| Objective:1.To investigate the recent stages changes of etiology of chronic suppurative otitis media.2.To analyze the microbial sensitivity test results of chronic suppurative otitis media.3.To study the virulence genes of Staphylococcus aureus and Pseudomonas aeruginosa.Methods:1.Etiological identification of chronic suppurative otitis media(CSOM):The middle ear secretions of patients with chronic suppurative otitis media were collected and cultured for bacteria and fungi.The cultured positive strains were identified by the Vitec-Compact instrument.2.Drug sensitivity test:The drug sensitivity test scheme was referred to the technical scheme of the China Antimicrobial Resistance Surveillance System(CARSS),and the implementation standard of drug sensitivity test was CLSI M100-29.3.Virulence gene test:PCR method was used to detect the virulence genes carried by the isolated and identified Staphylococcus aureus and Pseudomonas aeruginosa.Result:1.The detection rate of pathogenic bacteria in chronic suppurative otitis media was 79.89%.According to the proportion of detection rate,the top three were Staphylococcus aureus(29.94%,50/167),Filamentous fungi(20.36%,34/167),and Pseudomonas aeruginosa(7.19%,12/167).2.The microbial sensitivity tests showed that gram-positive bacteria had the highest drug resistance rate to penicillin G(77.78%).Gram-negative bacteria had the highest resistance rate to ciprofloxacin(22.73%)3.Among the virulence genes of Staphylococcus aureus,the detection rate of HLa gene was the highest,up to 100%.Among the virulence genes of Pseudomonas aeruginosa,the detection rate of ToxA was the highest,up to 100%.Conclusion:1.The pathogen spectrum of chronic suppurative otitis media is completely different from what it was many years ago.The detection rate of Staphylococcus aureus was the highest.Fungi were detected in higher proportion,and there were quite a few cases of mixed infection with two pathogenic bacteria.2.No effect of age and sex on the distribution of pathogenic bacteria of CSOM was found.3.Gram-positive bacteria have the highest rate of drug resistance to penicillin G,which is far beyond the standard of the "Measures for the Administration of Clinical Application of Antibacterial Drugs".Therefore,targeted clinical application should be suspended.Erythromycin and ampicillin should be alerted to clinical staff.Gram-negative bacteria had the highest drug resistance rate to ciprofloxacin,although it did not reach the drug warning,but it still needs to be noticed.4.The detection rate of HLa gene of Staphylococcus aureus and ToxA gene of Pseudomonas aeruginosa were very high,which were closely related to their pathogenicity.5.Summarize the dynamic change characteristics of the main pathogens of chronic suppurative otitis media in the region on a regular basis,as a scientific basis,to carry out targeted prevention and treatment,to provide the greatest scientific support for the proper administration of drugs in clinic,and to further promote individual treatment and precise treatment,which has great medical and social value. |
