慢性化脓性中耳炎(CSOM)是耳鼻咽喉头颈外科常见疾病之一，是中耳及乳突内不可逆慢性炎症改变。截至目前本病的发病原因和机制尚不完全明确，其病因复杂，发病与多种因素有关，主要包括感染、咽鼓管功能障碍及免疫功能不健全等。其中病原菌感染是引起CSOM最重要、最直接的外源性致病因素。目前，随着抗生素的广泛应用，CSOM病原菌对抗生素的敏感性逐渐降低，其病原菌组成也发生着变化。因此，尽早检测CSOM中病原菌及明确其药物敏感性，对临床治疗CSOM具有重要的指导意义。本文通过查阅近年国内外相关文献，就CSOM病原菌分布及其耐药性研究、病原菌检测和抗菌药物合理应用的部分相关问题作一介绍。%Chronic suppurative otitis media (CSOM) is one of the common diseases in the Department of Oto-laryngology Head and Neck Surgery. It is the irreversible chronic inflammation in the middle ear and the mastoid. Up to now, the etiology of the disease and the mechanism is not completely clear. Its etiology is complex, and its occurrence is related to a variety of factors, including infection, dysfunction of eustachian tube and immunologic inadequacy. Bacterial infection is one of the most important and direct exogenous pathogenic factors of CSOM. At present, with the wide use of antibiotics, the sensitivity of CSOM pathogenic bacteria to antibiotics is gradually decreased, and the composition of the pathogen is also changing. Therefore, detecting the pathogenic bacteria in CSOM and identifying its drug sensitivity as soon as possible is of great significance for clinical treatment of CSOM. This review summarizes the distribution and drug resistance of pathogenic bacteria of CSOM, pathogenic bacteria detection and rational use of antimicrobial agents, based on the relevant literatures at home and abroad in recent years.
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