstract: 　 Objectives　To analyze pathogen distribution and antimicrobial resistance of bacilli among children with otitis media. Methods Pathogenic bacteria was isolated from children with suppurative otitis media. The VITEK32 was used for identification. The bacterial susceptibility testing was done by Kirby-Bauer method. According to CLSI standard the antimicrobial susceptibility was determined. Results From Jan 2010 to Dec 2012, 425 children with suppurative otitis media were examined. 347 strains were isolated, of which the detectable rate was 81.65%. The detectable rate of bacteria and fungus was 93.37% (324/347) and 6.63% (23/347), respectively. Among bacteria, the detectable rate of streptococcus pneumoniae was 40.92% (142/347) and staphylococcus aureus was 33.43% (116/347). The detectable rate of haemophilus influenza was 7.78% (27/347). The prevalence of streptococcus pneumoniae is high in children aged 1-3years, with detectable rate at 47.09%. There was no statistical difference among different age groups. The prevalence of methicillin-resistant staphylococcus aureus (MRSA) in middle ear secretion was 1.11% （5/45）, 18.75% （9/48） and 30.43% （7/23） in 2010, 2011 and 2012 respectively, with no statistical difference (χ²=3.86, P=0.145). The prevalence of penicillin -resistant streptococcus pneumoniae (PRSP) in middle ear secretion was 9.26%, 3.92% and 27.03% in 2010, 2011 and 2012 respectively, with statistical difference (χ²=11.47, P=0.003). Conclusions Choosing correct therapy according to the result of middle ear secretion culture and antibiotics sensitive test can increase the recovery rate of otitismedia.

何萍，季正华，徐俊，陶云珍，朱宏，王运中. 儿童中耳感染病原菌的构成及主要病原菌耐药性的监测[J]. 临床儿科杂志, 2014, 32(2): 136-139.

HE Ping,JI Zhenghua,XU Jun,TAO Yunzhen,ZHU Hong,WANG Yunzhong. Surveillance of pathogen distribution and antimicrobial resistance of bacilli among children with otitis media [J]. , 2014, 32(2): 136-139.