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桃園地區某醫院含膿性鼻及鼻竇炎之嗜氧性細菌學研究

The Aerobic Bacteriology of Purulent Rhinosinusitis at a Regional Hospital in Taoyuan

Abstracts


背景:鼻及鼻竇炎是耳鼻喉科常見的疾病,本文針對本院門診之鼻及鼻竇炎患者,進行鼻道膿液之嗜氧性細菌培養。 材料及方法:對於桃園地區某醫院自2005年元月到2008年3月間,所有鼻及鼻竇炎的病患,共計324名(男182名,女142名),年齡範圍爲小於1歲至87歲(39.3±22.8),其中小於18歲者75名,18歲以上者249名。根據就診當下症狀期的長短,可以區分爲急性(10天~4週)157名、亞急性(4~12週)26名及慢性(12週以上)141名,採集鼻道膿液進行嗜氧菌的培養,並測試其對抗生素的敏感性或抗藥性。 結果:陰性培養率爲49.7%(161/324)。小於18歲者,急性鼻及鼻竇炎鼻腔內嗜氧性細菌培養以Streptococcus屬、Staphyloccoccus屬或Moraxella catarrhalis屬最多,亞急性者以Streptococcus屬最多,而慢性者以Streptococcus屬或Staphylococcus屬最多;18歲以上者,急性鼻及鼻竇炎以Staphyloccoccus屬、Streptococcus屬或Klebsiella屬最多,亞急性者以Staphyloccoccus屬最多,而慢性者以Staphylococcus屬、Streptococcus屬或Klebsiella屬最多。 結論:本院鼻及鼻竇炎嗜氧性細菌感染以Staphylococcus屬或Streptococcus屬最多,抗生素敏感性測試結果亦不盡相同。因此,爲避免藥物的濫用產生抗藥性菌種,最好還是等待細菌培養報告出爐後,再根據敏感性給予適當的抗生素。

Parallel abstracts


BACKGROUND: rhinosinusitis (RS) is a common otorhinolaryngologic disease. The mucopus was obtained from RS patients and then transmitted for aerobic bacterial cultures. MATERIALS AND METHODS: 324 RS patients (male 182, female 142) were enrolled at a regional hospital in Taoyuan between January 2005 and March 2008. Their ages ranged from less than 1 year to 87 years (39.3±22.8). Of them, 23.1% (n=75) were aged less than 18 years, and 76.9% (n=249) were aged at least 18 years. Besides, 48.5% (n=157) suffered from acute RS; 8.0% (n=26), subacute RS; and 43.5% (n=141), chronic RS. Mucopus were obtained from their nasal cavities, and then transmitted for aerobic bacterial cultures with sensitivity test of antibiotics. RESULTS: of the whole 324 patients, 49.7% (n=161) reported negative. In the lessthan-18-year group, Streptococcus species, Staphylococcus species, or Moraxella catarrhalis predominated in acute RS; Streptococcus species predominated in subacute RS; and Streptococcus species, or Staphylococcus species predominated in chronic RS. In the at-least-18-year group, Staphylococcus species, Streptococcus species, or Klebsiella species predominated in acute RS; Staphylococcus species predominated in subacute RS; and Staphylococcus species, Streptococcus species, or Klebsiella species predominated in chronic RS. CONCLUSIONS: Staphylococcus species, or Streptococcus species predominated in our RS patients, and sensitivities to antibiotics varied. To avoid the abuse and the comitant resistance of antibiotics, antibiotics should be introduced by the report of bacterial culture.

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