急性化膿性中耳炎の臨床細菌学的評価

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The evaluation of isolated bacteria from patients with acute otitis media varies among investigators, and to elucidate this problem microbiological investigations and a study on the related host defense mechanism were carried out in a total of 183 out-patients between December 1977 and December 1978.Middle ear fluids were aspirated when the patients were first seen and again 24 hours later.The following results were obtained:1) Sole strain was isolated in 134 cases.On the initial investigation, Haemophilus influenzae was the most frequent organism grown from the fluids in children under 5 years of age. Staphylococcus aureus (S. aureus) was predominantly isolated from the patients older than 6 years of age.The predominant organisms except S. aureus isolated in the first visit altered to S. aureus in 20. 9% of the patients in the reexamination after 24 hours.2) Mixed isolates were found in 49 cases.It was observed that in many cases the mixed isolates including both low and high pathogenic strains in the first examination had changed into the single strain high pathogenicity 24 hours later. An increasing frequency of low pathogenic organisms was remarkable particularly in older patients.3) Nitroblue-tetrazolium test;A significant increase in number and percentage of NBT-positive neutrophils were noted in patients with leukocytosis (104/mm3 or more) and fever (above 37.5°C), and notably in patients with S. aureus infection.4) Serum immunoglobulins;It was impossible to obtain the satisfactory result on the correlation between each immunoglobulin (IgG, IgA and IgM) and acute middle ear infection.5) Our conclusion was that the isolates from middle ear fluids are varied with the passage of time and the relationship between host defense mechanism and parasite.
社団法人日本耳鼻咽喉科学会の論文

急性化膿性中耳炎の臨床細菌学的評価

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