Fihman V, Raskine L, Petitpas F, Mateo J, Kania R, Gravisse J, Resche-Rigon M, Farhat I, Berçot B, Payen D, Sanson-Le Pors M J, Herman P, Mebazaa A
Service de Bactériologie-Virologie, Université Paris 7-Denis Diderot, Groupe Hospitalier Lariboisière-Fernand Widal, GHU Nord, Assistance Publique-Hôpitaux de Paris, 2 rue Ambroise Paré, 75475 Paris Cedex 10, Paris, France.
Eur J Clin Microbiol Infect Dis. 2008 Aug;27(8):691-5. doi: 10.1007/s10096-008-0491-9. Epub 2008 Mar 4.
Cervical necrotizing fasciitis (CNF) is a life-threatening complication of pharyngeal or dental infections. The aim of this paper was to investigate whether dental or pharyngeal source result from different pathogen(s) in CNF and whether antibiotics, given before admission, influence the antimicrobial resistance of pathogens. In 152 CNF patients, Streptococcus milleri group and Prevotella species were the predominant isolates, frequently copathogens, mostly in dental CNF samples. Penicillin and clindamycin resistance were observed in 39% and 37% of cases, respectively, independently of any previous antibiotic therapy. Thus, a combined aerobe-anaerobe infection may have a synergistic effect, which allows the infection to spread in cervical tissues.
颈部坏死性筋膜炎(CNF)是咽部或牙科感染的一种危及生命的并发症。本文旨在研究CNF中牙科或咽部感染源是否由不同病原体引起,以及入院前使用的抗生素是否会影响病原体的抗菌耐药性。在152例CNF患者中,米勒链球菌属和普雷沃菌属是主要分离株,常为共病原体,多见于牙科CNF样本。分别有39%和37%的病例观察到对青霉素和克林霉素耐药,与之前是否接受过抗生素治疗无关。因此,需氧菌-厌氧菌混合感染可能具有协同作用,使感染在颈部组织中扩散。