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A study of risk factors for intractable otitis media and nasopharyngeal transmission of causative pathogen

顽固性中耳炎危险因素及病原菌鼻咽传播的研究

基本信息

批准号：
15591828
负责人：
TAMURA Shinji
金额：
$ 2.11万
依托单位：
Wakayama Medical University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2003
资助国家：
日本
起止时间：
2003 至 2005
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-15591828/
关键词：
acute otitis media antimicrobial resistant pathogen

项目摘要

1. Risk factors for intractable otitis mediaClinical course of pediatric acute otitis media were evaluated in 368 cases (10 to 86 months olds, 200 males, 168 females) by a scoring system depending on the clinical symptoms such as otalgia, fever, and irritability / crying and tympanic membrane finding including bulging, redness and obliteration of light corn.(1) Correlation between nasopharyngeal pathogens and severity.S.pneumoniae were frequently identified in severe cases, while in non-severe cases M.catarrhalis or no pathogen were identified.(2) Risk factors for prolonged symptoms.Young ages, severity at the first visit, identification of S.pneumoniae were the risk factors for prolonged symptoms (Odds ratio : age 9.64, severity 0.28).(3) Risk factors for prolonged abnormal finding in tympanic membraneYoung ages (<2 y.o.), severity, nasopharyngeal colonization with drug resistant S.pnuemoniae were risk factors for prolonged abnormalities in tympanic membrane (Odds : age 3.68, nasopharyngeal colonization with drug resistant pathogens 1.9)(4) Risk factors for antimicrobial treatmentYoung age (<2), severe cases, and nasopharyngeal colonization with drug resistant S.pnuemoniae were risk factors for treatment failure in severe cases.(5) Risk factors for antimicrobial treatmentYoung age (<2), severe cases, and nasopharyngeal colonization were risk factors for necessity of antimicrobial treatment in non-severe cases.2. Detection of drug resistant pathogens30% of S.pneumoniae isolated from the nasopharynx had mutations in pbp genes. β-lactamase nonproducing ampicillin resistant H.influenzae (BLNAR) were isolated in about 20%.3. Nasopharyngeal transmission of causative pathogensCausative pathogens were transmitted among sibling.

1.顽固性中耳炎的危险因素对368例（10 ~ 86月奥尔兹，男200例，女168例）小儿急性中耳炎的临床过程进行了评估，根据临床症状如耳痛、发热、烦躁/哭闹和鼓膜检查结果（如鼓出、发红和轻度鸡眼消失）进行评分。(1)鼻咽部病原体与严重程度的相关性：严重病例中经常发现肺炎链球菌，而在非严重病例中则发现卡他莫拉菌或未发现病原体。(2)年龄小、首次就诊时严重程度、肺炎链球菌感染是症状延长的危险因素（比值比：年龄9.64，严重程度0.28）。(3)鼓膜长期异常发现的危险因素年轻人（<2岁），（4）抗生素治疗的危险因素年龄<2岁、病情重、鼻咽部耐药肺炎链球菌定植是重症患者治疗失败的危险因素。(5)抗菌药物治疗的危险因素年轻（<2岁）、病情重、鼻咽部定植是非重症患者需要抗菌药物治疗的危险因素.鼻咽部肺炎链球菌pbp基因突变率为30%。非产β-内酰胺酶的氨苄青霉素耐药流感嗜血杆菌（BLNAR）检出率约为20%.病原体的鼻咽传播病原体在同胞之间传播。