The 2022 World Health Organization guidelines recommend use of two core anti-tuberculosis (TB) drugs, bedaquiline (BDQ) and clofazimine (CFZ), for treatment of drug-resistant (DR)-TB. However, several mutated Mycobacterium tuberculosis (MTB) genes, conferring BDQ and CFZ resistance, have been reported that predominantly arose from sporadic mutations that have not been comprehensively characterized. Herein, MTB clinical isolates collected from drug-susceptible (DS)-, multidrug-resistant (MDR)-, and extensively drug-resistant (XDR)-TB patients were cultured in vitro with BDQ or CFZ to generate progeny strains with resistance to these drugs. Progeny strains exposed to CFZ exhibited increased CFZ minimum inhibitory concentrations (MICs) that exceeded MIC increases of BDQ-exposed progeny strains. Notably, mmpR and pepQ mutations accounted for 83% and 17% of BDQ-induced spontaneous gene mutations, respectively, and 86% and 14% of CFZ-induced spontaneous gene mutations, respectively. Analyses of predicted mutation-induced changes in amino acid sequences and structures of MmpR and PepQ mutants revealed several point mutations affected sequence conversation and functionality as an underlying mechanism for observed acquired BDQ/CFZ resistance. Moreover, our results revealed differences in patterns of BDQ- and CFZ-induced acquired spontaneous mutations that may enhance our understanding of MTB BDQ/CFZ-resistance mechanisms.IMPORTANCE This study of MTB drug resistance mechanisms revealed patterns of spontaneous MTB mutations associated with acquired BDQ and CFZ resistance that arose after clinical MTB isolates were cultured in vitro with BDQ or CFZ. Results of protein sequence and structural analyses provided insights into potential mechanisms underlying associations between MTB gene mutations and DR phenotypes. Taken together, these results revealed differences in acquired BDQ and CFZ resistance mechanisms as a new perspective that may enhance our understanding of BDQ/CFZ resistance mechanisms and facilitate the development of new methods for detecting MTB drug resistance genes.

目的 系统评价儿童细菌性脑膜炎后听力损害的危险因素.方法 计算机检索PubMed、EMbase、Web of Science、CNKI、Smomed、Wanfang data、VIP.检索时限为建库～2021年9月20日,收集国内外有关儿童细菌性脑膜炎后听力损害危险因素的相关研究,由两名研究者独立筛选文献、提取资料后,采用纽卡斯尔渥太华量表(NOS)评价研究质量,并采用Stata 16.0软件进行Meta分析.结果 纳入12项研究(3项队列研究,9项病例对照研究),对2041例细菌性脑膜炎患儿进行了听力检查,其中出现听力损害(特指感音神经性聋)者301例.共对4种危险因素进行Meta分析,显示肺炎链球菌感染[OR=2.70,95％CI(1.89,3.87),P＜0.001]、癫痫发作[OR=2.31,95％CI(1.29,4.14),P=0.00S]是儿童细菌性脑膜炎后听力损害的危险因素;年龄≤1岁[OR=1.00,95％CI(0.34,2.97),P=0.998]、性别[OR=1.06,95％CI(0.70,1.58),P=0.794]与儿童细菌性脑膜炎后听力损害不相关.结论 研究的结果表明致病菌为肺炎链球菌、病程中出现癫痫发作是儿童细菌性脑膜炎后听力损害的危险因素.对有上述危险因素的患儿,应格外重视其听力的变化并加强随访.

Pediatric tuberculosis (TB) is a serious infectious disease that affects many children worldwide and is more likely to be extrapulmonary than adult TB. However, the clinical and epidemiological profile, and cost burden of pediatric extrapulmonary TB (EPTB) in China remain unknown. Here, we conducted a descriptive, multicenter study of pediatric TB patients from 22 hospitals across all six regions in China from October 2015 to December 2018. Of 4,654 patients, 54.23% (2,524) had pulmonary TB (PTB), 17.76% (827) had EPTB, and 28.00% (1,303) had concurrent extrapulmonary and pulmonary TB (combined TB). Compared with PTB, EPTB and combined TB were associated with lower hospitalization frequency (2.43 and 2.21 vs. 3.16 times), longer length of stay (10.61 and 11.27 vs. 8.56 days), and higher rate of discharge against medical advice (8.46% and 9.44% vs. 5.67%). EPTB was associated with higher mortality (0.97% vs. 0.24% and 0.31%), higher rate of low birth weight (17.69% vs. 6.79% and 6.22%), worse diagnosis at the first visit (21.16% vs. 34.67% and 44.47%), and worse hospitalization plan situation (4.35% vs. 7.81% and 7.44%), compared with PTB and combined TB. EPTB and combined TB had higher financial burdens (17.67% and 16.94% vs. 13.30%) and higher rates of catastrophic expenditure (8.22% and 9.59% vs. 5.03%), compared with PTB. Meningitis TB (34.18%) was the most frequent form of total extrapulmonary infection and had the highest cost burden and rate of catastrophic expenditure. In conclusion, improved screening approaches for pediatric EPTB are needed to reduce diagnostic challenges and financial burden.

