CLINICAL STUDIES ON PSEUDOMONAL INFECTION IN CHRONIC OTITIS MEDIA
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概要
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Since there is a tendency for pseudomonal infection to increase recently in every field of medical sciences, the author attempted to clarify clinical problems of this infection in the ORL field. The results were as follows: Pseudornonas aeruginosa was detected in average 32.6% of the patients with chronic otorrhea in the Department of ORL, Japan Red Cross Central Hospital during the last three years (35.6% in 1963, 37.1% 1964, 25.7% 1965), second to the most frequent staphylococcal infection. Mixed infections were present in 37.6% of the patients with pseudomonal infection. Alterations in bacterial flora from Pseudomonas to Staphylococcus were more frequent than those from Staphylococcus to Pseudomonas.Although the color of the area infected with pseudomonas is an important clinical finding, only the gross observation may sometimes make to misdiagnose. One out of 35 strains studied was colorless on King's media. Also some of them showed no coloration depending on the condition of the environment. For example, pyocyanin fraction extracted from No.11 strain was blue in alkali and almost coloreless in pH 5.0-5.1.In the comparison of MIC (Minimum Inhibitory Concentration) in in vitro dilution method between Colistin sulfate (Ch-S) and Sodium colistinmethanesulfonate (CL-M), the former was more effective than the latter. CL-M was kept higher concentration in the blood and it showed more rapid absorption and excretion than CL-S. The combination of CL-M with Tetracycline, Chloramphenicol or Streptomycin produced a little additional effect.For a conservative therapy, bacteriological detection was planned to perform every week.The combination of local administration of CL-S and intramuscular injection of CL-M was more effective than single local administration.Cresol and mercurochrome were selected as effective disinfectants for Pseudomonas aeruginosa, but boric acid solution was almost without effect.In order to know the origin of infections, the pseudomonal strains from chronic otitis media were tested by sero-typing and phage-typing.But no definite conclusion suggesting the cross-in-fection with particular strains was obtained from present study.
- 一般社団法人 日本耳鼻咽喉科学会の論文