摘要
目的对比研究中耳炎差异球菌、肺炎链球菌、流感嗜血杆菌、卡他莫拉菌、金黄色葡萄球菌、草绿色链球菌在慢性分泌性中耳炎(secretory otitis media,SOM)儿童及成人患者的中耳积液(middle ear fluid,MEF)及鼻咽部分泌物(nasopharynx,Nph)中的检出率。方法运用PCR技术,观察并比较6种细菌在慢性分泌物中耳炎儿童组与成人组患者的MEF及Nph中的阳性率。结果(1)本研究中SOM儿童组与成人组患者MEF的主要细菌分布相似。PCR检测阳性率分别为91.30%(63/69)和88.25%(30/34),差异无统计学意义(χ~2=0.244,P>0.05);(2)儿童组及成人组患者的MEF中,常可检测出2种或2种以上的细菌,但儿童组较成人组更为常见,差异具有统计学意义(P<0.05);(3)儿童组患者MEF中阳性率最高的细菌为肺炎链球菌及金黄色葡萄球菌,成人组患者MEF中阳性率最高的细菌为金黄色葡萄球菌;(4)儿童组患者的MEF中,肺炎链球菌的阳性率高于成人组,差异具有统计学意义(χ~2=5.526,P<0.05),其余5种细菌差异无统计学意义(P>0.05);(5)儿童组MEF与Nph细菌阳性率比较,NPh中草绿色链球菌、流感嗜血杆菌、卡他莫拉菌的阳性率均高于MEF(χ~2=21.852,P<0.05;χ~2=21.369,P<0.05;χ~2=4.309,P<0.05),差异具有统计学意义(P<0.05);而金黄色葡萄球菌、肺炎链球菌及耳炎差异球菌在MEF与Nph中阳性率相似,差异均无统计学意义(P>0.05);(6)成人组MEF与Nph细菌检出率比较,除草绿色链球菌在Nph中阳性率高于MEF(χ~2=15.281,P<0.05)外,其余5种细菌差异均无统计学意义(P>0.05)。结论SOM儿童患者较成人更易发生中耳腔多种细菌混合性感染。
Objective To investigate the differences of bacteriological characteristics between adults and children with chronic secretory otitis media （SOM） via detecting the prevalences of six kinds of bacteria including Alloiococcus otitidis, Streptococcus pneumonia, Haemophilus influenzae, Moraxella catarrhails, Staphylococcus aureus, and Streptococcus viridans in the middle ear fluid （MEF） and nasopharyngeal secretion （NS）. Methods The prevalences of Alloiococcus otitidis, Streptococcus pneumonia, Haemophilus influenzae, Moraxella catarrhails, Staphylococcus aureus, and Streptococcus viridans were investigated by polymerase chain reaction （PCR） in the MEF and nasopharyngeal swabs of all the patients. Results ① With similar bacterial spectrum, the bacterium detection rates in adults and children were 91.30% （63/69） and 88.25% （63/69） respectively. The difference was statistically insignificant （ P 〉 0.05 ）. ② In the MEF of chronic SOM patients, two or more kinds of bacteria could be detected. The prevalence in children was higher than that in adults, and the difference was statistically significant （ P 〈 0. 05 ）. ③As for the bacteria detected in MEF, Streptococcus pneumoniae and Staphylococcus aureus were the most frequent pathogens in children, Staphylococcus aureus was the most common in adults. ④ In the MEF, the detection rate of Streptococcus pneumonia in children was higher than that in adults （P 〈 0.05 ）, while the prevalence differences of the other 5 bacteria between children and adults were all statistically insignificant （ all P 〉 0. 05 ）. ⑤ In children with SOM, the detection rates of Streptococcus viridans, Haemophilus influenzae, Moraxella catarrhails in NS were higher than those in MEF with statistical significant differences （all P 〈 0.05 ）. The detection rates of Alloiococcus otitidis, Staphylococcus aureus and Streptococcus pneumonia in NS were similar to those in MEF, their differences were all statistically insignificant （ all P 〉 0.05
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2017年第3期256-261,共6页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
基金
湖南省卫生厅科研基金课题(B2013-125)
关键词
中耳炎
渗出液
中耳积液
鼻咽
儿童
成人
Otitis media, with effusion
Middle ear effusion
Nasopharynx
Child
Adult
