Reports On 110 Cases Secretion Culture And Antibiotic Sensitivity Test Of Common Disease In Otolaryngology

Objectives:To determine the main pathogen in common clinical otolaryngology disease as chronic suppurative otitis media, chronic sinusitis, chronic tonsillitis and otitis external by sending the effusion from the middle ear, nasal canal, surface of the tonsil and the external ear canal respectively to culture and antibiotic sensitivity tests, so as to further guide clinical antibiotic use.Methods:110 patients from both out and in-patient department of chronic suppurative otitis media, chronic sinusitis, chronic tonsillitis and otitis external are collected of their effusion from the middle ear, surface of the tonsil and the external ear canal under frontal mirror and from nasal canal under endoscopy respectively. Specimens were sent for culture and antibiotic sensitivity test; results were recorded and processed by statistic software.Results:Of the 32 patients with chronic suppurative otitis media,20 were cultured positive (62.5%), of which 19 were of single strain infection,1 was co-infection; 7 were Staphylococcus aureus(21.88%),2 were Staphylococcus haemolyticus(6.25%), 2 were Pseudomonas aeruginosa (6.25%), antibiotic sensitivity test showed Staphylococcus aureus was sensitive to Gentamycin,Linezolid,Trimethoprim-sulfamethoxazole (SMZ) and Vancomycin (100%) while resistant to Penicillin G; Pseudomonas aeruginosa was sensitive to Amikacin,Ciprofloxacin,Imipenem,Levofloxacin Lactate,Ceftazidimefor and Tobramycin while resistant to,Ceftriaxone,Cefazolin and SMZ. Of the 23 patients with chronic nasal sinusitis,5 were cultured positive (21.74%) of which 1 (4.34%) was accompanied by fungal infection; 2 were Staphylococcus epidermidis (8.70%),1 Staphylococcus aureus (4.35%) 1 Acinetobacter lwoffii (4.34%) and 1 Klebsiella ozaenae (4.34%)。Antibiotic sensitivity test showed Staphylococcus was sensitive to Moxifloxacin,Quinupristin,Fosfomycin,Fusidic Acid,Linezolid,Rifampicin,Tetracycline,Teicoplanin and Vancomycin while resistant to Clindamycin,Erythromycin and Penicillin G. Acinetobacter lwoffii and Klebsiella ozaenae were sensitive to Cefepime,Imipenem,Sulbactam and Piperacillin while resistant to Ampicillin.Of the 26 patients with chronic tonsillitis,4 were cultured positive (15.38%) with 3 Staphylococcus aureus (11.54%); 1 Pseudomonas aeruginosa (3.85%), antibiotic sensitivity test showed Staphylococcus was sensitive to Gentamycin,Linezolid,Ampicillin,Nitrofurantoin,Levofloxacin Lactate,Moxifloxacin,Oxacillin % Tetracycline and Vancomycin (100%) while resistant to Penicillin G.Of 29 patients with otitis external,22 were cultured positive (75.86%),of which 19 were single strain infection and 3 were co-infection.2 Staphylococcus aureus (6.90%);2 Acinetobacter Calcoaceticus-baumannii (6.90%) and 1 Enterobacter amnigenus (3.48%); 17 were fungi (58.62%);antibiotic sensitivity test showed Staphylococcus were sensitive to Gentamycin,Fosfomycin,Fusidic Acid,Imipenem,Linezolid,Ampicillin,Nitrofurantoin,Ciprofloxacin,Moxifloxacin,Oxacillin,Quinupristin,Tetracycline,Teicoplanin and Vancomycin (100%) while resistant to penicillin G and SMZ; Acinetobacter Calcoaceticus-baumannii was sensitive to Amiklin,Sulbactam,Cefepime % Gentamycin,Imipenem,Levofloxacin Lactate,Meropenem,Ceftazidimeforand Piperacillin while resistant to Ampicillin,Cefoxitin,Cefuroxime Axefil,Cefuroxime sodium and Cefazolin.Conclusions:As for chronic suppurative otitis media, pathogens are mainly Gram positive, Fluoroquinolones like Ciprofloxacin are effective. Under circumstances that culture or antibiotic sensitivity test are not available, it is likely to be the top option. Meanwhile, increasing fungal infection rate is possibly related to the wider use of antibiotics, or super infection together with the humid climate in southern China. Therefore, properly choose the right antibiotic according to the results of the culture and sensitivity test is of vital importance.As for chronic sinusitis, Moxifloxacin or Cefepime is the first choice. Taking culture and sensitivity test results into account, we consider it more effective while help preventing antibiotic resistance. At the same time, attention should also be paid to anaerobic bacteria infection,β-lactamase type antibiotics with general spectrum towards both Gram positive and Gram negative are preferred, Carbapenems is of this kind due to its stronger anti-bacteria effect and wider spectrum when treating severe nasal sinus infection.Chronic tonsillitis is generally considered of multi-bacteria infection due to the synergistic pathogenesis of aerobic bacteria and anaerobic bacteria.It is recommended to collect the effusions from the surface of the tonsil for culture and antibiotic sensitivity test so as to further guide clinical antibiotic treatment. For those of anaerobic bacteria and aerobic bacteria infection, Combination of antibiotics treatment is more effective.In otitis external, Gram positive and Gram negative bacteria there are mainly sensitive to Fluoroquinolones, meanwhile, there is a trend of fungal infection increase, which is possibly related to antibiotic abuse.