IMPORTANCE:First branchial cleft anomalies (FBCAs) are rare congenital malformations, accounting for < 8% of all branchial cleft anomalies. However, little is currently known about the cause of FBCAs at the molecular level.OBJECTIVE:To identify genomic alterations related to the genetic etiology of FBCAs in Chinese children.METHODS:We performed whole-exome sequencing of samples from 10 pediatric patients with FBCAs. Data analysis was carried out using the Burrow-Wheeler Alignment software package, and the dbSNP database for comparisons. Rare variants were further validated by Sanger sequencing. Insertion/deletions (indels) were examined using the Genome Analysis Toolkit.RESULTS:We identified 14 non-synonymous mutations in seven potential FBCA-susceptibility genes (TRAPPC12, NRP2, NPNT, SH3RF2, RHPN1, TENM4, and ARMCX4). We also detected 133 shared small indels in 125 genes. Gene Ontology analysis indicated that most of the identified genes played critical roles in development and differentiation pathways involved in regulating organ development.INTERPRETATION:We characterized the mutational landscape in pathways involved in development and differentiation in Chinese children with FBCA. The results identified potential pathogenic genes and mutations related to FBCA, and provide molecular-level support for the branchial theory of FBCA pathogenesis.

目的 分析慢性鼻窦炎(CRS)合并腺样体肥大患儿腺样体表面及鼻腔内细菌谱,比较腺样体手术对CRS的临床疗效及相关因素分析.方法 收集2017年10月—2019年10月就诊于北京儿童医院耳鼻咽喉科的30例CRS合并腺样体肥大患儿的相关临床资料,其中男22例,女8例.所有患儿均行腺样体和/或扁桃体切除术,术中采集腺样体表面及鼻腔分泌物,采用16S rRNA方法对细菌谱进行分析.并分别于术后3、6、12个月对患儿进行随访,通过术前和术后上呼吸道感染频次、各项鼻部主观评分变化,分析腺样体手术对患儿CRS症状改善的有效性,探讨腺样体切除术对CRS患儿预后的影响因素.结果 30例患儿腺样体和鼻腔内细菌检出率为100％.患儿鼻腔表面的主要细菌为卡拉莫氏菌、流感嗜血杆菌、肺炎链球菌、金黄色葡萄球菌.腺样体表面主要细菌为肺炎链球菌、流感嗜血杆菌、具核酸杆菌、卡拉莫氏菌.腺样体切除术3个月后所有患儿鼻部主观症状除喷嚏外,评分均明显降低(P＜0.01),随访至12个月,上呼吸道感染次数明显减少(P＜0.01).术后12个月CRS完全控制率63.3％(19/30),部分控制36.7％(11/30).结论 腺样体切除术可以明显改善CRS患儿的临床症状,是治疗儿童CRS的有效治疗手段.由于样本量有限,相关数据显示环境因素、细菌谱等CRS致病因素对腺样体术后的患儿预后均没有明确影响.

目的 明确儿童复发性分泌性中耳炎(OME)的高危致病因素,为指导复发性OME的治疗提供依据.方法 检索英文PubMed、MEDLINE和EMBASE及中文中国期刊全文数据库(CNKI)、中国科技期刊全文数据库(VIP)、万方数据库,收集各个数据库建库至2020年5月1日已发表的文献.检索策略:英文检索(pediatric or children)AND(recurrent otitis media with effusion or refractory otitis media with effusion or recurrent OME or refractory OME);中文检索(儿童)AND(复发性分泌性中耳炎OR难治性分泌性中耳炎).结果 共纳入符合检索策略的文献15篇,总研究例数1867例,反复上呼吸道感染合并OR值为4.67(95％CI为2.97～7.36),性别合并OR值为1.18(95％CI为0.80～1.73),吸烟环境合并OR值为0.91(95％CI为0.67～1.22),腭裂合并OR值为3.80(95％CI为2.50～5.79).结论 儿童复发性OME的高危因素主要包括反复上呼吸道感染和腭裂2类.对于有高危因素的复发性OME患儿,建议延长鼓膜置管留置时间至12个月以上,以最大程度降低复发率.

