Saini Santosh, Gupta Naveen, Sachdeva O P
Department of Pathology, Pt. B.D. Sharma PGIMS, Rohtak.
Indian J Pathol Microbiol. 2005 Jul;48(3):413-6.
Chronic suppurative otitis media (CSOM) is one of the commonest illnesses in ENT practice which requires medical attention all the more in children of poor socio-economic status having in past inadequate treatment and negligent medical care. The present study was conducted to find out the various aerobic and anaerobic microorganisms associated with CSOM in paediatric and adult cases and their current antimicrobial susceptibility pattern as a guide to therapy. Samples were collected from 109 clinically diagnosed cases of CSOM and processed according to standard protocols. Out of 74 paediatric CSOM cases, 72 (97.2%) were bacterial culture positive while out of 35 adult CSOM cases, 28 (80%) were culture positive. Bilateral CSOM was slightly more common in adults (25%) than paediatric (21.4%) age group. Polymicrobial nature of CSOM was noted in both paediatric (70.8%) and adult (71.4%) cases while number of organisms isolated per lesion was slightly higher in adults (2.5) as compared to paediatric (1.95) cases. In paediatric CSOM, Staphylococcus aureus was the commonest aerobic isolate while in adult CSOM, Pseudomonas aeruginosa was the commonest one. Among anaerobes Peptostreptococcus spp. was commonest in CSOM where as Prevotella melaninogenica in adult CSOM. Sensitivity of S. aureus to cefuroxime was 72.2% while that of gram negative bacilli was higher to cefotaxime (90 to 100%). Among anaerobes higher sensitivity was seen to metronidazole (98.6%), clindamycin (95.7%) and chloramphenicol (98.6%). In view of the polymicrobial etiology of CSOM, prompt appropriate antimicrobial therapy can effectively reverse the disease process thereby preventing longterm sequelae.
慢性化脓性中耳炎（CSOM）是耳鼻喉科临床最常见的疾病之一，对于社会经济地位低下、过去治疗不充分且医疗护理疏忽的儿童而言，更需要医疗关注。本研究旨在找出儿科和成人CSOM病例中相关的各种需氧和厌氧微生物，以及它们目前的抗菌药敏模式，以此作为治疗的指导。从109例临床诊断为CSOM的病例中采集样本，并按照标准方案进行处理。在74例儿科CSOM病例中，72例（97.2%）细菌培养呈阳性，而在35例成人CSOM病例中，28例（80%）培养呈阳性。双侧CSOM在成人（25%）中比儿科（21.4%）年龄组略为常见。在儿科（70.8%）和成人（71.4%）病例中均发现CSOM具有多微生物特性，而每个病变分离出的微生物数量在成人（2.5种）中略高于儿科（1.95种）病例。在儿科CSOM中，金黄色葡萄球菌是最常见的需氧菌分离株，而在成人CSOM中，铜绿假单胞菌是最常见的。在厌氧菌中，消化链球菌属在CSOM中最常见，而产黑色素普雷沃菌在成人CSOM中最常见。金黄色葡萄球菌对头孢呋辛的敏感性为72.2%，而革兰氏阴性杆菌对头孢噻肟的敏感性更高（90%至100%）。在厌氧菌中，对甲硝唑（98.6%）、克林霉素（95.7%）和氯霉素（98.6%）的敏感性较高。鉴于CSOM的多微生物病因，及时进行适当的抗菌治疗可有效逆转疾病进程，从而预防长期后遗症。
