口腔颌面部间隙感染病原菌与耐药性  

Pathogenic bacteria and drug resistance in oral and maxillofacial space infections

作　　者：王静静[1] 郭丽芳[2] 王芳[1] 霍玉青 WANG Jing-jing;GUO Li-fang;WANG Fang;HUO Yu-qing(Affiliated Hospital of Binzhou Medical University,Binzhou,Shandong 256600,China)

机构地区：[1]滨州医学院附属医院口腔颌面外科,山东滨州256600 [2]滨州医学院附属医院神经外科,山东滨州256600 [3]滨州医学院附属医院肿瘤科,山东滨州256600

出　　处：《中华医院感染学杂志》2020年第20期3142-3145,共4页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(ZR2015CM025)。

摘　　要：目的研究口腔颌面部间隙病原菌感染患者的菌体类型、感染部位和耐药性特点,为临床预防和治疗感染提供参考。方法分析滨州医学院附属医院2014-2019年收治的口腔颌面部间隙感染患者646例的临床资料,采集感染者颌面和口咽间隙的脓液加入含有疱肉培养液的管中,分别在厌氧和需氧的条件下培养并进行药敏试验。结果646例口腔颌面部间隙感染患者,多为急性炎症,发病原因中牙源性感染占62.07%(401/646),其次为腺源性感染占17.18%(111/646),以及外伤性感染占12.69%(82/646);病原菌以感染眶下间隙、颌下间隙和咬肌间隙等部位为主;感染患者共培养分离病原菌397株,其中革兰阳性菌297株占74.81%,以星座链球菌、肺炎链球菌、草绿色链球菌、金黄色葡萄球菌为主;革兰阴性菌100株占25.19%,以铜绿假单胞菌、肺炎克雷伯菌、阴沟肠杆菌、干燥奈瑟菌为主。肺炎链球菌和肺炎克雷伯菌对亚胺培南较敏感,耐药率为11.11%和11.54%;草绿色链球菌对青霉素相对较敏感,耐药率为31.11%;金黄色葡萄球菌对环丙沙星较敏感,耐药率为10.00%。结论口腔颌面部间隙感染患者以革兰阳性菌为主要感染源,其中大部分为链球菌属;眶下间隙和颌下间隙部位感染为主,牙源性感染为主要病因;感染病原菌对临床常用抗菌药物存在不同程度耐药,因此临床应根据本地区病原菌特点及时采取有效措施,防止患者病情继续发展十分重要。OBJECTIVE To study the bacterial cell types,infection sites and drug resistance characteristics of patients with pathogenic bacteria infection in oral and maxillofacial space,so as to provide reference for clinical prevention and treatment of infection.METHODS The clinical data of 646patients with oral and maxillofacial space infection admitted to Affiliated Hospital of Binzhou Medical University from 2014to 2019were analyzed.The pus from the maxillary and oropharyngeal space of the infected person was collected and added to a tube containing blister culture medium,and then cultured under anaerobic and aerobic conditions respectively for drug sensitivity test.Then the drug sensitivity test was carried out for different bacteria after separation.RESULTS Totally 646patients with oral and maxillofacial space infection were mostly acute inflammations.Among the causes,odontogenic infection accounted for 62.07%(401/646),followed by glandular infection accounted for 17.18%(111/646),and traumatic infection accounted for 12.69%(82/646).Pathogens mainly infected the suborbital space,submandibular space and masseter muscle space.A total of 397pathogenic bacteria were co-cultured and isolated from infected patients,of which 297strains of gram-positive bacteria accounted for 74.81%mainly Streptococcus.,Streptococcus pneumonia,Streptococcus viridans and Staphylococcus aureus;100strains of gram-negative bacteria accounted for 25.19%,mainly Pseudomonas aeruginosa,Klebsiella,Enterobacter cloacae,and Neisseria aureus.Streptococcus pneumoniae and Klebsiella pneumoniae were more sensitive to imipenem,with resistance rate of 11.11%and 11.54%,respectively;Streptococcus viridans was relatively sensitive to penicillin,with a resistance rate of 31.10%;Staphylococcus aureus was more sensitive to ciprofloxacin,with a resistance rate of 10.00%.CONCLUSIONIn patients with oral and maxillofacial space infection,gram-positive bacteria were the main source of infection,most of which were Streptococcus.Infections in the infraorbital space and sub

关 键 词：多间隙感染 病原菌 耐药性 

分 类 号：R782[医药卫生—口腔医学]