Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2023, Vol. 37 ›› Issue (1): 35-40.doi: 10.6040/j.issn.1673-3770.0.2021.494

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The bacteriological characteristics and drug sensitivity of the oropharyngeal region in children and adults with OSAHS

ZHANG Xiaoxue1, WANG Wei2, LIU Jie1, XU Zhenju1, QIAN Yongheng1, HAN Min1   

  1. 1. Department of Otorhinolaryngology & Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266071, Shandong, China;
    2. Department of Cardivascular Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266071, Shandong, China
  • Published:2023-02-06

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Abstract: Objective To analyze the difference of oropharyngeal flora between children and adults with obstructive sleep apnea hypopnea syndrome(OSAHS)and the results of drug sensitivity, so as to provide reference basis for rational selection of antibiotics in OSAHS patients after surgery. Methods OSAHS patients diagnosed by polysleep monitoring and treated by surgery in the Department of Otolaryngology Head and Neck Surgery of the Affiliated Hospital of Qingdao University from January 2018 to October 2021 were selected as the research objects. They were divided into children group and adults group according to age. After admission, some oropharyngeal secretions of the two groups were timely sent for bacterial culture and drug sensitivity analysis, to compare the oropharyngeal flora and drug sensitivity between children with OSAHS and adults with OSAHS. Results A total of 78 strains of pathogenic bacteria were isolated and cultured in 66 of 211 patients, with a positive rate of 31.28%, including 55 strains of Gram-positive cocci(70.51%), 29 strains of Staphylococcus aureus(37.18%)and 18 strains of Streptococcus pneumoniae(23.08%)were the main strains; there were 19 strains of Gram-negative bacilli(24.36%), mainly 15 strains of Haemophilus influenzae(19.23%). There was significant difference in detection rate of pathogenic bacteria between children group and adults group. There was significant difference in Streptococcus pneumoniae between the two groups, the detection rate of Streptococcus pneumoniae in children group was higher than that in adults group; there was no significant difference between Staphylococcus aureus and Haemophilus influenzae in the two groups. Streptococcus pneumoniae had high resistance rate to tetracycline, clindamycin and erythromycin. The resistance rate of Staphylococcus aureus to penicillin was high, and the drug resistance rates of Haemophilus influenzae to ampicillin, cefaclor, cotrimoxazole and cefuroxime were high. Conclusion The empirical application of antibiotics to prevent and treat infection after OSAHS surgery should be treated differently between children and adults patients, and the antimicrobial regimen should be adjusted according to the drug sensitivity results to slow down the production of drug-resistant bacteria.

Key words: Obstructive sleep apnea hypopnea syndrome, Children, Adults, Bacterial culture, Drug sensitivity test

CLC Number: 

