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牙源性感染的机构微生物分析及其经验性抗生素敏感性

Institutional microbial analysis of odontogenic infections and their empirical antibiotic sensitivity.

作者信息

Sebastian Aneesh, Antony P G, Jose Mathew, Babu Arun, Sebastian Jubin, Kunnilathu Abraham

机构信息

Dept. of Oral and Maxillofacial Surgery, PMS Dental College, Trivandrum, Kerala University of Health Science, Kerala, India.

Dept. of Oral and Maxillofacial Surgery, Government Dental College, Kottayam, Kerala India.

出版信息

J Oral Biol Craniofac Res. 2019 Apr-Jun;9(2):133-138. doi: 10.1016/j.jobcr.2019.02.003. Epub 2019 Feb 13.

Abstract

UNLABELLED

Most purulent orofacial infections are of odontogenic origin. It is well established that odontogenic infections are polymicrobial in nature. Empiric antibiotics were administered before the culture and sensitivity test results were obtained and specific antibiotics were administered based on the culture and sensitivity test results. But resistance was a challenging problem all throughout along with development of more virulent strains of microorganisms which were more infectious and resistant to many known antibiotics.

OBJECTIVE

To identify the causative aerobic and anaerobic micro-organisms responsible for orofacial infections and to evaluate the resistance against empirical antibiotics used in the treatment of space infections.

METHOD

142 patients with head and neck fascial space infections of odontogenic origin were randomly taken, the pus samples and aspirates were collected aseptically from patients for aerobic and anaerobic microbiological study.

RESULTS

In this study the most common aerobic organism isolated was (34.49%), most common anaerobe was (61.11%) and the most common mixed organism was (30%). Amoxicillin was the most commonly used empirical drug in all cases and showed highest resistance (96.55%) for all the organisms. But linezolid (100%) was sensitive to all the aerobic, anaerobic and mixed group of organisms. Metronidazole (100%) turned out to be sensitive to the entire anaerobic group. Clindamycin (100%) appeared sensitive to the entire aerobic group.

CONCLUSION

Knowledge about the pathologic flora involved in head and neck infection in a locality and their sensitivity and resistance to commonly used antibiotics will help the clinician in administering appropriate antibiotics.

摘要

未标注

大多数化脓性口腔面部感染起源于牙源性。牙源性感染本质上是多微生物感染,这一点已得到充分证实。在获得培养和药敏试验结果之前给予经验性抗生素,并根据培养和药敏试验结果给予特定抗生素。但耐药性一直是一个具有挑战性的问题,同时出现了更具毒性、更具传染性且对许多已知抗生素耐药的微生物菌株。

目的

确定导致口腔面部感染的需氧和厌氧微生物,并评估对用于治疗间隙感染的经验性抗生素的耐药性。

方法

随机选取142例牙源性头颈部筋膜间隙感染患者,无菌采集患者的脓液样本和吸出物进行需氧和厌氧微生物学研究。

结果

在本研究中,分离出的最常见需氧菌是(34.49%),最常见厌氧菌是(61.11%),最常见混合菌是(30%)。阿莫西林是所有病例中最常用的经验性药物,对所有微生物的耐药率最高(96.55%)。但利奈唑胺(100%)对所有需氧、厌氧和混合菌群均敏感。甲硝唑(100%)对整个厌氧菌群敏感。克林霉素(100%)对整个需氧菌群敏感。

结论

了解当地头颈部感染中涉及的病理菌群及其对常用抗生素的敏感性和耐药性,将有助于临床医生使用合适的抗生素。

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Odontogenic infections: Microbiology and management.牙源性感染:微生物学与管理
Contemp Clin Dent. 2014 Jul;5(3):307-11. doi: 10.4103/0976-237X.137921.

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J Maxillofac Oral Surg. 2009 Dec;8(4):329-33. doi: 10.1007/s12663-009-0080-1. Epub 2010 Apr 24.
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Diagnosis and treatment of deep neck space abscesses.颈部深部间隙脓肿的诊断与治疗
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The microbiology of the acute dental abscess.急性牙脓肿的微生物学
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Deep space neck infection: principles of surgical management.深部颈部感染:外科治疗原则
Oral Maxillofac Surg Clin North Am. 2008 Aug;20(3):353-65. doi: 10.1016/j.coms.2008.04.002.
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Severe odontogenic infections, part 1: prospective report.严重牙源性感染,第一部分:前瞻性报告。
J Oral Maxillofac Surg. 2006 Jul;64(7):1093-103. doi: 10.1016/j.joms.2006.03.015.
10
The changing face of odontogenic infections.牙源性感染的变化面貌。
J Oral Maxillofac Surg. 2001 Jul;59(7):739-48; discussion 748-9. doi: 10.1053/joms.2001.24285.

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