口腔颌面部间隙感染病原菌分布及耐药性分析  

Analysis of Distribution and Drug Resistance of Pathogens Causing Oral and Maxillofacial Space Infections

作　　者：陈鑫[1,2,3] 郭瑜鑫 周航 石建峰 Chen Xin;Guo Yuxin;Zhou Hang;Shi Jianfeng(Laboratory Center of Stomatology,College of Stomatology,Xi'an Jiaotong University,Xi'an 710004,Shaanxi Province,China;不详)

机构地区：[1]西安交通大学口腔医院陕西省颅颌面精准医学研究重点实验室,陕西省西安市710004 [2]陕西省牙颌疾病临床研究中心,陕西省西安市710004 [3]西安交通大学口腔医院口腔医学检测中心,陕西省西安市710004

出　　处：《中国病案》2025年第3期109-112,共4页Chinese Medical Record

基　　金：西安交通大学口腔医院院级科研项目(080163)。

摘　　要：目的探究口腔颌面部间隙感染病原菌的分布特点及其耐药性,为抗菌药物的合理应用提供参考依据。方法选取2012年1月1日—2023年12月31日西安市某三甲医院收治的416例口腔颌面部间隙感染患者的病例信息,回顾性分析其病原菌分布及耐药性的特征。结果416例患者中共198例检出病原菌,其中革兰阳性菌151株,革兰阴性菌44株。检出率最高的为链球菌属(47.5%),其次为葡萄球菌属(26.8%)、克雷伯菌(9.1%)。比较2012—2017年和2018—2023年链球菌属、葡萄球菌属和克雷伯菌属检出率,差异具有统计学意义。链球菌属和克雷伯菌属呈上升趋势,而葡萄球菌属呈下降趋势。药敏试验显示链球菌属对红霉素和克林霉素的耐药率较高分别为72.3%和81.9%。在研究期间青霉素类抗菌药物的耐药性出现了上升趋势。葡萄球菌属对青霉素耐药率最高(86.8%),红霉素次之(69.8%)。克雷伯菌属在多间隙感染患者中检出率较高,对氨苄西林的耐药率相对较高(38.9%),对头孢菌素(22.2%)、左氧氟沙星(11%)和哌拉西林(5%)的耐药率相对较低。与之前6年相比,克雷伯菌属对大多数抗菌药物的耐药率有所增加。结论链球菌和克雷伯菌呈上升趋势,在研究期间葡萄球菌呈下降趋势,但是对青霉素抗菌药物的耐药出现上升趋势。因此在经验性治疗时应根据所在区域的主要病原菌及其耐药特点选择适宜的抗菌药物,避免耐药菌的产生。Objectives This study aims to investigate the distribution characteristics and drug resistance of pathogens isolated from oral and maxillofacial space infections,and to provide reference for the rational application of antibiotics.Methods A total of 416 patients with oral and maxillofacial space infection admitted to a tertiary hospital in Xi'an from January 1,2012 to December 31,2023 were selected,and the distribution and drug resistance characteristics of pathogens were retrospectively analyzed.Results Pathogens were detected in 198 of the 416 patients,including 151 Gram-positive bacteria and 44 Gram-negative bacteria.The highest detection rate was for Streptococcus(47.5%),followed by Staphylococcus(26.8%)and Klebsiella(9.1%).The detection rates of Streptococcus,Staphylococcus,and Klebsiella were compared between 2012-2017 and 2018-2023,and the differences were statistically significant.The genera Streptococcus and Klebsiella showed an increasing trend,while Staphylococcus showed a decreasing trend.The drug sensitivity test showed that the resistance rates of Streptococcus to erythromycin and clindamycin were high,at 72.3% and 81.9% respectively.There was an increasing trend in resistance to penicillin-type antimicrobial drugs during the study period.Staphylococcus had the highest resistance rate to penicillin(86.8%),followed by erythromycin(69.8%).Klebsiella was detected more frequently in patients with multi-space infection,and had a relatively high resistance rate to ampicillin(38.9%),but relatively low resistance rates to cephalosporins(22.2%),levofloxacin(11%),and piperacillin(5%).Compared with the previous 6 years,the resistance rate of Klebsiella to most antimicrobial drugs has increased.Conclusions The study suggested that Streptococcus and Klebsiella were on the rise,while Staphylococci were on the decline during the study period,but their resistance to penicillin antibiotics was on the rise.Therefore,during empirical treatment,appropriate antibiotics should be selected according to the main pathogenic

关 键 词：口腔颌面部间隙感染 耐药性 药敏试验 病原菌 

分 类 号：R446.5[医药卫生—诊断学]