緑膿菌およびその他のブドウ糖非醗酵グラム陰性桿菌感染耳の中耳手術

Surgical Treatment of Chronic Otitis Media Caused by Pseudomonas Aeruginosa and Other Gram-negativeRods

I．はじめに

　緑膿菌およびその他のブドウ糖非醗酵グラム陰性桿菌感染（以下非醗酵菌と略す）は，耐性ブドウ球菌，真菌などとともに菌交代現象^1）によるものとされている。緑膿菌感染耳の中耳手術に関しては石井ら^2）の報告があるが．今回われわれは中耳炎に対して手術を施行した77症例（84耳）について緑膿菌および非醗酵菌の検出経過とその術後経過，さらにこれらの細菌に対する薬剤の感受性について検討したので報告する。

　Infection with Pseudomonas aeruginosa (PA) or other Gramnegative rods (GNR) was caused by superinfection. Postoperative course and bacteriological findings in 31 cases with chronic otitis media of these bacteria were reported.

　Before surgery, PA were found 24.7%, of cases and GNR were found in 15.6%. PA were mostly present in cholesteatoma otitis media (47%) and reoperative cases (42%). In the postoperative recurrent infection, PA and GNR, if they were detected preoperatively, were found for a long period in the PA infected cases.

　The tympanoplasty of columella type III in which incus and malleus had to be removed was adopted in surgeries of otitis media chronica caused by PA, because massive granulation blocked the attic. Tympanoplasty type I was more frequently applied in GNR infection cases.