Brook I
Georgetown University School of Medicine, Washington, DC.
Pediatr Infect Dis J. 1994 Mar;13(3):188-93. doi: 10.1097/00006454-199403000-00004.
The aerobic and anaerobic microbiology and management of 69 children who had chronic suppurative otitis media were studied retrospectively. A total of 188 isolates (103 anaerobic and 85 aerobic) were recovered. Anaerobic organisms alone were isolated from 11 (16%), aerobic bacteria only in 21 (30%) and mixed aerobic and anaerobic flora was present in 37 (54%). Forty-five beta-lactamase-producing bacteria were recovered from 60 (58%) patients. The most rapid time for resolution was noticed with clindamycin (8.3 +/- 0.6 days) (P < 0.001), as compared with ampicillin (12.0 +/- 0.8 days), erythromycin (16.5 +/- 1.6 days) and cefaclor (14.6 +/- 2.3 days). Resolution of the infection was achieved in 16 of 20 (80%) of those treated with clindamycin, 12 of 24 (50%) treated with ampicillin, 6 of 13 (46%) treated with erythromycin, and 4 of 12 (33%) treated with cefaclor. Organisms resistant to the antimicrobial used were recovered in 26 of 31 of patients who failed to respond to therapy. These findings indicate the role of resistant aerobic and anaerobic organisms in the polymicrobial etiology of chronic otitis media in children and illustrate the superiority of therapy effective against anaerobic bacteria.
对69例慢性化脓性中耳炎患儿的需氧和厌氧微生物学情况及治疗进行了回顾性研究。共分离出188株菌株（103株厌氧菌和85株需氧菌）。仅分离出厌氧菌的有11例（16%），仅分离出需氧菌的有21例（30%），需氧菌和厌氧菌混合菌群存在的有37例（54%）。从60例（58%）患者中分离出45株产β-内酰胺酶细菌。与氨苄西林（12.0±0.8天）、红霉素（16.5±1.6天）和头孢克洛（14.6±2.3天）相比，克林霉素治疗时症状缓解最快（8.3±0.6天）（P<0.001）。接受克林霉素治疗的20例中有16例（80%）感染得到缓解，接受氨苄西林治疗的24例中有12例（50%），接受红霉素治疗的13例中有6例（46%），接受头孢克洛治疗的12例中有4例（33%）。在31例治疗无效的患者中，有26例分离出对所用抗菌药物耐药的菌株。这些发现表明耐药需氧菌和厌氧菌在儿童慢性中耳炎多微生物病因中的作用，并说明了针对厌氧菌的治疗的优越性。
