Dahlén G, Blomquist S, Carlén A
Department of Oral Microbiology, Institute of Odontology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Oral Dis. 2009 May;15(4):265-72. doi: 10.1111/j.1601-0825.2009.01520.x.
The aim of this study was to microbiologically analyze oral mucosal samples collected during 2 years from patients with oral mucosal complaints.
Mucosal scraping samples were taken from 297 patients and semiquantified by culture for detection of opportunistic microorganisms e.g. Staphylococcus aureus, enterococci, aerobic Gram-negative bacilli (AGNB) and yeasts. Antibiotic susceptibility test was performed.
Altogether 297 patients were sampled (mean age 56.8 +/- 20.7). Among the 110 patients with known medical condition, 48 were systemically immunocompromised, 35 had systemic diseases, and 27 had only local oral complaints. Opportunists in moderate growth or more were present commonly in all three groups and most frequent in the immunocompromised patients (66.7%). Candida species were the most frequent opportunist (68.8%), however, their level was low and combinations with bacterial opportunists were common (39.6%). All bacterial opportunists tested were antibiotic multiresistant. Follow-up samples were collected in 23 cases out of which seven showed still presence of opportunists in heavy growth despite repeated treatment with ciprofloxacin.
This study showed a frequent presence of bacterial and fungal opportunists in patients with oral mucosal complaints, which were most common in immunocompromised individuals, however, also frequent in patients with local oral complaints only. Systematic evaluation of different treatment strategies is needed.
本研究旨在对2年内因口腔黏膜不适就诊患者的口腔黏膜样本进行微生物学分析。
采集297例患者的黏膜刮片样本,通过培养进行半定量检测,以检测机会性微生物,如金黄色葡萄球菌、肠球菌、需氧革兰氏阴性杆菌(AGNB)和酵母菌。进行抗生素敏感性试验。
共采集297例患者样本(平均年龄56.8±20.7岁)。在110例已知病情的患者中,48例存在全身免疫功能低下,35例患有全身性疾病,27例仅有局部口腔不适。中等程度及以上生长的机会性微生物在所有三组中均普遍存在,在免疫功能低下患者中最为常见(66.7%)。念珠菌属是最常见的机会性微生物(68.8%),但其水平较低,且与细菌性机会性微生物合并存在的情况较为常见(39.6%)。所有检测的细菌性机会性微生物均对多种抗生素耐药。对23例患者采集了随访样本,其中7例尽管多次使用环丙沙星治疗,但仍显示有大量生长的机会性微生物存在。
本研究表明,口腔黏膜不适患者中细菌和真菌性机会性微生物频繁存在,在免疫功能低下个体中最为常见,但在仅患有局部口腔不适的患者中也很常见。需要对不同的治疗策略进行系统评估。