Background: The neonatal period is a critical period for the establishment of the intestinal microbial community. Antibiotics can change the composition of gut microbiota.Methods: Fecal samples were collected from 14 patients with pneumonia and 14 patients with meningitis before and after antibiotic treatment, and fecal samples from five healthy neonates at the 14th and 21st days after birth were collected as well. DNA of fecal samples was extracted, and PCR amplification was performed targeting the V3–V4 variable region of 16S rDNA. After detection by high-throughput sequencing, OTU (operational taxonomic unit) clustering, species annotation, and α diversity analysis were calculated and analyzed statistically.Results: In the healthy control group, the abundance of Bifidobacterium increased significantly from 16.75 to 40.42%, becoming the most dominant bacteria. The results of α diversity analysis suggested that the Sobs indexes of the gut microbiota in the pneumonia and meningitis groups were significantly lower than that in the healthy control group (p < 0.05). PCoA analysis showed that the gut microbiota of pneumonia and meningitis groups clustered distinctly with the control group (Adonis p = 0.001, R2 = 0.565), and there was no significant change in the diversity of gut microbiota before and after the use of antibiotics.Conclusions: The gut microbiota of neonates with infectious diseases were mainly related to the disease conditions. The initial state of neonatal gut microbiome determines its state after 1-week antibiotic treatment. Antibiotic application with 7 days had little effect on the community richness and some effect on the composition of gut microbiota of neonates with pneumonia or meningitis.

Papillary thyroid carcinoma (PTC) is the most common type of thyroid carcinoma, and its incidence has been on the increase in recent years. However, the molecular mechanism of PTC is unclear and misdiagnosis remains a major issue. Therefore, the present study aimed to investigate this mechanism, and to identify key prognostic biomarkers. Integrated analysis was used to explore differentially expressed genes (DEGs) between PTC and healthy thyroid tissue. To investigate the functions and pathways associated with DEGs, Gene Ontology, pathway and protein-protein interaction (PPI) network analyses were performed. The predictive accuracy of DEGs was evaluated using the receiver operating characteristic (ROC) curve. Based on the four microarray datasets obtained from the Gene Expression Omnibus database, namely GSE33630, GSE27155, GSE3467 and GSE3678, a total of 153 DEGs were identified, including 66 upregulated and 87 downregulated DEGs in PTC compared with controls. These DEGs were significantly enriched in cancer-related pathways and the phosphoinositide 3-kinase-AKT signaling pathway. PPI network analysis screened out key genes, including acetyl-CoA carboxylase beta, cyclin D1, BCL2, and serpin peptidase inhibitor clade A member 1, which may serve important roles in PTC pathogenesis. ROC analysis revealed that these DEGs had excellent predictive performance, thus verifying their potential for clinical diagnosis. Taken together, the findings of the present study suggest that these genes and related pathways are involved in key events of PTC progression and facilitate the identification of prognostic biomarkers.

当前,由结核分枝杆菌(MTB)引发的结核病仍是全球传染病最主要的死因,耐药菌株的传播给结核病的治疗造成了极大困难.德拉马尼(delamanid,Dlm)作为抗结核新药对耐多药和广泛耐药结核病(MDR-TB/XDR-TB)均有较好的治疗作用,准确并及时地对Dlm耐药菌株进行检测可以最大限度地保证药品临床应用的有效性,提高MDR-TB/XDR-TB的治愈率.MTB获得性耐药多与耐药相关基因突变有关,作者综述了MTB对Dlm耐药的机制及其耐药相关基因突变,为对Dlm耐药菌株进行早期分子诊断提供参考.

