口腔颌面部间隙感染患者的临床特点及病原菌分析
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摘要
目的:分析口腔颌面部间隙感染患者的细菌分布及药敏性,为临床治疗提供依据。方法:回顾分析2013-03～2016-10我科治疗的153例口腔颌面部间隙感染患者资料,收集、分析其细菌培养及药敏试验结果。结果:153例患者中,眶下间隙、咬肌间隙和颌下间隙感染分别为29. 41%、24. 84%和15. 03%;病因中牙源性、腺源性感染分别为62. 74%和20. 92%;共检出病原体401株,需氧菌-厌氧菌混合感染占44. 89%为主;需氧菌感染38. 15%,其中金黄色葡萄球菌感染占14. 96%,肺炎链球菌感染8. 98%;厌氧菌感染占16. 96%,以普氏菌多见(7. 98%)。金黄色葡萄球菌对万古霉素、头孢硫脒、环丙沙星敏感;肺炎链球菌、溶血性链球菌对万古霉素和亚胺培南敏感;普氏菌对亚胺培南敏感。结论:口腔颌面部感染以眶下及咬肌间隙感染多见;牙源性是感染的主要因素;以需氧菌-厌氧菌混合感染为主,其次为需氧菌感染;临床治疗中应进行细菌培养及药敏试验,合理使用抗生素。
Objective: To analysize the distribution of pathogenic bacteria and clinical characteristics of the patients with oral and maxillofacial space infection so as to provide evidence for clinical treatment. Methods: The distribution of pathogenic bacteria and clinical characteristics of 153 patients with oral and maxillofacial space infenction treated in our oral department from February. 2013 to October. 2016 were retrospectively analyzed. Results: Among the 153 patients,those with infraorbital space,masseter muscle infection and submaxillary space,accounted for 29. 41%,24. 84% and 15. 03%,odontogenic infection and parotid infection were 62. 74%and 20. 92% respectively. 401 strains of pathogenic bacteria were isolated from 153 patients,including aerobic-anaerobic mixed bacteria( 44. 89%) and aerobic bacteria( 38. 15%),among which staphylococcus aureus and streptococcus pneumonia were dominant,accounted for 14. 96% and 8. 98% respectively,anaerobic bacteria( 16. 96%),among which Prevotella was dominant,accounted for7. 98%. The drug susceptibility test showed that staphylococcus aureus was susceptible to ciprofloxacin,cafathiamidine and vancomycin. Streptococcus pneumonia was susceptible to nancomycin and imipenem. Provetella was high susceptible to imipenem. Conclusion: The patients with infraorbital space and masseter muscle space infection are dominant in the cases with oral and maxillofacial space infenction. The odontogenic infection is the main cause,followed by glandular infection. The aerobic-anaerobic mixed bacteria infection is the most common in clinic,followed by aerobic bacterial infection. It is necessary to take drug susceptibility test for treatment.
Objective: To analysize the distribution of pathogenic bacteria and clinical characteristics of the patients with oral and maxillofacial space infection so as to provide evidence for clinical treatment. Methods: The distribution of pathogenic bacteria and clinical characteristics of 153 patients with oral and maxillofacial space infenction treated in our oral department from February. 2013 to October. 2016 were retrospectively analyzed. Results: Among the 153 patients,those with infraorbital space,masseter muscle infection and submaxillary space,accounted for 29. 41%,24. 84% and 15. 03%,odontogenic infection and parotid infection were 62. 74%and 20. 92% respectively. 401 strains of pathogenic bacteria were isolated from 153 patients,including aerobic-anaerobic mixed bacteria( 44. 89%) and aerobic bacteria( 38. 15%),among which staphylococcus aureus and streptococcus pneumonia were dominant,accounted for 14. 96% and 8. 98% respectively,anaerobic bacteria( 16. 96%),among which Prevotella was dominant,accounted for7. 98%. The drug susceptibility test showed that staphylococcus aureus was susceptible to ciprofloxacin,cafathiamidine and vancomycin. Streptococcus pneumonia was susceptible to nancomycin and imipenem. Provetella was high susceptible to imipenem. Conclusion: The patients with infraorbital space and masseter muscle space infection are dominant in the cases with oral and maxillofacial space infenction. The odontogenic infection is the main cause,followed by glandular infection. The aerobic-anaerobic mixed bacteria infection is the most common in clinic,followed by aerobic bacterial infection. It is necessary to take drug susceptibility test for treatment.
引文
[1]王愿林,程莉,王和平,等.口腔颌面部间隙感患者治疗的临床研究[J].中华医学感染性杂志,2016,26(7):1606-1608.
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[3]何吉琼,李婷燕,王怡丹,等.口腔颌面部间隙感染患者的病原菌分布、临床感染特点及相关预防措施[J].中华医院感染学杂志,2017,27(6):1359-1362.
[4]范美巧,胡婷姿,金磊.口腔颌面部多间隙感染的病原学分析与临床治疗[J].中华医院感染学杂志,2014,24(23):5931-5933.
[5]江志红,常玉,徐静,等.厌氧菌培养鉴定与药敏试验在口腔颌面部间隙感染中的应用[J].检验医学与临床,2014,11(zl):249-250.
[6] Rega AJ,Aziz SR,Ziccardi VB. Microbiology and antibiotic sensitivities of head and neck space infections of odontogenic origin[J]. J Oral Maxillofac Surg,2006,64(9):1377-1380.
[7]景蔚,闫德民.口腔颌面部间隙感染病原菌耐药性分析及疗效评价[J].医药论坛杂志,2014,35(4):35-37.
[8]赵小衍,郭威孝,张浚睿,等.口腔颌面部间隙感染的管理(一)——经验用药策略[J].实用口腔医学杂志,2018,34(1):136-140.
[9]吕继连,张瑞,闫大勇,等.口腔颌面部间隙感染的病原菌药敏分析[J].中华医院感染学杂志,2016,26(11):2565-2567.
[2]蔡圳,朱德全.口腔颌面部间隙感染患者病原菌分布及药敏敏感性分析[J].山东医学高等专科学校学报,2014,36(5):349-353.
[3]何吉琼,李婷燕,王怡丹,等.口腔颌面部间隙感染患者的病原菌分布、临床感染特点及相关预防措施[J].中华医院感染学杂志,2017,27(6):1359-1362.
[4]范美巧,胡婷姿,金磊.口腔颌面部多间隙感染的病原学分析与临床治疗[J].中华医院感染学杂志,2014,24(23):5931-5933.
[5]江志红,常玉,徐静,等.厌氧菌培养鉴定与药敏试验在口腔颌面部间隙感染中的应用[J].检验医学与临床,2014,11(zl):249-250.
[6] Rega AJ,Aziz SR,Ziccardi VB. Microbiology and antibiotic sensitivities of head and neck space infections of odontogenic origin[J]. J Oral Maxillofac Surg,2006,64(9):1377-1380.
[7]景蔚,闫德民.口腔颌面部间隙感染病原菌耐药性分析及疗效评价[J].医药论坛杂志,2014,35(4):35-37.
[8]赵小衍,郭威孝,张浚睿,等.口腔颌面部间隙感染的管理(一)——经验用药策略[J].实用口腔医学杂志,2018,34(1):136-140.
[9]吕继连,张瑞,闫大勇,等.口腔颌面部间隙感染的病原菌药敏分析[J].中华医院感染学杂志,2016,26(11):2565-2567.