摘要
目的探讨化脓性中耳炎(SOM)患者病原菌分布及其耐药性,为SOM的临床诊断及合理用药提供依据。方法收集21例SOM患者耳道分泌物,同时收集40例健康大学生耳道分泌物作为对照。采用分离培养和16S rDNA宏基因组测序比较两组耳道微生物差异,并对分离得到的病原菌进行药敏试验。结果符合16S rDNA宏基因组检测要求的17例SOM耳道分泌物中,13例检出葡萄球菌(76.47%),还检出厌氧菌普雷沃菌、韦荣球菌等。21例SOM耳道分泌物中,10例分离培养出葡萄球菌(47.6%),主要为金黄色葡萄球菌,其次是耳葡萄球菌和表皮葡萄球菌等;共分离到病原菌16株,其中革兰阳性菌14株(87.5%),革兰阴性菌1株(6.25%),真菌1株(6.25%)。健康人耳道分泌物分离的前三位细菌为头葡萄球菌、耳葡萄球菌及表皮葡萄球菌。SOM患者分离的金黄色葡萄球菌对头孢呋辛、头孢吡肟、妥布霉素等的敏感率>75.0%,对青霉素的耐药率为100%,其中1株金黄色葡萄球菌对万古霉素耐药;健康人耳道分泌物中的分离菌对大多数抗菌药物的敏感性较高。结论临床应积极开展SOM的病原菌检测及药敏分析,指导临床用药,提高治疗效率。
Objective To explore the distribution and drug resistance of pathogenic bacteria in patients with suppurative otitis media(SOM),and to provide evidence for clinical diagnosis and rational drug use of SOM.Methods Ear canal secretions were collected from 21 SOM patients,and 40 healthy university students as controls.Isolation culture and 16S rDNA metagenomic sequencing were used to analyze pathogenic bacteria in patients with SOM.The isolated pathogens were tested for drug resistance.Results Staphylococcus was detected in 13 of 17 SOM ear canal secretions that met the requirements of 16S rDNA metagenomic detection,and the anaerobe prevotella and veillonella were also detected.Staphylococcus were cultured in 10 of 21 ear canal secretions from SOM(47.60%),S.aureus,S.auricus and S.epidermidis.A total of 16 pathogenic bacteria strains were cultured,including 14 gram-positive bacteria(87.50%),1 gram-negative bacteria(6.25%)and 1 fungus(6.25%).However,S.cephalus,S.auricus and S.epidermidis were the main isolates of ear canal secretions from healthy persons.S.aureus isolated from SOM showed high sensitivity to cefuroxime,cefepime,tobramycin and other commonly used clinical antibiotics,reaching more than 75.00%,and the resistance rate to penicillin was 100.00%,among which one strain of S.aureus was resistant to vancomycin.Conclusion In clinical practice,pathogenic detection and drug resistance analysis pathogenic bacteria in patients with SOM should be actively carried out to guide clinical drug use and improve treatment efficiency.
出处
《浙江临床医学》
2022年第10期1447-1450,共4页
Zhejiang Clinical Medical Journal
基金
国家自然科学基金资助项目(31600644)
浙江中医药大学校级科研基金资助项目(2020ZG25)。
关键词
病原谱
化脓性中耳炎
耳道分泌物
16S
rDNA宏基因组测序
分离培养
药敏分析
Pathogenic spectrum
Suppurative otitis media
Ear canal secretion
16S rDNA metagenomic sequencing
Isolation culture
Drug resistance
