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评价基于门诊开展的牙源性炎症和牙科手术操作中微生物的药物敏感性。

Evaluation of Drug Susceptibility of Microorganisms in Odontogenic Inflammations and Dental Surgery Procedures Performed on an Outpatient Basis.

机构信息

Department of Oral Surgery, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Pl. Akademicki 17, Bytom 41-902, Poland.

Department of Conservative Dentistry with Endodontics, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Plac Akademicki 17, Bytom 41-902, Poland.

出版信息

Biomed Res Int. 2019 Oct 7;2019:2010453. doi: 10.1155/2019/2010453. eCollection 2019.

Abstract

Bacterial infections are the most common cause of purulent soft tissue inflammations in the head and neck area. These bacteria are also responsible for the majority of inflammatory complications after third molar removal. The key to success of antibacterial treatment in both cases is the use of an appropriate antibacterial agent. The aim of the study was to evaluate the susceptibility profile of bacteria isolated from material collected from patients with intraoral odontogenic abscesses. The test material consisted of swabs taken from the odontogenic abscesses, after their incision and drainage. Another swab was collected from the lesion area, 10 days after the initial visit. Results were compared with an identical study conducted on a control group of healthy patients, who had undergone third molar removal. Bacteria identified in this study consisted of aerobic and anaerobic strains, both Gram-positive and Gram-negative. According to the EUCAST guidelines, none of the tested antibiotics was recommended for all identified bacteria. The percentage of bacterial strains sensitive to amoxicillin and clavulanic acid was 78.13% and 81.48% in the study and control groups, respectively, whereas, the percentage of those sensitive to clindamycin was 96.43% and 80.00%, respectively. For Gram-negative aerobic bacteria, gentamicin and ciprofloxacin were among medications affecting all cultured species. 100.00% of strains were found to be susceptible to these antibiotics. Statistically significant relationship between the presence of Gram-negative aerobic strains and the occurrence of complications was found. In the case of the most frequently occurring bacteria in the study, amoxicillin with clavulanic acid and clindamycin were shown to be very effective. In cases of severe purulent odontogenic inflammations, it is recommended to use a combination of antibiotics. Amoxicillin with ciprofloxacin and clindamycin with cefuroxime seem to be the proper choices based on the results of this study.

摘要

细菌感染是头颈部脓性软组织炎症的最常见原因。这些细菌也是第三磨牙拔除后大多数炎症并发症的原因。这两种情况下抗菌治疗成功的关键是使用适当的抗菌剂。本研究的目的是评估从口腔内生牙源性脓肿患者采集的标本中分离的细菌的药敏谱。试验材料由切开引流后的脓肿标本和初次就诊后 10 天取自病变区域的标本组成。结果与对接受第三磨牙拔除的健康患者进行的相同对照研究进行了比较。本研究中鉴定的细菌包括需氧和厌氧菌株,革兰阳性和革兰阴性菌株。根据 EUCAST 指南,没有一种测试抗生素被推荐用于所有鉴定的细菌。在研究组和对照组中,对阿莫西林克拉维酸敏感的细菌比例分别为 78.13%和 81.48%,对克林霉素敏感的细菌比例分别为 96.43%和 80.00%。对于革兰阴性需氧菌,庆大霉素和环丙沙星是影响所有培养物种的药物之一。所有抗生素均对 100.00%的菌株有效。发现革兰阴性需氧菌的存在与并发症的发生之间存在统计学上的显著关系。在研究中最常出现的细菌的情况下,阿莫西林克拉维酸和克林霉素显示出非常有效。对于严重的脓性牙源性炎症,建议使用抗生素联合治疗。根据本研究的结果,阿莫西林克拉维酸与环丙沙星和克林霉素与头孢呋辛似乎是合适的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d11/6800958/a4092cf374f9/BMRI2019-2010453.001.jpg

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