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抗生素耐药性与引流耳中的耳真菌病:基于诊断的培养结果。

Antibiotic resistance and otomycosis in the draining ear: culture results by diagnosis.

机构信息

Section of Otolaryngology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.

出版信息

Am J Otolaryngol. 2011 Nov-Dec;32(6):470-6. doi: 10.1016/j.amjoto.2010.09.009. Epub 2010 Oct 30.

Abstract

OBJECTIVE

The objective of the study was to better define changes in the bacteriology of suppurative otitis in recent years and the role of cultures in the management of these patients.

STUDY DESIGN

A retrospective review was performed.

METHODS

Outpatient records from 170 patients collected over 3 years with information regarding the bacteria cultured, antibiotic resistance, and clinical diagnosis were analyzed.

RESULTS

A large variety of organisms were seen, with Staphylococcus aureus, Corynebacterium sp, and Pseudomonas aeruginosa being the most common. Forty percent of cultures showed bacteria with moderate antibiotic resistance, whereas 5% were sensitive to only intravenous antibiotics. Resistant bacteria were found in all diagnosis categories and were significantly higher in cases of chronic mastoiditis. The rate of methicillin-resistant S aureus infections was 7.8% and was significantly higher in cases of chronic myringitis. Fungus was often cultured in patients without clinical signs of otomycosis.

CONCLUSIONS

Community-acquired ear infections may be caused by antibiotic-resistant bacteria in a substantial number of patients. In our opinion, outpatient cultures play an important role in the management of suppurative otitis.

摘要

目的

本研究旨在更好地定义近年来化脓性中耳炎细菌学的变化,以及培养物在这些患者管理中的作用。

研究设计

回顾性研究。

方法

分析了 3 年来收集的 170 名患者的门诊记录,记录了培养的细菌、抗生素耐药性和临床诊断等信息。

结果

发现了大量不同的细菌,其中金黄色葡萄球菌、棒状杆菌和铜绿假单胞菌最为常见。40%的培养物显示出具有中度抗生素耐药性的细菌,而 5%的细菌仅对静脉用抗生素敏感。在所有诊断类别中都发现了耐药菌,慢性乳突炎病例中的耐药菌明显更高。耐甲氧西林金黄色葡萄球菌感染的发生率为 7.8%,慢性中耳炎的感染率明显更高。在没有耳真菌病临床症状的患者中,常培养出真菌。

结论

社区获得性耳部感染可能由大量患者的抗生素耐药菌引起。我们认为,门诊培养物在化脓性中耳炎的管理中发挥着重要作用。

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