| Background And Objective:Chronic otitis media(COM) as otolaryngology chronic diseases seriously affects people's health, and the incidence of this disease is still high at home and abroad. It is one of the main causes of hearing loss. Bacterial infection is an important risk factor leading to repeated attacks, so the anti-infection treatment is essential to the COM treatment. The main pathogens of COM is influenced by different factors which lead to different flora distributed in various regions, and for the use of antibiotics, the clinic need to select drugs which are sensitive to pathogenic bacteria. Currently, due to the widespread use of antibiotics, leading to resistant bacteria. Different regions have different habits of using the antimicrobial, the strain of drug-resistant phenotype in different regions is also different, so there are differences in the clinical antimicrobial drug selection, which is also one of the research content in COM. The purpose of this study is to get knowledge about the distribution of major pathogens causing COM and its drug resistance characteristics, reslut in providing references for the antibiotic treatment of COM in this region. Methods:Study included hospitalized patients with COM in different regions of the province from January 2013 to December 2014. Middle ear secretions are collected for culture and its drug resistence are detected. 369 patients with the inclusion criteria were selected to sequence the pathogen rate. In accordance with ear endoscopy, temporal bone CT and pathologic results, the patients are divided into two groups, namely chronic suppurative otitis media(active stage) group and middle ear cholesteatoma group. The bacterial culture positive results are recorded, the differences of pathogens detection are compared, and the dynamic analysis is carried out for bacterial drug resistance of patients with COM infected with Staphylococcus aureus. Results:1.184 cases of pathogenicbacteria are detected in specimens of 369 cases and detection rate is 49.86%. Among the 369 cases, there are and 236 cases of chronic suppurative otitis media and 133 cases of middle ear cholesteatoma, and 112 cases of pathogenic bacteria are detected in the former 236 cases, and 72 cases in the latter, and the detection rate is 47.46% and 54.13%, which has no statistical significance. 26 pathogenic bacteria were detected. Among the 184 cases of pathogen, there are 26 kinds of pathogenic bacteria, at the forefront followed by Staphylococcus aureus 72 cases(39.13%), Pseudomonas aeruginosa 24 cases(13.04%), coagulase-negative grapes 14 cases of cocci(7.61%), and 39 cases fungal(21.2%) including 26 cases of Aspergillus(66.67%). 2. Gnenerally speaking, there was no difference in the detection of pathogenic bacteria by comparing the CSOM(active stage) group and the middle ear, but the detected Pseudomonas aeruginosa and Gram-negative bacteria in the middle ear cholesteatoma group are much more than those in the CSOM(active stage) group, which was statistically significant(P <0.05).3. The detection rate of methicillin-resistant Staphylococcus aureus(MRSA) in the CSOM(active stage) group is 9.30% and 20.69% in the middle ear cholesteatoma group,which is not statistically significant.4. Comparae with two years(2013, 2014),Staphylococcus aureus strains stabilize sensitive to vancomycin, teicoplanin, linezolid oxacillin;Higher strain sensitivity to rifampicin,and the minimum sensitivity rate is 95.00%. Levofloxacin, quinolone antibiotic ciprofloxacin as a representative of higher sensitivity reached more than 80.00%.However, compound oxacillin, sulfamethoxazole, tetracycline drug resistance rate have increased, which is not statistically significant.5.MRSA resistance rates were significantly higher than MSSA, and two kinds of strains had significant differences on rifampicin., which has significant difference Conclusions:1. COM infectionin this area is mainly because of the gram-positive bacteria,Staphylococcus aureus is on the top list. Aslo with high detection rate of fungi.2. Though Pseudomonas aeruginosa and some Gram-negative bacteria have a higher dection rate in the middle ear cholesteatoma group.3. Staphylococcus aureus strains stabilize sensitive to vancomycin, teicoplanin, linezolid oxacillin. Staphylococcus aureus have a higher sensitivity to quinolones?MRSA strains have a certain resistance to rifampicin4. In the treatment of COM, before using the antibiotic, the results of bacterial culture should be improved and drug sensitivity test should be conducted as well. |
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