| Objective To explore the distribution and their characteristics of drug resistance of pathogenic bacteria causing chronic suppurative otitis media(CSOM),provide a preliminary clinical evidence for the management of CSOM..Methods Secretion samples of 60 patients with CSOM were collected before operations ,during operations and after operations . Samples collected before and after operations were taken from external auditory meatus, and the ones that collected during operations were taken from tympanic sinus (or cavity). All samples were cultured for aerobic bacterias, anaerobic bacterias and fungus respectively. The detectable aerobic bacterias were identified and were subjected to drug sensitivity test.Results (1)Among all the 180 samples,150 cases of aerobic bacteria(overall detection rate 83.33%,150/180), 73 cases of anaerobic bacteria(overall detection rate 40.56%,73/180) and 55 cases of fungus(overall detection rate 30.56%,55/180) were detected; The detectable rate gram positive bacteria is 58.5%,the detectable rate gram negative bacteria is 41.5%, Staphylococcus aureus(75strains), Bacillus proteus(33strains) and Pseudomonas aeruginosa(28 strains) ranks the top three kinds of aerobic bacterias.detected.(2) 60 cases of aerobic bacteria taken from external auditory meatus bacteria were detected before operations (detectable rate 100.00%,60/60), 47 cases of aerobic bacteria taken from tympanic sinus or cavity were detected during operations (detectable rate 78.33%,47/60), 43 cases of aerobic bacteria taken from external auditory meatus were detected after operations (detectable rate 71.67%,43/60);24 cases of anaerobic bacteria taken from external auditory meatus were detected before operations (detectable rate 40.00%,24/60), 26 cases of anaerobic bacteria taken from tympanic sinus or cavity were detected during operations (detectable rate 43.33%,26/60), 23 cases of anaerobic bacteria taken from external auditory meatus were detected after operations (detectable rate 38.33%,23/60); 24 cases of fungi taken from external auditory meatus were detected before operations (detectable rate 40.00%,24/60), 9 cases of fungi taken from tympanic sinus or cavity were detected druing operations (detectable rate 15.00%,9/60), 22 cases of fungi taken from external auditory meatus were detected after operations (detectable rate 36.67%,22/60). Analyzed by SPSS13.0: The comparison between intraoperative and postoperative detectable rate has statistics meaning. (P=0.008<0.05,Fisher exact propability), There were no significance between intraoperative and postoperative detectable rate. ( Pearsonχ~2=1.510, P=0.219>0.05). (3) No strain was found to be resistant to vancocin or imipenem. There's a higher sensitive rate to quinolones and a lower sensitive rate to penicillin and the first generation cephalosporins.Conclusion (1) CSOM is mainly infected with aerobic bacterias. Gram-Positive Bacterias were most frequently detected, most of them were mostly staphylococcus aureus. A high detection rate of anaerobic bacterias and fungus indicates that infections with anaerobic bacterias and fungus are un-neglectable. (2) It could exist difference in different part and different time for the the detection rate .The detection rate of samples taken from external auditory meatus preoperatively and tympanic sinus (or cavity) intraoperatively exist difference , but the detection rate of samples taken from tympanic sinus (or cavity) intraoperatively and external auditory postoperatively has no difference, It's presumed that the samples collected intraoperatively exclude the interence of normal human bacterial distribution, so it reflects the bacterial distribution in CSOM more accurately.and it could give guide value for postoperativemedication. (3) A certain number of drug-resistance strains were detected in drug sensitive test of aerobic bacterias. We recommended that bacterial culture and drug sensitive test should be proceeded before antibiotics were used. |
