北京地区老年口腔颌面部肿瘤术后感染患者厌氧菌分布及药敏分析
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摘要
目的研究口腔颌面部肿瘤术后感染患者厌氧菌分布及药敏分析,为临床相关诊治提供参考。方法选取北京积水潭医院2013年7月至2017年11月收治的口腔颌面部肿瘤术后感染患者370例,采集患者脓液标本,分离培养厌氧菌,采用纸片扩散法进行药敏试验,采用法国生物梅里埃公司VITEK生物鉴定系统进行细菌鉴定。结果 370例口腔颌面部肿瘤术后感染患者中,颌下间隙感染228例,咬肌间隙感染70例,咽旁间隙感染36例,舌下间隙感染20例,颊间隙感染16例;370例患者共检出厌氧菌134株,数量从多到少依次为卟啉单胞菌46株,普雷沃菌36株,梭杆菌20株,消化性球菌16株,似杆菌10株,其他6株,其中前3种约占76.1%;主要厌氧菌对青霉素、环丙沙星和左氧氟沙星耐药率较低,而对万古霉素、甲硝唑、亚胺培南及克林霉素耐药率较高。结论北京地区口腔颌面部感染患者厌氧菌分布以卟啉单胞菌、普雷沃菌及梭杆菌为主,对青霉素、环丙沙星和左氧氟沙星耐药率较低,值得临床上借鉴。
Objective To study the distribution and drug sensitivity of anaerobic bacteria in patients with oral and maxillofacial tumor after infection,and to provide reference for clinical diagnosis and treatment.Methods 370 cases of patients with infection of oral and maxillofacial surgery in our hospital from July 2013 to November 2017 were selected.Pus specimens were collected,anaerobic bacteria were isolated,drug sensitivity test was performed by disk diffusion method,the bacteria were identified by VITEK biological identification system from bioMerieux.Results In 370 cases with postoperative infection of oral and maxillofacial tumorsm,submaxillary space infection was found in 228 cases,masseter space infection in 70 cases,parapharyngeal space infection in 36 cases,hypoglossal space infection in 20 cases,and cheek space infection in 16 cases.134 strains of anaerobic bacteria were detected from 370 patients,the strains with the most amount to the least were porphyrinomonas porphyris(46 strains),prevotella intermedius(36 strains),clostridium(20 strains),digestive tract cocci(16 strains),bacillus like bacilli(10 strains),and others(6 strains),among which the top three accounted for about 76.1%;the main anaerobic bacteria had lower resistance to penicillin,ciprofloxacin and levofloxacin,but higher resistance to vancomycin,metronidazole,imipenem and clindamycin.Conclusion Porphyrinomonas porphyries,prevotella intermedius and clostridium were the main anaerobic bacteria in patients with oral and maxillofacial infection in Beijing area,and they had low resistance rate to penicillin,ciprofloxacin and levofloxacin,which could be used for reference in clinical practice.
Objective To study the distribution and drug sensitivity of anaerobic bacteria in patients with oral and maxillofacial tumor after infection,and to provide reference for clinical diagnosis and treatment.Methods 370 cases of patients with infection of oral and maxillofacial surgery in our hospital from July 2013 to November 2017 were selected.Pus specimens were collected,anaerobic bacteria were isolated,drug sensitivity test was performed by disk diffusion method,the bacteria were identified by VITEK biological identification system from bioMerieux.Results In 370 cases with postoperative infection of oral and maxillofacial tumorsm,submaxillary space infection was found in 228 cases,masseter space infection in 70 cases,parapharyngeal space infection in 36 cases,hypoglossal space infection in 20 cases,and cheek space infection in 16 cases.134 strains of anaerobic bacteria were detected from 370 patients,the strains with the most amount to the least were porphyrinomonas porphyris(46 strains),prevotella intermedius(36 strains),clostridium(20 strains),digestive tract cocci(16 strains),bacillus like bacilli(10 strains),and others(6 strains),among which the top three accounted for about 76.1%;the main anaerobic bacteria had lower resistance to penicillin,ciprofloxacin and levofloxacin,but higher resistance to vancomycin,metronidazole,imipenem and clindamycin.Conclusion Porphyrinomonas porphyries,prevotella intermedius and clostridium were the main anaerobic bacteria in patients with oral and maxillofacial infection in Beijing area,and they had low resistance rate to penicillin,ciprofloxacin and levofloxacin,which could be used for reference in clinical practice.
