急性牙髓炎的厌氧菌培养与药物敏感性分析  

Culture of anaerobic bacteria causing acute pulpitis and analysis of drug susceptibility

作　　者：曹薇[1] 牛巧丽[2] 季萍[1] 张朝霞[1] 

机构地区：[1]新疆医科大学第一附属医院医学检验中心,新疆乌鲁木齐830054 [2]新疆医科大学第一附属医院口腔牙体牙髓科,新疆乌鲁木齐830054

出　　处：《中华医院感染学杂志》2013年第13期3279-3280,3283,共3页Chinese Journal of Nosocomiology

摘　　要：目的研究急性牙髓炎的病原菌分布及耐药性,为临床抗感染治疗提供依据。方法对口腔牙体牙髓科门诊行根管治疗40例急性牙髓炎患者的牙髓取样进行需氧菌、厌氧菌培养,并行菌种鉴定及药敏试验。结果牙髓标本共分离出65株细菌,以革兰阴性厌氧菌为主,占66.1%,其中产黑色素普雷沃菌、脆弱拟杆菌、牙龈卟啉单胞菌多见,分别占21.5%、15.4%、10.7%;脆弱拟杆菌对青霉素、阿莫西林耐药率为100.0%,对甲硝唑、替卡西林/克拉维酸敏感率为100.0%;产黑色素普雷沃菌对青霉素、阿莫西林耐药率分别为57.2%和42.9%,对亚胺培南、氯霉素、甲硝唑、阿莫西林/克拉维酸敏感率均为100.0%;牙龈卟啉单胞菌对青霉素、阿莫西林耐药率为57.2%和42.9%。结论急性牙髓炎感染以革兰阴性厌氧菌为主,该菌对β-内酰胺类药物耐药率较高,治疗可考虑甲硝唑与不良反应小的敏感抗菌药物联合用药。OBJECTIVE To study the bacterial distribution and the characteristics of drug resistance of the pathogens causing acute pulpitis so as to guide the anti-infrction therapy.METHODS The bacterial cultures for aerobes and anaerobes were performed on pulp specimens of 40patients from department of cariology endodontology and operative dentistry,then the bacterial identification and the drug susceptibility testing were performed.RESULTS Totally 65strains of bacteria were isolated from infected pulp specimens,among which the gramnegative anaerobic bacteria accounted for 66.1%,the B.fragilis,P.melaninogenica,and P.gingivalis were the most common among the gram-negative anaerobic bacteria,accounting for 21.5%,15.4%,and 10.7%respectively.The drug resistance rates of B.fragilis to penicillin and amoxicillin were 100.0%.The drug sensitivity rates of B.fragilis to metronidazole and ticarcillin/clavulanate were 100.0%.The drug resistance rate of P.melaninogenica to penicillin was 57.2%,the drug resistance rate of P.melaninogenica to amoxicillin was 42.9%.The drug sensitivity rates of P.melaninogenica to imipenem,chloromycetin,metronidazole,and amoxicillin-clavulanate were 100.0%.The drug resistance rate of P.gingivalis to penicillin was 57.2%,the drug resistance rate of P.gingivalis to amoxicillin was 42.9%.CONCLUSION The bacteria isolated from acute pulpitis patients are mainly gram-negative anaerobic bacteria.The drug resistance rates of the gram-negative anaerobic bacteria toβ-lactam antibiotics are very high,the metronidazole combined with other sensitive antibiotics with less adverse reactions can be used for the treatment.

关 键 词：急性牙髓炎 厌氧菌 抗菌药物 耐药性 

分 类 号：R378.8[医药卫生—病原生物学]