Jang Chul-Ho, Cho Yong-Bum, Choi Cheol-Hee
Department of Otolaryngology, Chonnam National University Medical School, Gwangju, South Korea.
Int J Pediatr Otorhinolaryngol. 2007 Apr;71(4):591-5. doi: 10.1016/j.ijporl.2006.12.005. Epub 2007 Jan 18.
Bacterial biofilm formation has been implicated in the high rate of persistent otorrhea after tympanostomy tube insertion. In this study, we evaluated Pseudomonal biofilm formation from intractable post tympanostomy tube otorrhea in children.
Twelve patients (seven males, five females) with unilateral post tympanostomy tube P. aeruginosa otorrhea were evaluated prospectively. All patients were treated with ciprofloxacin otic drops but the otorrhea failed to resolve. Ear discharge for culture was collected from the external auditory canal using a swab. The tympanostomy tubes were removed and collected for evaluation of biofilm formation using a scanning electron microscopy.
In all cases, ciprofloxacin-resistant P. aeruginosa was the only organism grown. The surface of the silicone tube contained undulations or microfissures throughout. The thick biofilms present on most tube surfaces were densities with no intervening spaces, consistent with biofilms.
Biofilms can be directly observed by scanning electron microscopy. Therefore, our results demonstrate that bacterial aggregates called biofilms, that are resistant to treatment by antibiotics, can be detected by standard culture techniques, and may play a major etiologic role in posttympanostomy otorrhea.
鼓膜置管术后持续性耳漏发生率高与细菌生物膜形成有关。在本研究中，我们评估了儿童难治性鼓膜置管术后耳漏中铜绿假单胞菌生物膜的形成情况。
对12例单侧鼓膜置管术后铜绿假单胞菌耳漏患者（7例男性，5例女性）进行前瞻性评估。所有患者均接受环丙沙星耳滴剂治疗，但耳漏未愈。使用拭子从外耳道采集耳漏分泌物进行培养。取出鼓膜置管并收集，用扫描电子显微镜评估生物膜形成情况。
所有病例中，仅培养出耐环丙沙星的铜绿假单胞菌。硅胶管表面布满起伏或微裂缝。大多数管表面存在的厚生物膜密度高，无间隙，符合生物膜特征。
生物膜可通过扫描电子显微镜直接观察到。因此，我们的结果表明，被称为生物膜的细菌聚集体对抗生素治疗有抗性，可通过标准培养技术检测到，并且可能在鼓膜置管术后耳漏中起主要病因作用。