  • R766.49
[1] 李绍楠,于丹,文连姬. 阻塞性睡眠呼吸暂停综合征与呼吸循环系统疾病的相关性[J].山东大学耳鼻喉眼学报, 2019, 33(1): 140-144. doi:10.6040/j.issn.1673-3770.0.2018.528 LI Shaonan, YU Dan, WEN Lianji. Research progress on the relationship between obstructive sleep apnea syndrome and diseases of the respiratory and circulatory systems[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1):140-144. doi:10.6040/j.issn.1673-3770.0.2018.528
[2] 秦旭,陈爱欢,孙丽红,等.儿童阻塞性睡眠呼吸暂停低通气综合征诊断标准的探讨[J].中华儿科杂志, 2015, 53(7): 582-531. doi:10.3760/cma.j.issn.0578-1310.2015.07.012 QIN Xu, CHEN Aihuan, SUN Lihong, et al. Suggestions on the diagnostic criteria of childhood obstructive sleep apnea hypopnea syndrome[J]. Chinese Journal of Pediatrics, 2015, 53(7): 528-531. doi:10.3760/cma.j.issn.0578-1310.2015.07.012
[3] Bonsignore MR, Saaresranta T, Riha RL. Sex differences in obstructive sleep apnoea[J]. Eur Respir Rev, 2019, 28(154):190030. doi: 10.1183/16000617.0030-2019
[4] 徐佩茹,阿布来提·阿不都哈尔,扎依旦·艾力.儿童阻塞性睡眠呼吸暂停低通气综合征诊断新进展[J]. 中华实用儿科临床杂志, 2017, 32(16): 1214-1217. doi:10.3760/cma.j.issn.2095-428X.2017.16.004 XU Peiru, Abulaiti·Abuduhar, Zhayidan·Aili. New progress in diagnosis of obstructive sleep apnea hypopnea syndrome in children[J]. Chinese Journal of Applied Clinical Pediatrics, 2017, 32(16): 1214-1217. doi:10.3760/cma.j.issn.2095-428X.2017.16.004
[5] 陈贵海, 张立强, 高雪梅,等. 成人阻塞性睡眠呼吸暂停多学科诊疗指南[J].中华医学杂志, 2018, 98(24): 1902-1914. doi:10.3760/cma.j.issn.0376-2491.2018.24.003
[6] 冯晨,郭瑞祥,王岩. 离子射频消融术在儿童阻塞性睡眠呼吸暂停中的应用和进展[J].山东大学耳鼻喉眼学报,2021, 35(2):16-21. doi:10.6040/j.issn.1673-3770.1.2020.105 FENG Chen, GUO Ruixiang, WANG Yan. Application and progress of coblation in children with obstructive sleep apnea[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(2):16-21. doi:10.6040/j.issn.1673-3770.1.2020.105
[7] Sheen D, Abdulateef S. Uvulopalatopharyngoplasty[J]. Oral Maxillofac Surg Clin North Am, 2021, 33(2): 295-303. doi:10.1016/j.coms.2021.01.001
[8] 龙燕,周珍文,王洁琳,等. OSAHS患儿腺样体、扁桃体病原菌分布及耐药性变迁[J]. 国际检验医学杂志, 2019,40(22): 2756-2761. doi: 10.3969/j.issn.1673-4130.2019.22.017 LONG Yan, ZHOU Zhenwen, WANG Jielin, et al. Distribution and drug resistance of pathogenic bacteria of adenoids and tonsils in children with OSAHS[J]. International Journal of Laboratory Medicine, 2019, 40(22): 2756-2761. doi:10.3969/j.issn.1673-4130.2019.22.017
[9] Yang WB, Shao L, Mulalibieke H, et al. Oropharyngeal Microbiome in Obstructive Sleep Apnea: Decreased Diversity and Abundance[J]. J Clin Sleep Med, 2019,15(12): 1777-1788. doi: 10.5664/jcsm.8084
[10] Johnston J, Hoggard M, Biswas K, et al. The bacterial community and local lymphocyte response are markedly different in patients with recurrent tonsillitis compared to obstructive sleep apnoea[J]. Int J Pediatr Otorhinolaryngol, 2018, 113: 281-288. doi: 10.1016/j.ijporl.2018.07.041
[11] Jeong JH, Lee DW, Ryu RA, et al. Bacteriologic comparison of tonsil core in recurrent tonsillitis and tonsillar hypertrophy [J]. Laryngoscope, 2007, 117(12): 2146-2151. doi:10.1097/MLG.0b013e31814543c8
[12] Sarmiento VL, Javier DR, Raquel R, et al. Role of tonsillar chronic inflammation and commensal bacteria in the pathogenesis of pediatric OSA[J]. Front Immunol, 2021, 12: 648064. doi: 10.3389/fimmu.2021.648064
[13] Brook I, Shah K, Jackson W. Microbiology of healthy and diseased adenoids[J]. Laryngoscope, 2000, 110(6): 994-999. doi:10.1097/00005537-200006000-00021
