Royal Adelaide Hospital, Adelaide, South Australia, Australia.
The University of Adelaide, Adelaide, South Australia, Australia.
Aust Dent J. 2018 Jun;63(2):187-192. doi: 10.1111/adj.12607. Epub 2018 May 10.
The aims of this study were to evaluate the microbiological trends in severe odontogenic infections requiring hospital admission in the South Australian Oral and Maxillofacial Surgery Unit. Rates of antibiotic resistance to empirical antibiotic regimens were determined to quantify the clinical implications of antibiotic-resistant odontogenic infections.
A retrospective case audit was performed on all odontogenic infections admitted to the Royal Adelaide Hospital over a 9-year period. Data was collected regarding demographics, microbiological culture and sensitivity results, and clinical outcome variables.
Of a total of 672 patients, microbiology data was available for 447 cases. Penicillin-resistant organisms were identified in 10.8% of patients, who required a significantly longer length of hospital admission (mean, 9.93 days) and higher rates of non-response to initial surgical therapy (40%).
There were moderate rates of antibiotic-resistant odontogenic infections within the South Australian population. Patients within this subgroup demonstrate markedly poorer clinical outcomes. Effective treatment of odontogenic infections involves early operative intervention, with adjunctive use of appropriate antibiotic therapy that involves close monitoring of response to removal of the cause and use of first-line antibiotic agents. Cases that fail to respond require urgent specialist review in order to reduce morbidity and mortality outcomes.
本研究旨在评估需要住院治疗的严重牙源性感染的微生物学趋势，该研究在南澳大利亚口腔颌面外科进行。测定经验性抗生素方案的抗生素耐药率，以量化抗生素耐药性牙源性感染的临床意义。
对皇家阿德莱德医院 9 年间收治的所有牙源性感染患者进行回顾性病例审核。收集人口统计学、微生物培养和药敏结果以及临床结局变量的数据。
在总共 672 名患者中，447 例患者的微生物学数据可用。10.8%的患者存在青霉素耐药菌，他们需要更长的住院时间（平均 9.93 天），并且初始手术治疗无反应的比例更高（40%）。
在南澳大利亚人群中，存在中等比例的抗生素耐药性牙源性感染。该亚组患者的临床结局明显较差。有效治疗牙源性感染需要早期手术干预，辅助使用适当的抗生素治疗，密切监测去除病因后的反应，并使用一线抗生素药物。对未反应的病例需要紧急进行专科审查，以降低发病率和死亡率。
