齒源性感染之細菌學特色及抗生素敏感性試驗之回溯性研究

Retrospective Study of Bacteriologic Features and Antimicrobial Susceptibility in Odontogenic Infection

陳文惠(Wen-Hui Chen) ； 楊家福(Jia-Fure Yang) ； 黃逸岳(I-Yueh Huang) ； 陳俊明(Chun-Ming Chen) ； 陳中和(Chung-Ho Chen)

《中華民國口腔顎面外科學會雜誌》 16卷1期 (2005/03) Pp. 17-29

https://doi.org/10.7104/CJOMS.200503.0017

摘要

顏面部感染大多是齒源性感染，治療上除病源齒治療及手術引流外，適當的抗生素治療也是必須的，本研究即在了解於本科就醫之齒源性感染患者其細菌學及抗生素敏感性試驗的結果，以作為經驗性抗生素選擇的參考。
我們回溯284位患者的資料，其膿液樣本共培養出236株細菌，以需氧革蘭氏陽性菌最多，有136株(57.6%)，其中以Viridans streptococcus最常見，厭氧格蘭氏陰性桿菌有39株(16.5%)，以Prevotella最常見。混合性感染佔17.9%，常見於有Viridans streptococcus存在的環境。抗生素敏感性試驗方面，Cefamezin和含有Beta-lactamase inhibitor的抗生素都有很好的效果，Oxacilllin只建議用於S . aureus的感染，雖然有較多抗藥性菌株，但Penicillin和Clindamycin分別對常見需氧菌和厭氧菌仍是有效的。

關鍵字

齒源性感染 ； 抗生素 ； 細菌學

並列摘要

Most of the orofacial infections are odontogenic. Appropriate antibiotic treatment is one of the important managements. The aim of this study is to obtain information about the bacteriologic features and antimicrobial susceptibility in odontogenic infection.
284 patients with odontogenic infection were reviewed. Aerobic gram-positive cocci (57.6%) were much more than anaerobic gram-negative rods (16.5%). Viridans streptococcus and Prevotella are the most common pathogens among the aerobic and anaerobic bacteria respectively. Cephalosporin and penicillin plus β-lactamase inhibitor are effective against most of the pathogens. The effect of penicillin, clindamycin and metronidazole is fair. Oxacillin is not advised unless susceptible S. aureus is reported. Due to the fact that more resistant bacteria were found in this study, strategies to prevent improper use of antibiotics are necessary.

並列關鍵字

Odontogenic infection ； Antimicrobial susceptibility ； Bacteriology