Background: The pathologic features and potential predictive biomarkers for recurrence of antrochoanal polyps (ACPs) in children are not fully understood. Objectives: To identify the pathologic differences between recurrent and nonrecurrent group and to explore potential clinical markers which predict recurrence of ACPs in children. Material and Methods: A total of 11 recurrent and 21 nonrecurrent ACPs children were enrolled into this retrospect study. Clinical basic information was collected before the first surgery. The counts of vessels were evaluated by hematoxylin–eosin (HE) staining, and CD34 was detected by immunohistochemistry. Meanwhile, the percentage of each tissue inflammatory cells (eosinophils, neutrophils, lymphocytes, and plasma cells) was assessed by HE staining. Results: No statistical significance was observed between the 2 groups in the basic clinical features. Moreover, both the counts of blood vessels and the tissue neutrophils percentage were enhanced significantly in group with ACPs recurrence ( P < .05). According to the receiver operating characteristic curves, the area under the curve for the counts of blood vessels and tissue neutrophils percentage in the prediction of ACPs’ recurrence was 0.779 ( P = .0105) and 0.989 ( P < .0001) respectively. Conclusions and Significance: It was concluded that the counts of blood vessels and the percentage of tissue neutrophils appeared to be potential excellent predictors of ACPs recurrence in children.

Chronic rhinosinusitis (CRS) is a chronic inflammatory disease of the nasal and sinus mucosa.Despite considerable research,the etiology of CRS remains poorly understood,and debate on potential roles of microbial communities is unresolved.Modem molecular techniqueshave vastly improved our understanding of the microbiology.This review presents a comprehensive discussion of the current understanding of bacterial,fungal,and viral associations with CRS.

目的明确慢性鼻-鼻窦炎患者鼻腔的菌群分布情况,为指导慢性鼻-鼻窦炎的诊疗提供依据。方法通过PubMed、EMBASE和MEDLINE数据库检索英文文献,通过中国期刊全文数据库（CNKI）、中国科技期刊全文数据库（VIP）、万方数据库系统检索中文文献,收集各数据库自建库至2018年9月发表的所有慢性鼻-鼻窦炎微生态（包括细菌和病毒）分布情况研究的文献全文。检索策略:英文检索（chronic rhinosinusitis） AND （microbio*OR bacteria OR virus）;中文检索（鼻-鼻窦炎）并且（微生态或者细菌或者病毒）。结果共纳入20篇文献,共计2 141例慢性鼻-鼻窦炎,金黄色葡萄球菌阳性率为0.24（95%CI:0.17～0.31）,表面葡萄球菌阳性率0.17（95%CI:0.11～0.23）,肺炎链球菌阳性率0.06（95%CI:0.02～0.11）、铜绿假单胞杆菌阳性率0.09（95%CI:0.05～0.14）、流感嗜血杆菌阳性率0.09（95%CI:0.03～0.15）。结论在慢性鼻-鼻窦炎患者鼻腔中,金黄色葡萄球菌、表面葡萄球菌是主要的致病菌,其次阳性率较低的是肺炎链球菌、铜绿假单胞杆菌和流感嗜血杆菌。

Objective: To evaluate and compare the microbiological features in ACPs groups and control subjects in pediatric group, further to explore the potential role of microbial in the etiology of ACPs. Methods: A total of 32 patients with ACPs, and 10 control subjects were enrolled in this study. Demographic datas were collected. The TaqMan low-density array assays were used to detect the microbial of swab specimens and nasal tissue samples from ACPs patients. Results: A total of 15 species were identified in all groups. Of all the species, Mycoplasma pneumoniae was the most common species in ACP patients, but was negative in control group. Of all the viruses detected, Adenovirus positivity was significantly higher in control group than that in ACPs middle meatus on unaffected side, ACPs middle meatus on affected side, and ACPs polypous surface group (P < 0.05). Cytomegalovirus positivity was significantly higher in control group than that in ACP polypous group (P < 0.05). Human herpesvirus 6 (HHV-6) was absent in control goup, and positive in ACP middle meatus on affected side was significantly higher than that in ACP polypous surface and ACP polyp group (P < 0.05). The expression of other microbial differed not significantly in unaffected side, affected side of ACPs, ACPs polypous surface, and ACPs polyp. Conclusions: Mycoplasma pneumoniae was the most common species in ACP patients. Streptococcus pneumonia and Moraxella catarrhalis were the only bacteria detected at certain frequency in nasal polyps and control subjects. Human herpesvirus 6 and Mycoplasma pneumoniae may have potential role in the development of ACPs. The isolates rate of microbial differed in middle meatus on unaffected and affected side of ACPs, ACPs polypous surface, ACPs polyp, and their role in the etiology of ACPs need to be further studied.

