Kim Sang Hoon, Kim Myung Gu, Kim Sung Soo, Cha Sung Ho, Yeo Seung Geun
Department of Otorhinolaryngology, Kyung Hee University, Seoul, Republic of Korea.
J Int Adv Otol. 2015 Aug;11(2):151-6. doi: 10.5152/iao.2015.1106.
To investigate changes in Pseudomonas aeruginosa (PA) and methicillin-resistant Staphylococcus aureus (MRSA) and their antibiotic sensitivities over 13 years in patients diagnosed with chronic suppurative otitis media (CSOM).
The current study reports on a retrospective analysis of the outcomes of 2256 outpatients who visited the Department of Otorhinolaryngology clinics of 3 tertiary medical centers and who were diagnosed with chronic otitis media (COM) or chronic cholesteatomatous otitis media (CCOM) from January 2001 to December 2013. Aural discharge was collected from each patient. Infectious bacteria were identified, and their antibiotic sensitivities were determined.
The most frequent age range of patients diagnosed with CSOM was 41 to 50 years. In patients aged more than 30 years, CSOM was more frequent in females than in males, whereas in those aged less than 30 years, it was more frequent in males. Regardless of age, the isolated MRSA strains showed high sensitivity to vancomycin, teicoplanin, and trimethoprim/sulfamethoxazole, whereas the isolated PA strains showed high sensitivity to cefepime, amikacin, and ceftazidime. The isolation rate of MRSA in patients with CSOM slightly decreased over the 13-year study period; however, PA resistance to quinolones and aminoglycosides showed a tendency to increase.
Bacteria isolated from patients with CSOM showed little change between 2001 and 2013, whereas their antibiotic resistance showed changes; in particular, increased PA resistance to quinolones was observed. Empirical antibiotic treatment can lead to bacterial resistance, and changes in antimicrobial agents commonly used to treat CSOM should be considered.
调查慢性化脓性中耳炎(CSOM)患者13年间铜绿假单胞菌(PA)和耐甲氧西林金黄色葡萄球菌(MRSA)的变化及其抗生素敏感性。
本研究报告了对2001年1月至2013年12月期间就诊于3家三级医疗中心耳鼻喉科门诊、被诊断为慢性中耳炎(COM)或慢性胆脂瘤型中耳炎(CCOM)的2256例门诊患者的结局进行的回顾性分析。收集每位患者的耳漏。鉴定感染细菌,并确定其抗生素敏感性。
诊断为CSOM的患者最常见的年龄范围是41至50岁。在30岁以上的患者中,CSOM在女性中比在男性中更常见,而在30岁以下的患者中,在男性中更常见。无论年龄如何,分离出的MRSA菌株对万古霉素、替考拉宁和甲氧苄啶/磺胺甲恶唑表现出高敏感性,而分离出的PA菌株对头孢吡肟、阿米卡星和头孢他啶表现出高敏感性。在13年的研究期间,CSOM患者中MRSA的分离率略有下降;然而,PA对喹诺酮类和氨基糖苷类的耐药性呈增加趋势。
2001年至2013年间,从CSOM患者中分离出的细菌变化不大,但其抗生素耐药性发生了变化;特别是,观察到PA对喹诺酮类的耐药性增加。经验性抗生素治疗可导致细菌耐药,应考虑治疗CSOM常用抗菌药物的变化。