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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 compare the effects of otitis media, pneumococcus, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus and Streptococcus viridans on the middle ear of children with secretory otitis media (SOM) and adults Middle ear fluid (MEF) and nasopharynx (Nph). Methods The positive rates of MEF and Nph in 6 children with and without chronic otitis media were observed and compared using PCR. Results (1) The main bacterial distribution of MEF in SOM children group and adult group was similar in this study. The positive rate of PCR detection was 91.30% (63/69) and 88.25% (30/34) respectively, with no significant difference (χ ~ 2 = 0.244, P> 0.05). (2) The MEF , Two or more kinds of bacteria could be usually detected, but the children group was more common than the adult group, the difference was statistically significant (P <0.05); (3) The highest positive rate of MEF in children group was Streptococcus pneumoniae and Staphylococcus aureus, the highest positive rate of MEF in adult patients was Staphylococcus aureus; (4) The prevalence of Streptococcus pneumoniae in MEF was higher in children than in adults, the difference was statistically significant (P <0.05). (5) The positive rates of MEF and Nph in children group were significantly higher than those in other groups (P <0.05) The positive rate of Haemophilus and Moraxella catarrhalis were higher than that of MEF (χ ~ 2 = 21.852, P <0.05; χ ~ 2 = 21.369, P <0.05; (P <0.05). However, the positive rates of Staphylococcus aureus, Streptococcus pneumoniae and otrophic bacteria in MEF and Nph were similar (P> 0.05). (6) There was no significant difference between MEF and Nph Nph bacteria detection rate comparison, weeding green hammerhead In the positive rate Nph MEF (χ ~ 2 = 15.281, P <0.05), the other five bacteria was no significant difference (P> 0.05). Conclusion SOM children are more susceptible to mixed bacterial infection in the middle ear cavity than adults.