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尼日利亚东南部感染艾滋病毒儿童慢性化脓性中耳炎的微生物学特征

Microbiological profile of chronic suppurative otits media among HIV infected children in South Eastern Nigeria.

作者信息

Ofogbu Chike V, Orji Foster T, Ezeanolue Basil C, Emodi Ifeoma

出版信息

Niger J Med. 2016 Jan-Mar;25(1):5-11.

Abstract

BACKGROUND

Immune compromised HIV/AIDS infected children have consistently shown a higher prevalence of chronic suppurative otitis media than their immune competent counterparts.This study aimed to compare the microbial isolates from ear discharges in HIV infected and non infected children.

METHOD

This was a Hospital based prospective cohort study designed to determine the relative prevalence of the common organisms present in chronically discharging ears of HIV infected children and their antimicrobial sensitivities and compare that of age and sex matched non HIV infected children. Fifty HIV infected children being followed up at the paediatric HIV clinic of a tertiary health facility, had ear swabs obtained for culture and antimicrobial sensitivity.The same was done for another cohort of fifty age and sex matched non HIV infected children.

RESULTS

The mean age of the study population and controls were 6years 11months (SD 0.96) and 7years 11 months (SD 1.00) respectively. Male to female ratio for each group was 1:1.Ear discharge was bilateral in 27(54%) HIV infected children and in 35(70%) of the controls. The most prevalent bacterial isolate in both groups was Pseudomonas aeruginosa though it was more prevalent in HIV infected children(P=0.005). Fungal isolates were commoner in non HIV infected children(P=0.001).Ninety percent sensitivity to the 4 Quinolones was recorded by isolates in HIV infected children while sensitivity to the Aminoglycosides was greater in non HIV infected children

CONCLUSION

Pseudomonas aeruginosa is the predominant organism isolated from HIV infected children with chronic otitis media.Fungal isolates are less frequently encountered in ear discharges of HIV infected children. The 4 Quinolones are the drugs of choice in treatment of Chronic suppurative otitis media in HIV infected children.

摘要

背景

免疫功能受损的艾滋病毒/艾滋病感染儿童慢性化脓性中耳炎的患病率一直高于免疫功能正常的儿童。本研究旨在比较艾滋病毒感染儿童和未感染儿童耳分泌物中的微生物分离株。

方法

这是一项基于医院的前瞻性队列研究,旨在确定艾滋病毒感染儿童慢性耳流脓中常见病原体的相对患病率及其抗菌敏感性,并与年龄和性别匹配的未感染艾滋病毒儿童进行比较。在一家三级医疗机构的儿科艾滋病毒诊所接受随访的50名艾滋病毒感染儿童进行了耳拭子培养和抗菌敏感性检测。对另一组50名年龄和性别匹配的未感染艾滋病毒儿童也进行了同样的检测。

结果

研究人群和对照组的平均年龄分别为6岁11个月(标准差0.96)和7岁11个月(标准差1.00)。每组的男女比例均为1:1。27名(54%)艾滋病毒感染儿童和35名(70%)对照组儿童的耳流脓为双侧性。两组中最常见的细菌分离株均为铜绿假单胞菌,不过在艾滋病毒感染儿童中更为常见(P=0.005)。真菌分离株在未感染艾滋病毒儿童中更为常见(P=0.001)。艾滋病毒感染儿童的分离株对4种喹诺酮类药物的敏感性为90%,而未感染艾滋病毒儿童对氨基糖苷类药物的敏感性更高。

结论

铜绿假单胞菌是从患有慢性中耳炎的艾滋病毒感染儿童中分离出的主要病原体。艾滋病毒感染儿童的耳分泌物中较少遇到真菌分离株。4种喹诺酮类药物是治疗艾滋病毒感染儿童慢性化脓性中耳炎的首选药物。

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