Neuroblastoma (NB) is one of the most common extracranial solid tumors in children, which has complex molecular mechanisms. Increasing evidence has suggested that long noncoding RNAs (lncRNAs) account for NB pathogenesis. However, the function of small nucleolar RNA host gene 16 (SNHG16) in NB is currently unclear. In the present study, publically available data and clinical specimens were employed to verify the expression of SNHG16 in NB. Colony formation, real-time cell proliferation and migration assays were performed to demonstrate the status of cellular proliferation and migration. Flow cytometry was used to examine cell cycle progression in SH-SY5Y cells, and acridine orange/ethidium bromide staining and caspase-3/7 activity measurements were applied to study cell apoptosis. To explore the underlying mechanism of SNHG16 function, an online database was used to identify potential RNA-binding proteins that bind SNHG16. The expression of SNHG16 was revealed to be in line with the clinical staging of NB, and high SNHG16 expression was positively associated with poor clinical outcome. Furthermore, SNHG16 silencing inhibited cell proliferation, repressed migration, and induced cell cycle arrest at the G(0)/G(1) phase in SH-SY5Y cells. Additionally, apoptosis was undetectable in SH-SY5Y cells following SNHG16 silencing. Bioinformatics analysis revealed that SNHG16 regulated cell proliferation in NB through transcriptional and translational pathways. These results suggested that SNHG16 may serve important roles in the development and progression of NB, and could represent a potential target for NB therapy.

The pathogenesis and etiology of antrochoanal polyps (ACPs) remains obscure. This study aimed to characterize the inflammatory profiles and investigate the effect of atopy on the pathogenesis of pediatric ACPs. Thirty-three ACP patients and ten control subjects were enrolled from January to December 2017. The severity of individual nasal symptoms was scored on a visual analogue scale (VAS). The serum total immunoglobulin E (IgE) and cytokines level was measured by multiplexed luminex assay. There was no significant difference in VAS scores and counts of inflammatory cells between atopic and nonatopic ACP. No difference in IFNγ, IL-4, IL-5, IL-13, IL-17A and IL-25 was found between control and whole ACP, nonatopic and atopic ACP. Significantly increased levels of IL-6 and IL-10 were found in ACP compared with control. For neutrophil chemotactic factor, significant increases of IL-8 and GRO were observed in ACP, but for eosinophil chemotactic factor, no difference was found in RANTES and GM-CSF. IL-6 level was positively correlated with IL-8, MCP1, and GRO level, and IL-10 level was positively correlated with IL-4 and IL-13 in ACP subjects. Nasal obstruction was the most common symptom in ACPs in children. Allergic condition may have a poor role in the pathogenesis of ACPs. IL-6 plays a crucial role in the pathogenesis of neutrophilic inflammation in patients with ACPs and may provide a new treatment strategy for ACPs in children. Treg cell associated cytokine IL-10 was involved in the inflammatory pathophysiological process of ACPs and played a certain regulatory role.

文献检索及应用能力是医学科研工作者重要的技能之一.目前我国医学研究生文献信息意识淡薄;文献信息检索知识短缺;文献信息使用能力薄弱.本文通过对医学研究生文献素质现状及存在问题的分析,结合我院研究生培养的经验,提出了对医学研究生文献检索及使用能力培养的建议,通过了利用系统的文献检索及利用课程、课题研究过程、课题组的例会等方面充分培养研究生的文献检索与应用能力,为培养医学研究生的综合素质提供强有力的支撑.

Objectives To investigate the genetic causes of hearing loss with enlarged vestibular aqueduct (EVA) in two children from unrelated two Chinese families. Methods Sanger sequencing of all coding exons in SLC26A4 (encoding Pendrin protein) was performed on the two patients, their sibling and parents respectively. To predict and visualize the potential functional outcome of the novel variant, model building, structure analysis, and in silico analysis were further conducted. Results The results showed that the proband from family I harbored a compound heterozygote of SLC26A4 c.1174A>T (p.N392Y) mutation and c.1181delTCT (p.F394del) variant in exon 10, potentially altering Pendrin protein structure. In family II, the proband was identified in compound heterozygosity with a known mutation of c.919-2A>G in the splice site of intron 7 and a novel mutation of c.1023insC in exon 9, which results in a frameshift and translational termination, consequently leading to truncated Pendrin protein. Sequence homology analysis indicated that all the mutations localized at high conservation sites, which emphasized the significance of these mutations on Pendrin spatial organization and function. Conclusion In summary, this study revealed two compound heterozygous mutations (c.1174A>T/c.1181delTCT; c.919- 2A>G/c.1023insC) in Pendrin protein, which might account for the deafness of the two probands clinically diagnosed with EVA. Thus this study contributes to improve understanding of the causes of hearing loss associated with EVA and develop a more scientific screening strategy for deafness.

