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北阿坎德邦一家三级医疗中心活动性慢性化脓性中耳炎(安全型与非安全型)临床细菌学特征及抗菌药物敏感性模式的当前趋势:一项观察性研究

Current Trends in Clinico-Bacteriological Profile and Antimicrobial Susceptibility Pattern in Active Chronic Suppurative Otitis Media (Safe and Unsafe) at a Tertiary Care Center in Uttarakhand: An Observational Study.

作者信息

Sammal Monika, Pant Bhawana, Negi Nidhi, Sikarwar Vikas

机构信息

Department of Otolaryngology and Head and Neck Surgery, Government Doon Medical College, Dehradun, IND.

Department of Microbiology, Government Doon Medical College, Dehradun, IND.

出版信息

Cureus. 2024 Sep 16;16(9):e69525. doi: 10.7759/cureus.69525. eCollection 2024 Sep.

Abstract

INTRODUCTION

Otitis media is defined as inflammation of the middle ear due to any cause that may also involve any contiguous pneumatized portion of the temporal bone. It is also one of the most common diseases of childhood after viral upper respiratory tract infection. As a result of the widespread availability of over-the-counter topical antibiotics and the irrational use of these agents, there is a development of multidrug-resistant bacteria.

AIM

The aim of this study was to assess the current bacteriological profile and antimicrobial susceptibility pattern in clinically diagnosed cases of active chronic otitis media (COM) at a tertiary care center in Uttarakhand.

MATERIALS AND METHODS

The proposed observational cross-sectional study was conducted in the Department of Otolaryngology and Head and Neck Surgery and Department of Microbiology of Government Doon Medical College Hospital, Dehradun, over a period of 18 months from August 2022 to January 2024. One hundred and thirty-seven cases of active COM fulfilling the inclusion criteria were recruited in the study. Under strict aseptic conditions, pus samples were collected from the middle ear using two sterile cotton swabs under microscopic examination and sent to the microbiology lab for pathogen identification and isolation. The isolated organisms were subjected to antibiotic susceptibility testing using VITEK-2 as per the latest Clinical and Laboratory Standards Institute (CLSI) guidelines.  Results: In the present study, the most common age group affected by COM was between 18 and 30 years with female predominance. (33.6%) was the predominantly isolated organism followed by (17.8%). Considering the antibiotic susceptibility, was susceptible to piperacillin/tazobactam and meropenem while least sensitive to levofloxacin and ciprofloxacin. was susceptible to linezolid, daptomycin, and vancomycin. The maximum resistance of was observed to ciprofloxacin and levofloxacin.

CONCLUSION

The study of changing clinico-bacteriological profile and antibiotic susceptibility pattern in cases of COM due to variations in the geography and environment of the study population can help to guide appropriate antibiotic treatment and thus prevent the development of multidrug-resistant bacteria.

摘要

引言

中耳炎被定义为中耳因任何病因引起的炎症,炎症可能还累及颞骨的任何相邻含气部分。它也是儿童期继病毒性上呼吸道感染之后最常见的疾病之一。由于非处方外用抗生素广泛可得且使用不合理,导致了多重耐药菌的出现。

目的

本研究的目的是评估北阿坎德邦一家三级医疗中心临床诊断的活动性慢性中耳炎(COM)病例的当前细菌学特征及抗菌药物敏感性模式。

材料与方法

本拟进行的观察性横断面研究于2022年8月至2024年1月在德拉敦政府杜恩医学院医院的耳鼻喉科及头颈外科和微生物科开展,为期18个月。本研究招募了137例符合纳入标准的活动性COM病例。在严格无菌条件下,在显微镜检查下用两根无菌棉签从中耳采集脓液样本,并送至微生物实验室进行病原体鉴定和分离。按照最新的临床和实验室标准协会(CLSI)指南,使用VITEK-2对分离出的微生物进行抗生素敏感性测试。

结果

在本研究中,受COM影响最常见的年龄组为18至30岁,女性居多。(33.6%)是主要分离出的微生物,其次是(17.8%)。考虑抗生素敏感性,对哌拉西林/他唑巴坦和美罗培南敏感,而对左氧氟沙星和环丙沙星最不敏感。对利奈唑胺、达托霉素和万古霉素敏感。观察到对环丙沙星和左氧氟沙星的耐药性最高。

结论

由于研究人群的地理和环境差异,对COM病例不断变化的临床细菌学特征和抗生素敏感性模式进行研究有助于指导适当的抗生素治疗,从而预防多重耐药菌的出现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa2b/11483178/009ca01bd5b1/cureus-0016-00000069525-i01.jpg

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