近3年內慢性中耳炎之細菌學研究

The Bacteriology of Chronic Otitis Media in Recent 3 Years

陳建志(Jiann-Jy Chen) ； 陳登郎(Dem-Lion Chen)

《台灣耳鼻喉頭頸外科雜誌》 44卷3期 (2009/06) Pp. 69-72

https://doi.org/10.6286/2009.44.3.69

摘要

背景：近15年內國內文獻已鮮少論及慢性中耳炎之細菌學，特報告行政院衛生署桃園醫院門診近3年內之慢性中耳炎患者耳道膿液之細菌培養的結果。
材料及方法：回顧該院自2005年1月到2008年3月間，所有慢性中耳炎的病患，共計83名（男43名，女40名），年齡爲52.6±18.9歲（平均值±標準差）（範圍：11~88歲），僅1名有明顯的膽脂瘤。採集耳道內靠近耳膜處之膿液，進行嗜氧菌與厭氧菌的培養，並測試其對抗生素的敏感性。
結果：共培養出79株優勢菌種，均爲嗜氧菌，其中39.2%(31/79)爲Staphylococcus屬，29.1%(23/79)爲Pseudomonas aeruginosa。Staphyloccoccus屬對Vancomycin、Rifampin、Levofloxacin及Trimethoprim/Sulfamethoxazole (TMP/SMX)等4種抗生素的敏感性超過90%，但是，對Penicillin的敏感性最低；Pseudomonas aeruginosa對Cefepime、Gentamycin、Imipenem、Cefazolin、Ciprofloxacin及Piperacillin-Tazobactam等6種抗生素的敏感性超過90%，但是，對TMP/SMX敏感性最低。
結論：慢性中耳炎目前以Staphylococcus屬或Pseudomonas aeruginosa感染最多，兩者對TMP/SMX呈現迥異的敏感性（90.3%與13.0%）；Pseudomonas aeruginosa對Gentamycin的敏感性比以前還要高(95.7%)。

關鍵字

慢性中耳炎 ； 細菌培養

並列摘要

BACKGROUND: Descriptions of the bacteriology of chronic otitis media (COM) have been limited in the Taiwan's scientific literature over the last fifteen years. In this study, we reported the bacteriology of COM culture collected at the Outpatient Department of Tao-Yuan Hospital, Department of Health, Executive Yuan over the last three years.
MATERIALS AND METHODS: From January 2005 to March 2008, 83 COM patients were enrolled; these consisted of 43 males and 40 females. They were aged 52.6±18.9 years (average±standard deviation) with a range from 11 years to 88 years. Only one cholestetoma was noted. Suppurative discharge was collected from near the perforated eardrum and then sent for aerobic and anaerobic culture including antibiotic sensitivity testing.
RESULTS: Seventy-nine aerobic bacteria were identified that gave significant growth. Among these cultures, 39.2% (31 of 79) were Staphylococcus species and 29.1% (23 of 79) were Pseudomonas aeruginosa. The Staphyloccoccus species isolates were mostly sensitive (＞90%) to Vancomycin, Rifampin, Levofloxacin or Trimethoprim/Sulfamethoxazole (TMP/SMX) and only a few were sensitive to penicillin. The Pseudomonas aeruginosa isolates were mostly sensitive (＞ 90%) to Cefepime, Gentamycin, Imipenem, Cefazolin, Ciprofloxacin, or Piperacillin-Tazobactam and only a few were sensitive to TMP/SMX.
CONCLUSIONS: At present Staphylococcus species and Pseudomonas aeruginosa predominate as the causative organisms of COM at this hospital and these different groups of isolates are differentially sensitive to TMP/SMX (90.3% vs 13.0%). Furthermore, it was found that the Pseudomonas aeruginosa isolates in the present study are more sensitive to Gentamycin (95.7%) than in the previous studies.

並列關鍵字

chronic otitis media ； bacterial culture