Weckwerth Paulo Henrique, de Magalhães Lopes Carlos Alberto, Duarte Marco Antonio Húngaro, Weckwerth Ana Carolina Villas Bôas, Martins Carlos Henrique Ferreira, Neto Domingos Lamônica, de Aguiar Helder Fernandes
University of Sagrado Coração, Bauru, Brazil.
Cleft Palate Craniofac J. 2009 Sep;46(5):461-7. doi: 10.1597/08-144.1. Epub 2009 Feb 4.
To investigate the microbial etiology of suppurative chronic otitis media (SCOM) in patients with complete cleft lip and palate and isolated cleft palate and to determine the sensitivity of isolated microorganisms to antibiotics by drug diffusion from impregnated discs in agar and the minimum inhibitory concentration of each drug to these microorganisms by drug dilution in agar.
DESIGN/PATIENTS: Effusion samples of SCOM obtained from 40 patients with cleft lip and palate registered at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, at Bauru, Brazil, were bacteriologically analyzed by cultures. The isolated bacteria were submitted to an in vitro susceptibility test to clinically used drugs.
Positive cultures were obtained in 100% of studied cases. Among the 57 strains observed, the most frequent were Pseudomonas aeruginosa (35%), Staphylococcus aureus (15.5%), Enterococcus faecalis (14%), and Proteus mirabilis (12%). The frequency of Gram-negative bacilli (enterobacteriaceae and nonfermentative bacilli) was 67%. Pseudomonas aeruginosa presented the highest sensitivity to ciprofloxacin, and enterobacteriaceae exhibited the highest sensitivity to gentamicin. The strains of S. aureus and E. faecalis presented the highest sensitivity to imipenem and sulfamethoxazole/trimethoprim, respectively.
Patients with cleft lip and palate presenting with SCOM exhibited 100% positive cultures, with the highest frequency of Pseudomonas and enterobacteriaceae. With regard to the action of antibiotics, imipenem was effective against the four species of isolated microorganisms, followed by ciprofloxacin, which was effective against 75% of isolated species.
调查完全性唇腭裂和孤立性腭裂患者化脓性慢性中耳炎（SCOM）的微生物病因，并通过琼脂中含药纸片的药物扩散法确定分离出的微生物对抗生素的敏感性，以及通过琼脂中的药物稀释法确定每种药物对这些微生物的最低抑菌浓度。
设计/患者：从巴西圣保罗大学包鲁颅面畸形康复医院登记的40例唇腭裂患者中获取SCOM的积液样本，进行细菌培养分析。将分离出的细菌进行临床常用药物的体外药敏试验。
100%的研究病例培养结果呈阳性。在所观察的57株菌株中，最常见的是铜绿假单胞菌（35%）、金黄色葡萄球菌（15.5%）、粪肠球菌（14%）和奇异变形杆菌（12%）。革兰氏阴性杆菌（肠杆菌科和非发酵杆菌）的发生率为67%。铜绿假单胞菌对环丙沙星的敏感性最高，肠杆菌科对庆大霉素的敏感性最高。金黄色葡萄球菌和粪肠球菌菌株分别对亚胺培南和磺胺甲恶唑/甲氧苄啶的敏感性最高。
患有SCOM的唇腭裂患者培养结果100%呈阳性，铜绿假单胞菌和肠杆菌科的发生率最高。关于抗生素的作用，亚胺培南对分离出的四种微生物有效，其次是环丙沙星，对75%的分离菌株有效。
