Acute otitis media and mastoiditis Chunfu dai m,d ph. d Otolaryngology Department Fudan Univeristy
Acute otitis media and mastoiditis Chunfu Dai M.D & Ph.D Otolaryngology Department Fudan Univeristy
Definition AOM: is an infectious process of the middle ear cleft and to a variable extent, of the mastoid air cell system t Eardrum 5 Semortulnr cants B Vestibular nerve Facial Nerve 4 StaDes
Definition ◼ AOM: is an infectious process of the middle ear cleft and to a variable extent, of the mastoid air cell system
Bacteriology Streptococcus pneumoniae(48%0) Haemophilus influenzae (31%) Moraxella catarrhalis(20%) P-hemolytic streptococcus (decreased following widespread immunization program 烫应科 Pseudomonas aeruginosa (uncommon cause of AOM)
Bacteriology ◼ Streptococcus pneumoniae (48%) ◼ Haemophilus influenzae (31%) ◼ Moraxella catarrhalis (20%) ◼ P-hemolytic streptococcus (decreased following widespread immunization program) ◼ Pseudomonas aeruginosa (uncommon cause of AOM)
阻断细菌耐药性的“恶性循环” 合理 临床■细菌 治疗 不合 治愈 消除 传 细 选择 药菌
阻断细菌耐药性的“恶性循环” 感染 耐药性 增加 传播 选择 耐药菌 细菌 未消除 不合理 治疗 合 理 治 疗 临 床 治 愈 细 菌 消 除
青霉素耐药的肺炎链球菌 9—98年在美国流行情况 50 40 30 s20 18% 10 0 R85S8高怒8S8 8s8 8艮§ (Doen. Am J Med. 1995: 99(6B): 3S-7S; Jacobs et al., AAC 1999: 43: 1901; Jacobs et al abstract C-61, ICAAC 1999)
(Doern. Am J Med. 1995;99(6B): 3S-7S; Jacobs et al., AAC 1999:43:1901; Jacobs et al abstract C-61, ICAAC 1999) 0 10 20 30 40 50 % Penicillin Resistance 中度敏感 (0.12 - 1.0 µg/ml) 耐药 ( 2.0 µg/ml) 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988-89 1990-91 1992-93 1994-95 1997 1998 16% 18% 29% 33% 青霉素耐药的肺炎链球菌 79－98年在美国流行情况