Roberts G J, Watts R, Longhurst P, Gardner P
Pediatr Dent. 1998 Jan-Feb;20(1):28-36.
The prevalence and intensity of bacteremia of dental origin were examined in 207 children divided into four groups: a baseline with no surgical intervention (group I), after a single tooth extraction (group II), multiple tooth extraction (group III), and mucoperiosteal flap elevation (group IV). The bacterial isolates were grown using a broth culture (Bactec) and lysis centrifugation (Paediatric Isolator) techniques. Dental plaque deposits, gingivitis, spontaneous gingival bleeding and the presence/absence of a dental abscess were recorded and their relationship to bacteremia assessed.
The broth culture was positive for group I 11% of the time, group II for 43%, group III for 54%, and group IV for 43%. The Paediatric Isolator system was found to be a poor method for detecting bacteremia, having only one quarter the sensitivity of the broth culture technique. When organisms were isolated, the intensity of bacteremia ranged from 1 to 3400 colony forming units per milliliter (cfu/mL). Bacterial isolates were susceptible to most of the antibiotics recommended for antibiotic prophylaxis, but erythromycin, gentamycin, penicillin G, and teicoplanin were only 80% (or less) effective in their efficacy while chlorhexidine, amoxicillin, clindamycin, and vancomycin were between 92 and 100% effective.
The antibiotics commonly used for an oral and/or parenteral prophylaxis are likely to be effective on at least 80% of occasions with most of them effective on 100% of occasions.
对207名儿童进行了牙科源性菌血症的患病率和强度检查，这些儿童被分为四组：无手术干预的基线组（第一组）、单次拔牙后组（第二组）、多次拔牙组（第三组）和粘骨膜瓣掀起组（第四组）。使用肉汤培养（Bactec）和裂解离心（儿科隔离器）技术培养细菌分离株。记录牙菌斑沉积、牙龈炎、自发性牙龈出血以及是否存在牙脓肿，并评估它们与菌血症的关系。
肉汤培养中，第一组阳性率为11%，第二组为43%，第三组为54%，第四组为43%。发现儿科隔离器系统检测菌血症的方法不佳，其灵敏度仅为肉汤培养技术的四分之一。分离出微生物时，菌血症强度范围为每毫升1至3400个菌落形成单位（cfu/mL）。细菌分离株对大多数推荐用于抗生素预防的抗生素敏感，但红霉素、庆大霉素、青霉素G和替考拉宁的疗效仅为80%（或更低），而氯己定、阿莫西林、克林霉素和万古霉素的有效率在92%至100%之间。
常用于口服和/或胃肠外预防的抗生素在至少80%的情况下可能有效，其中大多数在100%的情况下有效。
