Rath Sibanarayan, Das Saumya Ranjan, Padhy Rabindra Nath
Siksha 'O' Anusandhan University, Institute of Medical Sciences & Sum Hospital, Central Research Laboratory, Kalinga Nagar, Odisha, India.
Siksha 'O' Anusandhan University, Institute of Medical Sciences & Sum Hospital, Department of ENT, Kalinga Nagar, Odisha, India.
Braz J Otorhinolaryngol. 2017 Mar-Apr;83(2):201-206. doi: 10.1016/j.bjorl.2016.03.008. Epub 2016 Apr 22.
Suppurative otitis media is a critical disease causing perforation of the tympanic membrane associated with changes of the mucoperiosteum of the middle ear cleft.
To isolate causative bacteria from chronic suppurative ear discharges and to ascertain their antibiotic profiles, of patients attending outpatients department in 3 years.
For isolation of bacteria, samples of ear discharges were grown in suitable media and bacteria were subjected to antibiotic profiling by the Kirby-Bauer's method with presently used antibiotics.
A total of 1043 bacteria were isolated, including Pseudomonas aeruginosa and methicillin resistant Staphylococcus aureus, along with 121 fungal isolates. Among 371 P. aeruginosa isolates, tobramycin 30 had the highest susceptibility rate 93.2%, followed by ceftazidime 30, 91.5% and amikacin 10μg/disk 64.4%. Of 359 S. aureus isolates, there were 236 coagulase negative S. aureus+methicillin sensitive S. aureus isolates, while 123 isolates were methicillin resistant Staphylococcus aureus with 95.2% isolates susceptible to cloxacillin 15, 83.3% isolates to erythromycin 15 and 78.5% isolates to gentamicin 30μg/disk. Of 1164, 49 patients presented post aural abscess, 12 patients had intracranial complications, 9 patients had facial palsy and 3 patients had labyrinthitis. More than 90% P. aeruginosa and 90% S. aureus isolates were sensitive to tobramycin 30 and cloxacillin 30μg/disk, respectively.
Multidrug resistant strains of P. aeruginosa were more prevalent than those of S. aureus in ear discharges. Tobramycin and cloxacillin may be included in the formulatory antibiotic regimen to overcome bacterial infections in chronic suppurative otitis media.
化脓性中耳炎是一种严重疾病,可导致鼓膜穿孔,并伴有中耳裂黏骨膜的改变。
分离3年来门诊患者慢性化脓性耳分泌物中的致病细菌,并确定其抗生素敏感性。
为分离细菌,将耳分泌物样本接种于合适的培养基中,并采用Kirby-Bauer法对分离出的细菌进行当前使用抗生素的敏感性分析。
共分离出1043株细菌,包括铜绿假单胞菌和耐甲氧西林金黄色葡萄球菌,以及121株真菌。在371株铜绿假单胞菌分离株中,妥布霉素30μg/disk的敏感性率最高,为93.2%,其次是头孢他啶30μg/disk,为91.5%,阿米卡星10μg/disk为64.4%。在359株金黄色葡萄球菌分离株中,有236株凝固酶阴性金黄色葡萄球菌+甲氧西林敏感金黄色葡萄球菌分离株,而123株为耐甲氧西林金黄色葡萄球菌,其中95.2%的分离株对氯唑西林15μg/disk敏感,83.3%的分离株对红霉素15μg/disk敏感,78.5%的分离株对庆大霉素30μg/disk敏感。在1164例患者中,49例出现耳后脓肿,12例出现颅内并发症,9例出现面神经麻痹,3例出现迷路炎。超过90%的铜绿假单胞菌和90%的金黄色葡萄球菌分离株分别对妥布霉素30μg/disk和氯唑西林30μg/disk敏感。
耳分泌物中耐多药铜绿假单胞菌菌株比金黄色葡萄球菌菌株更普遍。妥布霉素和氯唑西林可纳入配方抗生素方案,以克服慢性化脓性中耳炎的细菌感染。