引文
[1]包振英,林琴,孟彦宏,等.厌氧菌检测技术在口腔颌面部感染治疗中的应用[J].北京大学学报:医学版,2016,48(1):76-79.
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[4]庞宝兴,冯元勇,李凤梅.口腔颌面部多间隙感染46例病原菌分析[J].中国实用口腔科杂志,2013,6(3):168-170.
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[8]王娜娜.脓肿切开引流联合高压氧治疗口腔颌面部多间隙感染的效果[J].临床医学,2016,36(7):107-108.
[9]邱勋定,廖天安,邓伟,等.口腔颌面部多间隙感染患者院内发生不良结局的相关危险因素分析[J].海南医学,2015,23(18):2707-2710.
[10]唐圣斌,雷邓,李玉峰.重症口腔颌面部多间隙感染的临床干预探析[J].中国医学工程,2015,29(5):77-79.
[11]范玉丽,曹征,吴莘,等.48例重症口腔颌面部多间隙感染临床分析[J].中国口腔颌面外科杂志,2015,13(3):249-252.
[12]孟岑,颜兴.口腔颌面部多间隙感染57例的临床分析及治疗[J].临床和实验医学杂志,2015,7(13):1076-1079.
[13]丛丙峰,丁明超,许方方,等.144例颌面部间隙感染患者的流行病学分析[J].实用口腔医学杂志,2016,32(2):212-215.
[14]胡青芳,杜衍晓,乔蕾,等.PCT检测对口腔颌面部多间隙感染病情及预后的意义[J].青岛大学医学院学报,2016,16(5):601-603.
[15]李良泉,赵丽芸.影响口腔颌面部多间隙感染患者治疗结果的转归因素分析[J].世界最新医学信息文摘(连续型电子期刊),2015,15(15):132-133.
[2]张力,唐君玲,兰玉燕,等.口腔颌面部鳞癌手术患者感染病原菌分布与机体对炎症反应的调节作用研究[J].中华医院感染学杂志,2016,17(4):898-899.
[3]刘登峰,孙仁义,肖进,等.口腔颌面外科患者医院感染病原菌分布及耐药性分析[J].中华医院感染学杂志,2014,8(23):5928-5930.
[4]庞宝兴,冯元勇,李凤梅.口腔颌面部多间隙感染46例病原菌分析[J].中国实用口腔科杂志,2013,6(3):168-170.
[5]苗丽丽.探讨口腔颌面部多间隙感染患者病原菌情况[J].中国继续医学教育,2015,8(21):89-90.
[6]石青.口腔颌面部多间隙感染的病原菌分布及临床治疗方法[J].中国农村卫生,2016,29(21):51,53.
[7]包振英,王瑶,谢秀丽,等.口腔颌面部感染患者厌氧菌分布及药敏试验结果分析[J].中国预防医学杂志,2016,24(2):143-147.
[8]王娜娜.脓肿切开引流联合高压氧治疗口腔颌面部多间隙感染的效果[J].临床医学,2016,36(7):107-108.
[9]邱勋定,廖天安,邓伟,等.口腔颌面部多间隙感染患者院内发生不良结局的相关危险因素分析[J].海南医学,2015,23(18):2707-2710.
[10]唐圣斌,雷邓,李玉峰.重症口腔颌面部多间隙感染的临床干预探析[J].中国医学工程,2015,29(5):77-79.
[11]范玉丽,曹征,吴莘,等.48例重症口腔颌面部多间隙感染临床分析[J].中国口腔颌面外科杂志,2015,13(3):249-252.
[12]孟岑,颜兴.口腔颌面部多间隙感染57例的临床分析及治疗[J].临床和实验医学杂志,2015,7(13):1076-1079.
[13]丛丙峰,丁明超,许方方,等.144例颌面部间隙感染患者的流行病学分析[J].实用口腔医学杂志,2016,32(2):212-215.
[14]胡青芳,杜衍晓,乔蕾,等.PCT检测对口腔颌面部多间隙感染病情及预后的意义[J].青岛大学医学院学报,2016,16(5):601-603.
[15]李良泉,赵丽芸.影响口腔颌面部多间隙感染患者治疗结果的转归因素分析[J].世界最新医学信息文摘(连续型电子期刊),2015,15(15):132-133.