[14] Jurcisek JA, Bookwalter JE, Baker BD, et al. The PilA protein of non-typeable Haemophilus influenzae plays a role in biofilm formation, adherence to epithelial cells and colonization of the mammalian upper respiratory tract[J]. Mol Microbiol, 2007, 65(5): 1288-1299. doi: 10.1111/j.1365-2958.2007.05864.x
[15] Murphy TF, Faden H, Bakaletz LO, et al. Nontypeable Haemophilus influenzae as a pathogen in children[J]. Pediatr Infect Dis J, 2009, 28(1): 43-48. doi: 10.1097/INF.0b013e318184dba2
[16] 张海军,方海. b型流感嗜血杆菌疫苗纳入免疫规划的卫生经济学研究系统评价[J]. 中国疫苗和免疫, 2020, 26(4): 455-459,473. doi:10.19914/j.cjvi.2020.04.023 ZHANG Haijun, FANG Hai. Health economics evaluation of introducing Haemophilus influenzae type b vaccine into the Expanded Program on Immunization: a systematic evaluation[J]. Chinese Journal of Vaccines and Immunization, 2020, 26(4): 455-459,473. doi:10.19914/j.cjvi.2020.04.023
[17] Katkowska M, Garbacz K, Stromkowski J. Staphylo-coccus aureus isolated from tonsillectomized adult patients with recurrent tonsillitis[J]. APMIS, 2017, 125(1): 46-51. doi: 10.1111/apm.12628
[18] Loganathan A, Arumainathan UD, Raman R. Comparative study of bacteriology in recurrent tonsillitis among children and adults[J]. Singapore Med J, 2006, 47(4): 271-275
[19] Develioglu ON, Ipek HD, Bahar H, et al. Bacteriological evaluation of tonsillar microbial flora according to age and tonsillar size in recurrent tonsillitis[J]. Eur Arch Otorhinolaryngol, 2014, 271(6): 1661-1665. doi: 10.1007/s00405-014-2898-5
[20] Zautner AE, Krause M, Stropahl G, et al. Intracelular persisting Staphylococcus aureus is the major pathogen in recurrent tonsillitis[J]. PLoS ONE, 2010,5(3): e9452. doi: 10.1371/journal.pone.0009452
[21] Kalra MG, Higgins KE, Perez ED. Common questions about streptococcal pharyngitis[J]. Am Fam Physician, 2016, 94(1): 24-31
[22] Syrjänen RK, Kilpi TM, Kaijalainen TH, et al. Nasopharyngeal carriage of Streptococcus pneumoniae in Finnish children younger than 2 years old[J]. J Infect Dis, 2001, 184(4): 451-459. doi: 10.1086/322048
[23] Archer NK, Harro JM, Shirtliff ME. Clearance of Staphylococcus aureus nasal carriage is T cell dependent and mediated through interleukin-17A expression and neutrophil influx[J]. Infect Immun, 2013, 81(6): 2070-2075. doi: 10.1128/IAI.00084-13
[24] Mettananda S, Kamalanathan P, Namalie KD, et al. Streptococcus bovis-unusual etiology of meningitis in a neonate with Down syndrome: a case report [J]. J Med Case Rep, 2018, 12(1): 93. doi: 10.1186/s13256-018-1634-y
[25] Fekete SG, Berenyi I, Gabriella K, et al. Aerobic and anaerobic bacteriology of chronic adenoid disease in children[J]. Int J Pediatr Otorhinolaryngol, 2010, 74(11): 1217-1220. doi: 10.1016/j.ijporl.2010.07.013
[26] Seishima N, Kondo S, Wakisaka N, et al. EBV infection is prevalent in the adenoid and palatine tonsils in adults[J]. J Med Virol, 2017, 89(6): 1088-1095. doi: 10.1002/jmv.24737
[27] 孙梦玲,牛勋,杨修平.等. EB病毒与儿童扁桃体腺样体肥大的相关研究现状[J]. 临床耳鼻咽喉头颈外科杂志, 2021, 35(5): 477-480. doi: 10.13201/j.issn.2096-7993.2021.05.022 SUN Mengling, NIU Xun,YANG Xiuping, et al. Research status of Epstein Barr virus in children with adenotonsillar hypertrophy[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2021, 35(5): 477-480. doi: 10.13201/j.issn.2096-7993.2021.05.022
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