Clinical Report on the Bacteriology of Acute Otitis Media in Childhood

小兒急性中耳炎細菌學之臨床報告

曾騰駒(Teng-Chu Tseng) ； 陳立群(Li-Ching Chen) ； 王拔群(Pa-Chun Wang) ； 黃政華(Cheng-Hua Huang) ； 陳雅惠(Ya-Hui Chen)

《輔仁醫學期刊》 5卷1期 (2007/03) Pp. 1-8

摘要

背景和目的：急性中耳炎是小孩常見的感染，然而國內仍沒有本土相關微生物分佈資料之研究，本研究主要報告某醫學中心急性中耳炎細茵學與敏感性。研究方法：研究回溯96株在感染時從中耳取得之細菌學資料。結果：49個樣本並無培養出細菌，其他47個樣本產生50株細菌，Streptococcus pneumoniae是最常見的菌株(16)，之後則為Homophilus influeniae (13)，敏感性測試顯示對盤尼西林具有抗藥性的Streptococcus pneumoniae (penicillin-resistant Str. pnoumoniae, PRSP)佔所有肺炎鏈球菌的73.3%，而對紅黴素具有具有抗藥性的Str. pneumoniae (erythromycin-resistant Str. pneumoniae, ERSP)佔42.9%。就診前使用過抗生素是產生盤尼西林抗藥性肺炎鏈球菌的影響因素(p=0.03)。結論：肺炎鏈球茵在急性中耳炎中之分佈情形與其他研究類似，如果最初沒有注意抗生素使用於小兒上呼吸道感染，可能會伴隨產生耳朵感染使病情更複雜化。

關鍵字

急性中耳炎 ； 細菌學 ； 肺炎鏈球菌

並列摘要

Background and Purpose: Acute otitis media (ACM) is a common infection among children. However, there are no domestic data on the distribution of microorganisms. In this study, we report the bacterial etiology of ACM in our institute and their susceptibility to antibiotics. Methods: We retrospectively reviewed the bacteriological data for 96 isolates obtained from middle ear discharges by tympanocentesis during the acute episode of infection. Results: In total, 49 samples revealed nothing, and the other 47 samples yielded 50 isolates of bacteria. Streptococcus pneumoniae was the most common isolate (16), followed by Hemophilus influenzae (13). The susceptibility tests (using a disc diffusion method, in compliance with the National Committee for Clinical Laboratory Standards) revealed that penicillin resistant Str. pneumoniae (PRSP) accounted for 73.3% of all pneumoeoeci, while the erythromyein resistant strains (FRSPs) accounted for 42.9% among all Str. pneumoniae isolates. We found that previous antibiotic treatment was a significant risk factor for the occurrence of PRSP (p 0.03). Conclusions: The frequency of Str. pneumoniae in ACM is similar to what has been reported by others. Inadvertent initial antibiotics treatment for pediatric upper airway infection may complicate the management of concomitant ear infections.

並列關鍵字

acute otitis media ； bacteriology ； Streptococcus pneumoniae