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牙源性头颈部间隙感染的微生物学及抗生素敏感性

Microbiology and antibiotic sensitivity of head and neck space infections of odontogenic origin.

作者信息

Walia Inderdeep Singh, Borle Rajiv M, Mehendiratta D, Yadav Abhilasha O

机构信息

Department of Oral & Maxillofacial Surgery, Maharishi Markandeshwar College of Dental Sciences & Research, Mullana, Ambala, India.

Department of Oral & Maxillofacial Surgery, Sharad Pawar Dental College, Datta Meghe Institute of Medical Sciences University, Sawangi (Meghe), Wardha, Maharashtra India.

出版信息

J Maxillofac Oral Surg. 2014 Mar;13(1):16-21. doi: 10.1007/s12663-012-0455-6. Epub 2013 Feb 19.

Abstract

This paper aim to assess the anatomical spaces of head and neck region and causative microorganisms responsible for infections, evaluate the resistance of antibiotics used in treatment and compare the findings with previously reported microbial flora in the orofacial infection. Forty-two patients were recorded. All underwent surgical incision and drainage, received antibiotics cover, and had culture and sensitivity test performed for gram positive and gram negative aerobes. There were 33 male (78.57 %) and 9 female (21.42 %). Out of the 42 patients 28 (66.66 %) presented with single space involvement. The submandibular space was the most frequent location for single space abscess (28.12 %). Fourteen patients presented with multiple space involvement, with a total of 64 spaces being involved. Forty microorganisms were isolated. There were 28 aerobes and 10 anaerobes. Two fungi were also identified. The most common bacteria isolated were Staphylococcus aureus, Klebsiella, Escherichia coli, Peptostreptococcus. The key issue here, which needs to be remembered, is that antibiotics alone cannot resolve odontogenic infection satisfactorily. Quick recovery of patients results with proper basic management comprising of early drainage/decompression which is equally important.

摘要

本文旨在评估头颈部区域的解剖间隙以及引起感染的致病微生物,评估治疗中使用的抗生素的耐药性,并将研究结果与先前报道的口腔面部感染中的微生物菌群进行比较。记录了42例患者。所有患者均接受了手术切开引流,接受了抗生素覆盖,并对革兰氏阳性和革兰氏阴性需氧菌进行了培养和药敏试验。其中男性33例(78.57%),女性9例(21.42%)。在42例患者中,28例(66.66%)表现为单个间隙受累。颌下间隙是单个间隙脓肿最常见的部位(28.12%)。14例患者表现为多个间隙受累,总共累及64个间隙。分离出40种微生物。其中有28种需氧菌和10种厌氧菌。还鉴定出2种真菌。分离出的最常见细菌是金黄色葡萄球菌、克雷伯菌、大肠杆菌、消化链球菌。这里需要记住的关键问题是,仅使用抗生素不能令人满意地解决牙源性感染。通过包括早期引流/减压在内的适当基本管理,患者可快速康复,这同样重要。

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