BackgroundIn this study, we aimed to optimize the condition of propidium monoazide (PMA) treatment for direct detection of Mycobacterium tuberculosis (MTB) from clinical specimens.MethodsThe light exposure time, dark incubation time, bacterial load, and PMA concentration were varied to determine the optimal condition of PMA treatment.ResultsOverall, the maximum ΔCq value was observed in the group receiving a light exposure time of 20 minutes, which was significantly higher than the others (P < 0.05). The prolongation of dark incubation time seemed more likely to result in greater ΔCq value, and the ΔCq values were 2.0, 4.1, 6.5, 10.1, and 12.7 cycles under dark incubation time of 10, 20, 40, 60, and 120 minutes, respectively. Alternatively, the 4+ samples exhibited favorable detection results at the application of 104‐fold dilution by PMA assay with Cq values higher than 35 cycles. Further evaluation revealed that the PMA assay showed an accordance rate of 98.0% (98/100) among clinical sputa.Conclusionswe develop an acceptable method to directly identify the live bacteria from sputum samples. Our data demonstrate that the dark incubation plays a crucial role in the efficacy of PMA treatment for MTB.

提高医学本科生的科研素养已经成为全面培养医学生的重要任务.培养具有较高科研素养的医学生为当今我国建立高素质医学团队打下了坚实的人才基础.对比传统的医学本科生基础实验课,正确引导学生根据自己的研究兴趣,尽早进入相应的实验室开展以科学问题为导向的科研训练,参与到真正的课题研究,对于全面提高医学本科生的科研能力具有不可替代的重要意义.从基础实验课与依托科研课题的基础科研训练的关系、依托科研课题的基础科研训练在医学生培养中的作用及医学本科生在实验室环境中进行基础科研训练的形式三方面进行探讨.

目的 分析腺样体肥大患儿的腺样体实质与表面分泌物中菌群分布及药敏特征,探讨细菌在儿童腺样体肥大及相关疾病发病机制中的作用.方法 选取自2013年8月至2014年8月就诊于北京儿童医院耳鼻咽喉头颈外科拟行腺样体切除术的101例患儿为研究对象,按照腺样体肥大程度将患者分为A组(腺样体增大阻塞后鼻孔0～50％,n=10)、B组(腺样体增大阻塞后鼻孔51％ ～75％,n=78)与C组(腺样体增大阻塞后鼻孔76％ ～100％,n=13).取患者术前腺样体表面分泌物、术中腺样体组织行常规细菌培养及药物敏感性试验并对其结果进行分析,比较不同腺样体肥大程度的群菌种类检出情况.结果 腺样体表面分泌物标本101份,细菌检出率为89.1％(90/101),分离细菌139株.主要为流感嗜血杆菌46株(33.1％),其次为金黄色葡萄球菌32株(23.0％)、肺炎链球菌21株(15.1％)、化脓链球菌14株(10.1％)、卡他莫拉菌10株(7.2％)等.50.5％的标本中培养出两种以上细菌.腺样体组织标本101份,细菌检出率为89.1％(90/101),分离细菌132株.主要为流感嗜血杆菌38株(28.8％),其次为金黄色葡萄球菌32株(24.2％)、肺炎链球菌25株(18.9％)、化脓链球菌14株(10.6％)、卡他莫拉菌8株(6.1％)等.49.5％的标本中培养出两种以上细菌.腺样体表面分泌物与腺样体组织菌群分布比较,差异无统计学意义(P>0.05).以上常见细菌对喹诺酮类、β-内酰胺酶抑制剂复合药物较敏感,对非β-内酰胺酶抑制剂普遍耐药,而对头孢菌素类、大环内酯类抗生素耐药性差异较大.腺样体不同肥大程度的各组间菌群种类数分布比较,差异有统计学意义(P<0.05).结论 腺样体表面分泌物可间接反映腺样体实体组织菌群分布与药敏特征.儿童腺样体中的不同菌种耐药性差异较大,治疗腺样体肥大及其相关疾病时,应根据鼻咽分泌物病原菌检测及耐药性分析,选择正确抗生素予以治疗,避免抗生素滥用.不同程度肥大腺样体中,菌群种类数分布有差异,考虑多种细菌混合感染可能是导致腺样体肥大的重要因素.