Microbiologic characteristics of persistent otitis media.
Microbiologic characteristics of persistent otitis media.
复制标题
持续性中耳炎的微生物学特征。
DOI：
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发表时间：
1998
期刊：
影响因子：
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通讯作者：
A. E. Gober
中科院分区：
文献类型：
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作者：
I. Brook;A. E. Gober
目标
鉴定从对抗菌药物治疗无反应的急性中耳炎儿童中分离出的病原体。
方法
对 46 名儿童鼓膜穿刺术获得的培养物进行回顾性分析。
结果
从 34 名儿童（74%）身上发现了微生物，并从这些人身上发现了 43 株分离株。这些微生物为肺炎链球菌（16 株）、非 b 型流感嗜血杆菌（12 株）、卡他莫拉菌（5 株）、化脓性链球菌（5 株）、金黄色葡萄球菌（3 株）和消化链球菌（2 株）。在 22 名患者 (48%) 中发现的 43 株分离株中，有 27 株 (63%) 对所用抗菌剂产生耐药性。在对阿莫西林治疗无反应的患者中，流感嗜血杆菌占主导地位。对甲氧苄啶和磺胺甲恶唑治疗无反应的 9 名患者中有 5 名（56%）肺炎链球菌康复，阿奇霉素治疗后 9 名患者中有 4 名（44%）恢复肺炎链球菌，阿莫西林治疗后 12 名患者中有 3 名（25%）恢复肺炎链球菌，头孢克肟治疗后 5 名患者中有 2 名（40%）恢复肺炎链球菌。甲氧苄啶和磺胺甲恶唑治疗后 5 名患者中有 2 名 (40%) 以及头孢克肟治疗后 5 名患者中有 2 名 (40%) 恢复了化脓性链球菌。
结论
这些数据说明了对抗菌药物治疗的耐药性与中耳炎患者未能改善之间的关系。他们还强调了诊断性鼓膜穿刺术在确定耐药微生物存在方面的重要性。
OBJECTIVE
To identify the pathogens isolated from children with acute otitis media who did not respond to antimicrobial drug therapy.
METHODS
Retrospective analysis of cultures obtained by tympanocentesis from 46 children.
RESULTS
Organisms were recovered from 34 children (74%), and 43 isolates were recovered from these individuals. The organisms were Streptococcus pneumoniae (16 isolates), Haemophilus influenzae non-type b (12 isolates), Moraxella catarrhalis (5 isolates), Streptococcus pyogenes (5 isolates), Staphylococcus aureus (3 isolates), and Peptostreptococcus species (2 isolates). Resistance to the antimicrobial agent used was found in 27 (63%) of 43 isolates found in 22 patients (48%). Of patients who did not respond to amoxicillin therapy, H influenzae predominated. Streptococcus pneumoniae was recovered from 5 (56%) of 9 of those who did not respond to trimethoprim and sulfamethoxazole therapy, 4 (44%) of 9 patients after azithromycin therapy, 3 (25%) of 12 patients after amoxicillin therapy, and 2 (40%) of 5 patients after cefixime therapy. Streptococcus pyogenes was recovered from 2 (40%) of 5 patients after trimethoprim and sulfamethoxazole therapy and from 2 (40%) of 5 patients after cefixime therapy.
CONCLUSIONS
The data illustrate the relation between resistance to antimicrobial drug therapy and failure of patients with otitis media to improve. They also highlight the importance of diagnostic tympanocentesis in establishing the presence of resistant microorganisms.