Kwon Gyu-Beom, Kim Chul-Hwan
Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea.
J Korean Assoc Oral Maxillofac Surg. 2023 Aug 31;49(4):198-207. doi: 10.5125/jkaoms.2023.49.4.198.
This study investigated causative strains and their antibiotic sensitivity in patients who were hospitalized for maxillofacial odontogenic infections at a tertiary center in South Korea over the past 10 years with the aim of providing guidelines for the selection of appropriate empirical antibiotics.
Patients with head and neck fascial space abscesses due to odontogenic infections who underwent incision and drainage surgery with pus culture tests between 2013 and 2022 at the Department of Oral and Maxillofacial Surgery, Dankook University Hospital were included. The bacterial isolates and antibiotic sensitivity of each strain were analyzed for 2013-2022, 2013-2017, and 2018-2022. The affected fascial spaces were classified into primary, secondary, and deep neck spaces.
In the 192 patients included in this study, 302 strains were detected. Viridans streptococcus had the highest frequency (51.7%), followed by Prevotella spp. (16.9%), spp. (5.6%), and (4.6%). The identification rate of viridans streptococcus significantly increased from 41.8% in 2013-2017 to 60.9% in 2018-2022. Viridans streptococcus showed an antibiotic sensitivity of 80.5% to ampicillin; the sensitivity to penicillin antibiotics decreased over the study period. Antibiotic susceptibility was approximately 94% for third-generation cephalosporins. , which was identified at a high percentage in patients with deep neck space infection, showed increasing antibiotic resistance to most antibiotics over the study period.
Viridans streptococcus was identified in head and neck fascial space abscesses with the highest frequency. Empirical antibiotics should be effective against this strain; penicillin antibiotics are considered inappropriate. For effective treatment of deep neck space abscesses, bacterial culture and antibiotic sensitivity tests performed as soon as possible are essential.
本研究调查了过去10年在韩国一家三级中心因颌面部牙源性感染住院患者的致病菌株及其抗生素敏感性，旨在为选择合适的经验性抗生素提供指导。
纳入2013年至2022年期间在丹国大学医院口腔颌面外科因牙源性感染导致头颈部筋膜间隙脓肿并接受切开引流手术及脓液培养检查的患者。分析了2013 - 2022年、2013 - 2017年和2018 - 2022年各菌株的细菌分离情况及抗生素敏感性。将受影响的筋膜间隙分为 primary、secondary 和深部颈部间隙。
本研究纳入的192例患者中，共检测到302株菌株。草绿色链球菌检出率最高（51.7%），其次是普雷沃菌属（16.9%）、 菌属（5.6%）和 菌属（4.6%）。草绿色链球菌的鉴定率从2013 - 2017年的41.8%显著增加到2018 - 2022年的60.9%。草绿色链球菌对氨苄西林的抗生素敏感性为80.5%；在研究期间对青霉素类抗生素的敏感性下降。第三代头孢菌素的抗生素敏感性约为94%。在深部颈部间隙感染患者中高比例检出的 菌属，在研究期间对大多数抗生素的耐药性呈上升趋势。
头颈部筋膜间隙脓肿中草绿色链球菌检出频率最高。经验性抗生素应能有效对抗该菌株；青霉素类抗生素被认为不合适。为有效治疗深部颈部间隙脓肿，尽早进行细菌培养和抗生素敏感性试验至关重要。
