慢性鼻窦炎患者鼻腔定植菌的筛查和耐药性分析

孙菲; 周柯; 陈晓栋; 徐修礼; 查定军

doi:10.13201/j.issn.1001-1781.2019.08.013

慢性鼻窦炎患者鼻腔定植菌的筛查和耐药性分析

- 1 空军军医大学西京医院耳鼻咽喉头颈外科(西安, 710032);
- 2 空军军医大学西京医院检验科全军临床检验医学研究所
基金项目:
空军军医大学第一附属医院2018年度学科助推项目 (No:XJZT18ML54)

详细信息

通讯作者: 周柯,E-mail:zhouke@fmmu.edu.cn; 查定军,E-mail:zhadjun@fmmu.edu.cn

中图分类号: R765.4

收稿日期: 2019-02-21

Screening and antibiotic resistance analysis of nasal colonized bacteria in patients with chronic rhinosinusitis

- Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine;
- Shanghai Jiaotong University School of Medicine Ear Institute;

More Information

Corresponding authors: ZHOU Ke ; CHA Dingjun

Received Date: 21 February 2019

摘要

摘要: 目的:总结慢性鼻窦炎(CRS)患者鼻腔定植菌的检出情况和耐药特征,探讨其与CRS发病的相关性。方法:通过在我院就诊的200例CRS患者进行鼻前庭标本采集,以微生物自动化系统接种于各类细菌培养液进行细菌培养和菌落观察,并进行质谱鉴定和相应的抗菌药物敏感性试验。结果:共检出鼻腔定植菌株275株,包括凝固酶阴性葡萄球菌、金黄色葡萄球菌、肺炎链球菌、卡他莫拉菌、流感嗜血杆菌、铜绿假单胞菌,以及大肠埃希菌、肺炎克雷伯菌等肠杆菌科细菌;部分菌株定植率在未成年和成年患者,或接受鼻内镜手术和非手术治疗患者间存在差异。结论:CRS患者鼻腔定植菌与CRS常见致病菌在构成上部分相似,并存在抗菌药物耐药性,这种耐药菌的储存库在特定条件下转化为CRS致病菌,开展鼻腔定植菌筛查有望为CRS的诊治提供新的思路。
- 鼻窦炎 /
- 鼻腔 /
- 共生菌群 /
- 抗菌药物耐药 /
- 鼻腔定植筛查
Abstract: Objective: Since bacterial infection is one of the common pathogenic factors lead to chronic rhinosinusitis (CRS), our study is designed to investigate the prevalence and antibiotic resistance of nasal colonized bacteria in patients with CRS, and to analyze the correlation between nasal colonized bacteria and pathogenesis of CRS. Method: Nasal vestibule samples collected from 200 patients with CRS were automatically inoculated on to various bacterial culture medium, cultured by WaspLab microbiology automated system, potential pathogenic bacterial colonies grew on agar plates were then examined, identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry, and analyzed their antibiotic-resistant phenotype by antibiotic susceptibility testing. Result: Two hundred and seventy-five bacterial strains of nasal colonization were isolated, including coagulase-negative Staphylococci, Staphylococcus aureus, Streptococcus pneumonia, Moraxella catarrhalis, Haemophilus influenza, Pseudomonas aeruginosa, and Enterobacteriaceae such as Escherichia coli and Klebsiella pneumoniae. All strains displayed various degrees of antimicrobial resistance among children and adult patients, or among patients with and without endoscopic sinus surgery. Conclusion: The constitution of nasal colonized commensal bacteria in patients with CRS was partially similar to that of pathogenic bacteria causing CRS. They may form a reservoir of antimicrobial resistant pathogens, which would transform into pathogenic bacteria causing CRS under certain conditions. Screening of nasal colonized bacteria may represent an alternative approach for diagnosis and treatment of CRS.
- chronic rhinosinusitis /
- nasal cavity /
- commensal bacteria /
- antimicrobial resistance /
- nasal colonization screening

HTML全文

参考文献(10)

[1]	HOGGARD M,WAGNER MACKENZIE B,JAIN R,et al.Chronic Rhinosinusitis and the Evolving Understanding of Microbial Ecology in Chronic Inflammatory Mucosal Disease[J].Clin Microbiol Rev,2017,30:321-348.
[2]	周兵,马晶影,韩德民.慢性鼻-鼻窦炎抗生素治疗的地位和作用[J].中华耳鼻咽喉头颈外科杂志,2010,45(3):260-264.
[3]	孟红委,刘瑶,刘俊兰,等.18~22岁健康人皮肤和鼻腔可培养共生菌多样性及耐药性分析[J].中华检验医学杂志,2018,41(3):196-202.
[4]	KRISMER B,WEIDENMAIER C,ZIPPERER A,et al.The commensal lifestyle of Staphylococcus aureus and its interactions with the nasal microbiota[J].Nat Rev Microbiol,2017,15:675-687.
[5]	翟如波,胡伟华,徐宏亮,等.我国东北地区某部队战士鼻腔内细菌定植情况及耐药性调查[J].临床军医杂志,2013,41(3):289-291.
[6]	刘洋,范立,汤燕琴,等.慢性鼻窦炎中金黄色葡萄球菌药敏结果分析[J].临床耳鼻咽喉头颈外科杂志,2018,32(11):864-867.
[7]	王志红,王德峰,苏磊,等.手术对慢性鼻窦炎患者鼻腔分泌物细菌学的影响[J].中华医院感染学杂志,2017,27(11):2569-2572.
[8]	李军,吴彦桥,李晓明,等.慢性鼻-鼻窦炎伴或不伴鼻息肉患者细菌培养及药敏试验分析[J].临床耳鼻咽喉头颈外科杂志,2016,30(2):115-118.
[9]	彭德嘉,邱建华,陈福权.慢性鼻窦炎患者中鼻道和筛窦的细菌学表现及相关性研究[J].临床耳鼻咽喉科杂志,2005,19(14):625-626,629.
[10]	WAGNER MACKENZIE B,WAITE D W,HOGGARD M,et al.Moving beyond descriptions of diversity:clinical and research implications of bacterial imbalance in chronic rhinosinusitis[J].Rhinology,2017,55:291-297.