van Cauwenberge P B, Vander Mijnsbrugge A M, Ingels K J
Department of Otorhinolaryngology, University Hospital, Ghent, Belgium.
Eur Arch Otorhinolaryngol. 1993;250 Suppl 1:S3-6. doi: 10.1007/BF02540108.
There exists no real controversy about the role of aerobic bacteria in acute sinusitis and in acute otitis media. The "infernal trio" Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis are by far the most common pathogens in these acute infections. On the contrary, there is still much debate about the normal flora of the paranasal sinuses and the middle ear, although there are some reports of the presence of anaerobes and aerobes in the majority of the normal paranasal sinuses. In chronic sinusitis bacteriological cultures show a greater variation than those in acute sinusitis. Nonetheless, it is demonstrated in most studies that besides the "infernal trio" additional bacteria are present, including anaerobes and gram negative bacteria. In otitis media with effusion (OME) we find the same bacteria as in acute otitis media (AOM) and a pathologic flora in the nasopharynx seems to be important for both AOM and OME. In chronic otitis cultures are nearly always positive and reveal Pseudomonas species, Klebsiella pneumoniae, Staphylococcus aureus, Proteus species and anaerobes.
关于需氧菌在急性鼻窦炎和急性中耳炎中的作用，不存在真正的争议。肺炎链球菌、流感嗜血杆菌和卡他莫拉菌这“邪恶三联体”是这些急性感染中迄今为止最常见的病原体。相反，关于鼻窦和中耳的正常菌群仍有很多争论，尽管有一些报道称在大多数正常鼻窦中存在厌氧菌和好氧菌。在慢性鼻窦炎中，细菌培养结果显示出比急性鼻窦炎更大的差异。尽管如此，大多数研究表明，除了“邪恶三联体”外，还存在其他细菌，包括厌氧菌和革兰氏阴性菌。在分泌性中耳炎（OME）中，我们发现与急性中耳炎（AOM）中相同的细菌，并且鼻咽部的病理性菌群似乎对AOM和OME都很重要。在慢性中耳炎中，培养几乎总是呈阳性，且显示出铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌、变形杆菌属细菌和厌氧菌。
