Phillips I, Warren C, Harrison J M, Sharples P, Ball L C, Parker M T
J Med Microbiol. 1976 Nov;9(4):393-404. doi: 10.1099/00222615-9-4-393.
Patients undergoing dental extractions were non-randomly allocated to three groups, one of which received no antibiotic, one benzylpenicillin followed by oral penicillin for 5 days, and the third intramuscular lincomycin followed by oral clindamycin. Dental extraction was performed at the beginning of the course of chemotherapy. Streptococci were isolated from the extracted teeth, from blood cultures collected before and immediately after dental extraction, and from sutures removed from the gums 5-7 days after the operation. The species of these organisms was determined, and their susceptibilities to penicillin, clindamycin, cephaloridine, erythromycin and tetracycline were assessed. The majority of streptococci isolated from teeth belonged to the species Streptococcus sanguis, S. mitior, S. mutans and S. milleri. Occasional isolates of each of these organisms collected before the antibiotic could take effect were resistant to penicillin. Three of these species, but not S. mutans, were the commonest streptococci to be isolated from the blood after dental extraction. Penicillin completely suppressed dental bacteriaemia under the conditions of our investigation, and lincomycin reduced the incidence by about 60 per cent. The commonest streptococci from sutures were also S. sanguis, S. mitior, S. mutans and S. milleri. S. faecalis was also isolated, but only in patients who had received antibiotics. Among the non-faecalis organisms, penicillin resistance was significantly more frequent among isolates from patients given penicillin than from patients not given this antibiotic, and clindamycin resistance was significantly more frequent among isolates from patients given lincomycin and clindamycin than from patients not given these antibiotics.
接受拔牙的患者被非随机地分为三组，其中一组未接受抗生素治疗，一组接受苄星青霉素治疗，随后口服青霉素5天，第三组接受肌肉注射林可霉素治疗，随后口服克林霉素。拔牙在化疗疗程开始时进行。从拔除的牙齿、拔牙前和拔牙后立即采集的血培养物以及术后5 - 7天从牙龈上取下的缝线中分离出链球菌。确定这些微生物的种类，并评估它们对青霉素、克林霉素、头孢菌素、红霉素和四环素的敏感性。从牙齿分离出的大多数链球菌属于血链球菌、轻链球菌、变形链球菌和米勒链球菌。在抗生素生效前偶尔分离出的这些微生物的菌株对青霉素耐药。在这四个菌种中，除变形链球菌外，有三个是拔牙后血液中最常分离出的链球菌。在我们的研究条件下，青霉素完全抑制了牙菌血症，林可霉素使发病率降低了约60%。缝线中最常见的链球菌也是血链球菌、轻链球菌、变形链球菌和米勒链球菌。粪肠球菌也被分离出来，但仅在接受抗生素治疗的患者中。在非粪肠球菌微生物中，接受青霉素治疗的患者分离出的菌株中青霉素耐药的频率明显高于未接受该抗生素治疗的患者，接受林可霉素和克林霉素治疗的患者分离出的菌株中克林霉素耐药的频率明显高于未接受这些抗生素治疗的患者。
