摘要
目的探讨患者口腔颌面部间隙感染病原菌培养及药敏性,以期为临床口腔颌面部间隙感染预防及治疗提供依据。方法收集医院2013年1月-2015年9月204例口腔颌面部间隙感染患者临床资料,观察患者一般资料、病原菌检出类型及主要菌株药物敏感性。结果牙源性感染患者占66.18%,腺源性感染患者占29.90%,医源性感染患者占3.92%,感染部位以颌下间隙最高占59.81%,舌下间隙最低为2.45%;204例患者标本中以混合感染为主占48.04%;共培养出病原菌238株,其中革兰阳性菌147株占61.77%,革兰阴性菌91株占38.23%,其中厌氧菌56株占23.53%;药敏结果显示,葡萄球菌属对利福平敏感率较高;链球菌属对左氧氟沙星敏感率较高;铜绿假单胞菌对万古霉素敏感率高;肺炎克雷伯菌对万古霉素、亚胺培南敏感率均为100.0%;厌氧菌对甲硝唑、亚胺培南及万古霉素敏感率较高。结论患者口腔颌面部间隙感染病原菌以混合感染为主,确诊后应尽早抗炎治疗,可根据病原菌分析结果选择抗菌药物联合抗厌氧菌药物治疗,同时给予药物敏感试验检查,明确后针对性抗炎。
OBJECTIVE To investigate the pathogenic bacteria culture and drug sensitivity of oral and maxillofacial space infections,so as to provide evidence for clinical prevention and treatment of oral and maxillofacial space infections.METHODS The clinical data of 204 patients with oral and maxillofacial space infections in hospital from Jan.2013 to Sep.2015 were collected,and the general information of the patients,the types of pathogenic bacteria and the drug sensitivity were analyzed.RESULTS The patients with odontogenic infection accounted for 66.18%,adenogenous infection accounted for 29.90%,and iatrogenic infection accounted for 3.92%.Jaw gap was the most infection site,accounting for 59.80%,and tongue gap was the lowest,which was 2.45%.In the 204 patients,the mixed infection was 48.04%.A total of 238 strains of pathogenic bacteria were cultivated,including147 strains of gram-positive bacteria（61.76%）and 91 strains of gram-negative bacteria（38.24%）,Of which 56 strains were anaerobic bacteria（23.53%）.Drug sensitivity results showed that Staphylococcus aureus had higher sensitive rates to rifampicin,Streptococcus were highly sensitive to levofloxalin,Pseudomonas aeruginosa had high sensitive rates to vancomycin,Klebsiella pneumoniae had higher sensitive rates to vancomycin and imipenem,with the susceptibility rate 100.00%.and anaerobic bacteria were highly sensitive to metronidazole,imipenem and vancomycin.CONCLUSIONThe main pathogens of oral and maxillofacial space infections were mixed infections.It should give anti-inflammatory treatment as soon as possible after diagnosis,and choose combination of antimicrobials with anti-anaerobic drugs according to the results of pathogenic bacteria analysis.At the same time,it should take drug sensitive test,and give targeted anti-inflammatory treatment according to the results.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第3期635-638,共4页
Chinese Journal of Nosocomiology
基金
河南省科技厅科技发展计划(14A329013)
关键词
口腔颌面部间隙
感染
病原菌
药敏性
Oral and maxillofacial space
Infected
Pathogenic bacteria
Drug sensitivity
