Microbiology and antibiotic sensitivity of head and neck space infections of odontogenic origin. Differences in inpatient and outpatient management
Microbiology and antibiotic sensitivity of head and neck space infections of odontogenic origin. Differences in inpatient and outpatient management
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DOI：
10.1016/j.jcms.2017.07.013
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发表时间：
2017-10-01
影响因子：
3.1
通讯作者：
Martini, Markus
中科院分区：
文献类型：
--
作者：
Heim, Nils;Faron, Anton;Martini, Markus
牙源性口腔颌面部感染的微生物群通常是多微生物群。在第一批抗生素大规模生产后不久，就发现了耐药微生物。方法：对我院收治的107例头颈部牙源性感染患者进行为期28个月的回顾性研究。所有患者均行手术切开引流。结果：男性65例（61%），女性42例（39%），年龄5 ~ 91岁，平均年龄48岁（SD = 21）。门诊52例，住院55例。107例患者共分离出92株细菌，平均每例患者分离出0.86株。总共从门诊患者中分离出46株细菌，从住院患者中分离出34株细菌。从门诊接受治疗的个体中分离出的32.6%的菌株对一种或多种测试抗生素耐药。住院个体的分离菌株耐药率为52.9%。讨论：根据这项研究的数据，青霉素仍然是一种非常有效的抗生素，可用于治疗翠绿链球菌、C群链球菌和普雷沃氏菌，而克林霉素作为一种经验性药物，对大多数牙源性感染没有效果。结论：对一种或多种标准抗生素治疗方案表现出低敏感性的微生物引起严重健康问题的可能性明显更高，有扩散的趋势，并且更有可能需要住院治疗并接受静脉注射抗生素。青霉素仍然是一种非常有效的抗生素，可用于治疗翠绿链球菌、C群链球菌和普雷沃氏菌，而克林霉素作为一种经验性药物，无法证明对大量牙源性感染有效。(C) 2017欧洲颅颌面外科协会。Elsevier Ltd.出版。版权所有。
Introduction: The microbial flora of infections of the orofacial region of odontogenic origin is typically polymicrobial. Shortly after mass production of the first antibiotics, antibiotic resistant microorganisms were observed.Methods: A 28-months retrospective study evaluated hospital records of 107 patients that were treated for head and neck infections of odontogenic origin. All patients underwent surgical incision and drainage.Results: There were 65 male (61%) and 42 female (39%) patients ranging in age from 5 to 91 years, with a mean age of 48 years (SD = 21). 52 patients underwent outpatient management and 55 patients inpatient management. A total of 92 bacterial strains were isolated from 107 patients, accounting for 0.86 isolates per patient. Overall 46 bacterial strains were isolated from patients that underwent outpatient and 34 bacterial strains that underwent inpatient treatment. 32.6% of the strains, isolated from outpatient treated individuals showed resistances against one or more of the tested antibiotics. Isolated strains of inpatient treated individuals showed resistances in 52.9%.Discussion: According to this study's data, penicillin continues to be a highly effective antibiotic to be used against viridans streptococci, group C Streptococci and prevotella, whereas clindamycin was not shown to be effective as an empirical drug of choice for most odontogenic infections.Conclusion: Microorganisms that show low susceptibility to one or more of the standard antibiotic therapy regimes have a significantly higher chance of causing serious health problems, a tendency of spreading and are more likely to require an inpatient management with admission of IV antibiotics. Penicillin continues to be a highly effective antibiotic to be used against viridans streptococci, group C Streptococci and prevotella, whereas clindamycin could not be shown to be effective as an empirical drug of choice for a high number of odontogenic infections. (C) 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.