Analysis of clinical distribution and drug resistance of pathogenic bacteria in children with acute otitis media in Shijiazhuang area#br#
LI Mei1, CHEN Zheng-li2*, ZHANG Wen-chao1, ZHOU Shan-shan1, XU Qian-ru1, GUO Ying-hui1
2020, 41(3):
319-323.
doi:10.3969/j.issn.1007-3205.2020.03.017
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［Abstract］ ObjectiveTo analyze the pathogen distribution and antimicrobial resistance in children with acute otitis media in Shijiazhuang area, and to provide evidence for clinical anti-infection treatment.
〖WTHZ〗MethodsThe clinical data of 291 children with acute otitis media were analyzed, the middle ear secretions were collected for culture. The strains were identified by biomerieux VITEK MS, and the antimicrobial sensitivity was detected by biomerieux VITEK2 Compact, BD Phoenix100 and K-B method.
〖WTHZ〗ResultsA total of 211 positive pathogen specimens were isolated from the purulent secretions in 291 samples with acute otitis media, and the positive rate was 72.5%, Among which 157 gram-positive strains were detected, the detection rate was 54.0%,and accounting for 74.4% of the total positive strains. The most common was streptococcus pneumonia(68), the detection rate and accounting for the total positive strains was 23.4% and 32.2% respectively. The second was staphylococcus aureus(62), the detection rate and accounting for the total positive strains was 21.3% and 29.4% respectively. The 42 strains of gram-negative bacilli accounting for 19.9% of the total positive strains were detected, the detection rate was 14.4%, in which the most common was haemophilus influenzae(28), with a detection rate of 9.6%, accounting for 13.3% of the total positive strains. There were statistically significant differences in the detection rates of pathogen in the four age groups of 0-1 year old, ＞1-3 years old, ＞3-6 years old and >6 years old(P＜0.05), and the highest positive detection rate at 0-1 year old, however the lowest positive detection rate at ＞3-6 years old. According to the time of occurrence, seasonal distribution had statistical differences(P＜0.05), with the highest detection rate in the fourth quarter and the lowest in the second quarter. The 68 strains of streptococcus pneumoniae from ear secretions were completely sensitive to Vancomycin and Linezolid, and completely resistant to Erythromycin, meanwhile the 62 strains of staphylococcus aureus were completely sensitive to Levofloxacin, Rifampicin, Gentamicin, Moxifloxacin, Vancomycin and Linezolid, and completely resistant to Erythromycin, Clindamycin and Penicillin, 34 strains of Methicillin-resistant staphylococcus aureus(MRSA) were found in Staphylococcus aureus, accounting for 54.8%. There were 28 strains of haemophilus influenzae, which were completely sensitive to Ceftazidine, Cefepime, Meropenem, Imipenem, Aztreonam and Ciprofloxacin, and higher resistance to cotrimoxazole.
〖WTHZ〗ConclusionStreptococcus pneumoniae, Staphylococcus aureus and haemophilus influenzae are the main pathogens of children′s acute otitis media in Shijiazhuang area. Many kinds of drugs commonly used in clinic are highly sensitive to them. In clinical, we can select reasonable antibiotics according to the results of bacterial culture and drug sensitivity test.
