Secretion analysis of pathogenic bacteria culture in 115 rural chronic nasal-sinusitis patients
-
摘要: 目的:了解农村地区慢性鼻-鼻窦炎(CRS)的细菌分布、药物敏感性特征及抗生素使用对病原菌培养的影响。方法:选取115例居住在农村地区的CRS患者的鼻腔鼻窦分泌物,分别行需氧菌、厌氧菌培养及药物敏感试验。统计患者2周及近2个月内使用抗生素的情况。结果:115例标本中共检出37例17种致病菌,需氧菌阳性率为32.17%。表皮葡萄球菌为农村地区CRS中最常见的需氧菌。17例上颌窦标本厌氧菌培养无结果。115例患者中近2个月内使用抗生素者有90例(78.26%),近2周内使用抗生素者有73例(63.48%)。采用χ2检验发现在伴鼻息肉的CRS组中,细菌培养率高(P<0.05),提示细菌性因素与鼻息肉生成有关联。CRS患者细菌培养阳性者对氧氟沙星、头孢噻肟、头孢他啶、头孢吡肟等敏感,而对青霉素G、氨苄西林、红霉素等有较高的耐药现象。结论:农村地区CRS细菌分布无特异性差异,CRS患者抗生素滥用及厌氧菌培养技术原因是导致培养阳性率低最主要的因素。合理使用抗菌药物应建立在细菌培养和药物敏感试验的基础上。Abstract: Objective:To investigate the bacteria distribution, drug bacterial sensitivity characteristics of the rural chronic rhinosinusitis (CRS). And to explore the effect of antibiotic on pathogenic bacteria culture. Method:Choose nasal sinus secretions from 115 CRS patients living in rural areas. Aerobic bacteria culture, anaerobic bacteria culture and drug sensitive test were procedured for each sample. At the same time the use of antibiotics nearly 2 months and nearly 2 weeks were collected. Result:Among one hundred and fifteen specimens, 17 kinds of germs were detected in 37 cases, the positive rate of aerobic bacteria was 32.17%. Staphylococcus aureus and epidermis staphylococcus aureus the most common type of aerobe in CRS patients at rural areas. There was negative result in the anaerobic bacteria culture of 17 maxillary sinus specimen. The cases of using antibiotics nearly 2 months was up to 90, accounting for 78.26%. Nearly 2 weeks, 73 cases, accounting for 63.48%. The chi-square analysis showed high bacterial culture rate,in chronic rhinosinusitis with nasal polyps (CRSwNP group), which revealed correlation between bacterial infection factors and nasal polyps formation.For CRS patients with positive result of bacterial culture, they were sensitive to ofloxacin, cefotaxime, organism, ciprofloxacin, magnitude cephalosporin, and were drug fast to penicillin G, ampicillin, erythromycin.Conclusion:No specific differences was found in the bacteria distribution of rural CRS. antibiotics abusage in rural CRS patients and the anaerobic bacteria culture techniques is the main factor resulting in low culture rate. Rational use of antimicrobial agents should be established on the basis of the bacterial culture and drug sensitive test.
-
Key words:
- chronic rhinosinusitis /
- bacteria
-
[1] 中华耳鼻咽喉头颈外科杂志编委会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组.慢性鼻-鼻窦炎诊断和治疗指南 (2012年, 昆明)[J].中华耳鼻咽喉头颈外科杂志, 2013, 48 (2):92-94.
[2] MELTZER E O, HAMILOS D L, HADLEY J A, et al.Rhinosinusitis:establishing definitions for clinical research and patient care[J].J Allergy Clin Immunol, 114 (6Suppl):155-212.
[3] BROOK I.Bacteriology of acute and chonic frontal sinusitis[J].Arch Otolaryngol Head Neck Surg, 2002, 128:583-585.
[4] 左可军, 史剑波, 樊韵平, 等.慢性鼻窦炎的细菌学研究[J].中华耳鼻咽喉头颈外科杂志, 2005, 40 (7):524-527.
[5] 李泽卿, 王秋萍, 江满杰, 等.慢性鼻窦炎细菌学普通培养结果分析[J].临床耳鼻咽喉科杂志, 2006, 20 (2):82-84.
[6] ALDOUS W K, JENSEN R, SIECK B M.Concaine and lidocaine with phenylephrine as topical anesthetics:antimicrobial activity against common nasal pathogens[J].Ear Nose Throat J, 1998, 77:554-557.
[7] 杨正烈, 欧德灯.基层医生使用抗生素的调查分析[J].中国药物与临床杂志, 2012, 12 (2):194-195.
[8] BROOK I.Acute and chronic bacterial sinusitis[J].Infect Dis Clin North Am, 2007, 21:427-428.
[9] BROOK I, FRAZIER E H.Bacteriology of chronic maxillary sinusitis associated with nasal polyposis[J].J Med Microbiol, 2005, 54:595-597.
[10] BROOK I.Bacteriology of chronic sinusitis and acute exacerbation of chronic sinusitis[J].Arch Otolaryngol Head Neck Surg, 2006, 132:1099-1101.
[11] BHATTACHARYYA N.Bacterial infection in chronic rhinosinusitis:a controlled paired analysis[J].Am J Rhinol, 2005, 19:544-548.
[12] 肖立智, 郑静, 杨蕾, 等.慢性鼻-鼻窦炎患者窦腔的细菌分布及药敏观察[J].临床耳鼻咽喉头颈外科杂志, 2011, 25 (15):692-694.
[13] 李华斌, 史剑波, 许庚.2012年欧洲鼻窦炎和鼻息肉意见书解读[J].中华耳鼻咽喉头颈外科杂志, 2012, 47 (11):877-880.
计量
- 文章访问数: 162
- PDF下载数: 57
- 施引文献: 0