厌氧菌检测技术在口腔颌面部感染治疗中的应用  

Application of anaerobic bacteria detection in oral and maxillofacial infection

作　　者：包振英[1] 林琴[1] 孟彦宏 何淳[1] 苏家增[2] 彭歆[2] 

机构地区：[1]北京大学口腔医学院.口腔医院检验科,北京100081 [2]北京大学口腔医学院.口腔医院口腔颌面外科,北京100081

出　　处：《北京大学学报（医学版）》2016年第1期76-79,共4页Journal of Peking University:Health Sciences

摘　　要：目的:探讨口腔颌面部感染患者的厌氧菌病原菌分布及耐药情况,以指导临床治疗。方法:对北京大学口腔医学院口腔颌面外科收治的61例口腔颌面部感染患者的脓液标本进行需氧菌和厌氧菌培养,应用API 20A试剂盒对耐氧试验阴性菌株进行菌种鉴定,采用Etest方法检测菌株进行药敏试验,确定病原菌类型及厌氧菌耐药情况。收集61例患者的临床治疗及抗菌药物应用情况,记录临床治疗效果。结果:61例脓液标本均培养分离出细菌,其中单纯需氧菌感染6例(9.8%),单纯厌氧菌感染7例(11.5%),厌氧菌与需氧菌混合感染48例(78.7%)。厌氧菌感染总例数为55例(90.2%),共分离出81株厌氧菌。分离率最高的革兰阳性厌氧菌为消化链球菌属(Peptostreptococcus)、双歧杆菌属(Bifidobacterium)和疮疱丙酸杆菌(Pemphigus propionbacterium),上述3类革兰阳性厌氧菌均未出现对头孢西丁、阿莫西林/克拉维酸耐药菌株;分离率最高的革兰阴性厌氧菌为卟啉单胞菌属(Porphyromonas)和普雷沃菌属(Prevotella),上述两类革兰阴性厌氧菌均未出现对甲硝唑、头孢西丁、阿莫西林/克拉维酸耐药菌株。根据药敏试验结果指导临床治疗48例口腔颌面部感染患者,临床治愈率达到81.3%。结论:口腔颌面部感染多为需氧菌和厌氧菌混合性感染,其中厌氧菌占有较高比例,厌氧菌的培养及药敏试验结果对临床治疗具有良好的指导作用。Objective：To investigate the distribution and drug resistance of anaerobic bacteria in the patients with oral and maxillofacial infection. Methods： Aerobic and anaerobic bacteria cultures from 61 specimens of pus from the patients with oral and maxillofacial infection in the Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology were identified. The culture type was evaluated by API 20A kit and drug resistance test was performed by Etest method. The clinical data and antibacterial agents for the treatment of the 61 cases were collected, and the final outcomes were recor- ded. Results：The bacteria cultures were isolated from all the specimens, with aerobic bacteria only in 6 cases （9.8 % ） , anaerobic bacteria only in 7 cases （ 11.5 % ） , and both aerobic and anaerobic bacteria in 48 cases （78.7%）. There were 55 infected cases （90.2%） with anaerobic bacteria, and 81 anaero- bic bacteria stains were isolated. The highest bacteria isolation rate of Gram positive anaerobic bacteria could be found in Peptostreptococcus, Bifidobacterium and Pemphigus propionibacterium. No cefoxitin, amoxicillin/carat acid resistant strain was detected in the above three Gram positive anaerobic bacteria. The highest bacteria isolation rate of Gram negative anaerobic bacteria could be detected in Porphy- romonas and Prevotella. No metronidazole, cefoxitin, amoxicillin/carat acid resistant strain was found in the two Gram negative anaerobic bacteria. In the study, 48 patients with oral and maxillofacial infection were treated according to the results of drug resistance testing, and the clinical cure rate was 81.3%. Conclusion： Mixed aerobic and anaerobic bacteria cultures are very common in most oral and maxillofa- cial infection patients. Anaerobic bacteria culture and drug resistance testing play an important role in clinical treatment.

关 键 词：细菌感染 细菌 厌氧 微生物敏感性试验 口腔外科手术 

分 类 号：R446.54[医药卫生—诊断学]