口腔种植体周围菌群分布及耐药性分析  

Distribution of bacteria surrounding oral implants and drug resistance analysis

作　　者：倪欢胜 王镶珊 韩翔 朱旌[2] 

机构地区：[1]杭州萧山区第一人民医院口腔科,浙江杭州311201 [2]杭州市第一人民医院口腔科,浙江杭州310006

出　　处：《中华医院感染学杂志》2014年第3期594-595,598,共3页Chinese Journal of Nosocomiology

基　　金：杭州市卫生科技计划基金项目(2009103147)

摘　　要：目的探讨口腔种植体周围菌群的分布及耐药性,为牙种植体周围炎的预防治疗提供依据。方法选择2005年1月-2011年12月280例患者的346枚种植体,采用法国生物梅里埃公司生产的细菌培养仪进行细菌培养,细菌鉴定及药敏试验采用全自动的细菌鉴定仪。结果 346枚种植体周围共分离病原菌624株,其中厌氧菌381株占61.06%,需氧菌196株占31.41%,有益菌47株占7.53%;厌氧菌株中排名前3位的为产黑色素普雷沃菌81株、口腔链球菌78株、中间普雷沃菌69株,分别占12.98%、12.50%、11.06%;厌氧菌对红霉素、磺胺甲噁唑/甲氧苄啶、克林霉素、苯唑西林等抗菌药物耐药率为92.13%、79.00%、65.88%、66.67%,对四环素、头孢曲松、万古霉素、左氧氟沙星的敏感性较强,敏感率均>70.00%。结论口腔种植体周围病原菌主要为厌氧菌,以产黑色素普雷沃菌、口腔链球菌、中间普雷沃菌为主,为预防牙种植体周围炎的发生,要特别注意该类病原菌感染,在治疗感染时应选用万古霉素、头孢曲松等敏感性较强的抗菌药物。OBJECTIVE To investigate the distribution of bacteria surrounding oral implants and drug resistance analysis, so as to provide basis for prevention and treatment of inflammation around dental implants. METHODS A total of 346 implants from 280 patients from Jan. 2005 to Dec. 2011 were selected. Bacteria were cultured in a bacterial culture system from French company and identified and drug sensitivity was tested in full automatic bacteria identification instrument. RESULTS A total of 624 strains were isolated from 346 peri-implant, including anaerobic bacteria 381 strains, accounting for 61. 06%, aerobic bacteria 196 strains, accounting for 31. 41%, beneficial bacterium 47 （7.53 %）. The top three anaerobic bacteria were producing melanin Pre-votella nigrescens （81 strains）, Streptococcus oralis （78 strains）, Prevotella intermedia （69 strains）, accounting for 12. 98%, 12.50%,11.06%, respectively. The drug resistance rates of anaerobic bacteria to erythromycin, sulfamethox- azole-trimethoprim, clindamycin, oxacillin were 92.13%, 79.00%, 65.88%, and 66.67%, respectively, while to tetracycline, ceftriaxone, vaneomycin, and levofloxacin were high, more than 70. 00%. CONCLUSION The pathogenic bacteria surrounding oral implants are mainly anaerobic bacteria, among which producing melanin Pre- votella nigrescens, S. oralis and P. intermedia are dominant. For prevention the occurrence of inflammation around dental implants, we should pay particular attention to the infections caused by these strains. Vancomycin, ceftriaxone and other sensitivity strong antibacterial drugs should be used for therapy.

关 键 词：种植体 病原菌 药敏试验 

分 类 号：R378[医药卫生—病原生物学]