老年口腔正畸感染者病原学分布及相关影响因素分析  

Analysis of etiology distribution and related influencing factors in elderly patients with orthodontic infection

作　　者：宋生璋[1] 程楚昕 阎转君 SONG Sheng-zhang;CHENG Chu-xin;YAN Zhuan-jun(Department of Orthodontic Treatment,Affiliated Hospital of Qinghai University,Xining 810000,China)

机构地区：[1]青海大学附属医院口腔修复正畸科,青海省西宁市810000

出　　处：《实用老年医学》2020年第3期266-269,共4页Practical Geriatrics

摘　　要：目的分析老年口腔正畸感染者病原学分布及相关影响因素。方法选取2016年6月至2018年12月在我院口腔正畸科实施治疗后发生感染者98例作为感染组,另选取同期90例未感染病人作为对照组。分析感染组病原学分布及相关影响因素;检测并比较2组血清中胰岛素样生长因子、骨桥蛋白和Fascin蛋白的表达水平。结果感染组共检出革兰阴性菌163株(73.09%)和革兰阳性菌60株(26.91%),主要分离菌株依次为伴放线放线杆菌、福赛坦氏菌、牙龈卟啉单胞菌、口腔链球菌、肺炎克雷伯菌、黏性放线菌、金黄色葡萄球菌和铜绿假单胞菌。多因素Logistic回归分析显示,并发DM、器械消毒差、未使用一次性设备、医护人员防护意识不强与医护人员操作不规范均是引发口腔正畸感染的独立危险因素(P<0.05)。此外,对照组血清胰岛素样生长因子、骨桥蛋白和Fascin蛋白表达水平均显著高于感染组(P<0.05)。结论在正畸治疗后,老年病人口腔感染病原菌主要为革兰阴性菌,造成感染的影响因素较多,医护人员应做好消毒工作,提升预防意识,避免交叉感染。Objective To analyze the etiology distribution and related influencing factors of the elderly patients with orthodontic infection.Methods Ninety-eight elderly patients with infection after orthodontics treatment in our hospital from June 2016 to December 2018 were enrolled as the infection group,and 90 uninfected patients in the same period were enrolled as the control group.The distribution and influencing factors of pathogenic microorganisms in the infection group were analyzed.The levels of insulin-like growth factor,osteopontin and Fascin protein were detected and compared between the two groups.Results There were 163 strains of Gram-negative bacteria(73.09%)and 60 strains of Gram-positive bacteria(26.91%)in the infection group.The main isolated strains were Actinobacillus actinomycetemcomitans,Tannerella forsythia,Porphyromonas gingivalis,Streptococcus oralis,Klebsiella pneumoniae,Actinomyces viscosus,Staphylococcus aureus and Pseudomonas aeruginosa respectively.Multivariate Logistic regression analysis showed that patients with diabetes,poor disinfection of equipment,no disposable equipment,poor protection awareness and non-standard operation of the medical staffs were the independent risk factors of orthodontic infection(P<0.05).In addition,the levels of serum insulin-like growth factor,osteopontin and Fascin protein in the control group were significantly higher than those in the infection group(P<0.05).Conclusions After orthodontic treatment,the main pathogens of oral infection in elderly patients are Gram-negative bacteria.The medical staffs should do a good job in disinfection,enhance the awareness of prevention and avoid cross-infection.

关 键 词：口腔正畸 感染 病原学 影响因素 老年人 

分 类 号：R787[医药卫生—口腔医学]