ACUTE OTORRHEA - BACTERIOLOGY OF A COMMON COMPLICATION OF TYMPANOSTOMY TUBES
ACUTE OTORRHEA - BACTERIOLOGY OF A COMMON COMPLICATION OF TYMPANOSTOMY TUBES
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DOI：
10.1177/000348949410300909
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发表时间：
1994-09-01
影响因子：
1.4
通讯作者：
KURSLASKY, M
中科院分区：
文献类型：
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作者：
MANDEL, EM;CASSELBRANT, ML;KURSLASKY, M
我们前瞻性地追踪了 246 名使用鼓膜置管的儿童，并观察到至少有 50% 的受试者通过功能正常的管出现急性耳漏。 42% 的发作中发现了急性中耳炎的典型病原体（肺炎链球菌、流感嗜血杆菌、卡他莫拉菌和化脓性链球菌）； 44% 的病例中发现了铜绿假单胞菌或金黄色葡萄球菌。首次发作时，6 岁以下受试者中发现急性中耳炎病原体的比例为 50.0%，而 6 岁或以上受试者中这一比例为 4.4% (p < .001)。铜绿假单胞菌在 6 岁或以上儿童中更常见（首次发作时为 43.5% 对比 20.5%，p = 0.052）。急性中耳炎的典型病原体在夏季较少流行（首次发作时为 14.7% 对比 52.2%，p = .001），而绿脓杆菌在夏季更为常见（首次发作时为 44.1% 对比 16.4%，p = .006）。这表明，虽然许多患有急性耳漏的年幼儿童可能对单独口服抗菌药物的治疗有反应，但年龄较大儿童的门诊治疗可能涉及使用局部抗假单胞菌药物，这种药物的安全性问题可能会使情况变得复杂。
We prospectively followed 246 children with tympanostomy tubes and observed acute otorrhea through a functioning tube at least once in 50% of subjects. Pathogens typical of acute otitis media (Streptococcus pneumoniae, Hemophilus influenzae, Moraxella catarrhalis, and Streptococcus pyogenes) were found in 42% of all episodes; Pseudomonas aeruginosa or Staphylococcus aureus was found in 44% of all episodes. Pathogens of acute otitis media were found in 50.0% of subjects under 6 years old versus 4.4% of subjects 6 years or over at the first episode (p < .001). Pseudomonas aeruginosa was found more often in children 6 years or older (43.5% versus 20.5% at the first episode, p = .052). Pathogens typical of acute otitis media were less prevalent in the summer months (14.7% versus 52.2% for the first episode, p = .001), while P aeruginosa was more prevalent in summer (44.1% versus 16.4% for the first episode, p = .006). This suggests that while many younger children with acute otorrhea may respond to treatment with oral antimicrobials alone, outpatient therapy of older children may involve use of topical antipseudomonal agents that may be complicated by the question of the safety of such medications.