严重颈深间隙感染患者病原菌分布与治疗研究  

Distribution of pathogens isolated from patients with severe cervical deep space infections and treatment measures

作　　者：罗颜[1] 曹忠胜[1] 沈红娟[1] 袁辉[1] 李瀛[1] 辛洁[1] 刘志勇[1] 

机构地区：[1]苏州大学附属第二医院耳鼻咽喉科,江苏苏州215004

出　　处：《中华医院感染学杂志》2016年第9期2096-2098,共3页Chinese Journal of Nosocomiology

基　　金：江苏省卫计委基金资助项目(20150443)

摘　　要：目的分析严重颈深间隙感染伴脓腔内积气患者的临床治疗效果和病原菌分布,为制定临床治疗方案提供客观依据。方法选取2008年1月-2015年8月40例严重颈深间隙感染伴脓腔内积气患者作为研究对象,对其均给予脓肿切开引流、抗感染治疗,对治疗的临床效果及脓腔脓液中病原菌分布进行观察和分析;应用BD Epicenter软件进行数据处理和统计分析。结果经治疗34例(85.0%)患者治愈且无术后并发症发生,患者脓腔脓液中共分离病原菌49株,其中革兰阳性菌和革兰阴性菌分别占85.7%和14.3%,以咽峡炎链球菌、乙型溶血性链球菌、铜绿假单胞菌为主,分别占30.6%、24.5%和12.2%;咽峡炎链球菌对万古霉素、利奈唑胺、左氧氟沙星较敏感,乙型溶血性链球菌对万古霉素、利奈唑胺、青霉素较敏感,铜绿假单胞菌对头孢吡肟、亚胺培南较敏感,以上耐药率均<50.0%。结论严重颈深间隙感染伴脓腔内积气患者具有较严重的化脓性感染症状,其病原菌分布具有一定的特征性,临床医师应及时给予脓肿切开引流和抗菌药物治疗,以提高治愈率、改善患者预后。OBJECTIVE To investigate the distribution of pathogens isolated from severe cervical deep space infections patients complicated with pneumatosis of vomica and observe the clinical therapeutic effect so as to provide objective basis for clinical treatment.METHODS A total of 40 severe cervical deep space infections patients complicated with pneumatosis of vomica who were treated in the hospital from Jan 2008 to Aug 2015 were recruited as the study objects and treated with incision and drainage of abscess combined with anti-infection treatment.The clinical therapeutic effect and distribution of pathogens isolated from abscess pus were observed,and the statistical analysis of data was performed with the use of BD Epicenter software.RESULTS Totally 34（85.0%）patients were cured and did not have postoperative complications after the treatment.A total of 49 strains of pathogens were isolated from the abscess pus,of which 85.7% were gram-positive bacteria,and 14.3% were gram-negative bacteria;the Streptococcus angina,β-hemolytic Streptococcus,and Pseudomonas aeruginosa were the predominant species,accounting for 30.6%,24.5%,and 12.2%,respectively.S.angina was highly susceptible to vancomycin,linezolid,and levofloxacin;theβ-hemolytic Streptococcus was highly susceptible to vancomycin,linezolid,and penicillin;the drug resistance rates of the P.aeruginosato cefepime and imipenem were less than 50.0%.CONCLUSIONThe severe cervical deep space infections patients complicated with pneumatosis of vomica have severe symptom of pyogenic infections,and the distribution of the pathogens shows certain characteristics.It is necessary for the clinician to conduct the incision and drainage of abscess as well as the drug therapy in a timely manner so as to raise the cure rate and improve the prognosis of the patients.

关 键 词：颈深间隙感染 脓腔积气 疗效观察 病原菌分布 

分 类 号：R762[医药卫生—耳鼻咽喉科]