Guiscafré H, Sierra G, Zúñiga V, Vivar G, Hurtado J A, Muñoz O
Bol Med Hosp Infant Mex. 1981 Sep-Oct;38(5):749-55.
Samples of otic secretion for culture were taken to 50 children with suppurative chronic otitis media; two techniques were followed: with a cotton swab from the external meatus or with a sterile metal aspirator, through the tympanic perforation under microscopic control. To 20 of them with unilateral chronic otitis media, a swab with product from the external meatus of the healthy ear was also taken; in 65% of the latter, the same germs were found in both ears, but when the sample was taken with the aspirator, only in 15% were the germs the same (p less than 0.01). Two or more germs were isolated in 54% of the ears following the technique of the swab and in 32% with the aspiration. The predominant microorganisms with the swab technique were gram-positive cocci (S. epidermidis 48% S. aureus 16%); while the aspiration technique reported gram-negative germs in 96% of cultures (Proteus sp. 42%, Pseudomonas sp. 30% and S. aureus only in 14%). We believe that the sample obtained with a swab has a high degree of contamination with the normal flora of the external meatus; therefore, it should be relinquished.
对50例慢性化脓性中耳炎患儿采集耳部分泌物样本进行培养；采用了两种方法：用棉拭子从外耳道采集，或使用无菌金属吸引器，在显微镜控制下经鼓膜穿孔采集。对其中20例单侧慢性中耳炎患儿，还从健康耳的外耳道采集了带有分泌物的拭子样本；在后者中，65%的患儿双耳发现相同病菌，但使用吸引器采集样本时，只有15%的患儿病菌相同（p<0.01）。采用棉拭子技术，54%的耳部分离出两种或更多病菌，采用吸引技术则为32%。棉拭子技术分离出的主要微生物是革兰氏阳性球菌（表皮葡萄球菌48%，金黄色葡萄球菌16%）；而吸引技术在96%的培养物中分离出革兰氏阴性病菌（变形杆菌属42%，假单胞菌属30%，金黄色葡萄球菌仅14%）。我们认为，用棉拭子采集的样本受外耳道正常菌群污染程度较高；因此，应摒弃这种方法。
