小児の鼻汁から得られた検出菌の検討 Bacteriology of Nasal Discharge in Children
Nasal discharge in 34 children under the age of 10 years was bacteriologically studied, who visited our department in 2006. Specimens were collected from middle meatus, whenever possible, for bacteriological identification and susceptibility testing.<br>We recovered 74 bacterial strains from 34, but no pathogens in 3 patients. The rate of strains was 31.1% (23 strains) for H. influenzae, 31.1% for S. pneumoniae, 23.0% (17 strains) for M. catarrhalis, 8.1% (6 strains) for S. aureus, and 1.4% (1 strain each) for Pseudomonas aeruginozae and S. milleli. Pathogen overlap was observed involving 1 strain in 7 patients (21%), 2 in 8 (24%), 3 in 14 (40%) and 4 in 2 (6%). At least one of such common pathogens as H. influenzae, S. pneumoniae, and M. catarrhalis was detected in 30 patients (88.2%). In 20 patients (58.9%) at least one penicillin-resistant bacteria was detected. M. catarrhalis was included in penicillin-resistant bacteria because about 99% of M. catarrhalis may produce beta-lactamase.<br>According to our findings, susceptibility of H. influenzae was 43.0% for beta-lactamase-negative ampicillin-susceptible strain (BLNAS), 8.7% for low beta-lactamase-negative ampicillin-resistant strain (low BLNAR), 38.9% for BLNAR, and 7.5% for beta-lactamase producing ampicillin-resistant strain (BLPAR). Susceptibility of S. pneumoniae was 40.0% for penicillin-susceptible S. pneumoniae (PSSP), 43.6% for penicillin-intermediate S. pneumoniae (PISP), and 16.4% for penicillin-resistant S. pneumoniae (PRSP).<br>Our study demonstrated the key importance of antibiotic therapy for rhinosinusitis in children due to the overlap of pathogenic bacteria and the existence of antibiotics-resistant strains.
日本鼻科学会会誌 47(2), 115-119, 2008-08-01