中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2017, Vol. 15 ›› Issue (6): 538-542.doi: 10.19438/j.cjoms.2017.06.012

• 论著 • 上一篇    下一篇

ICU中重症口腔颌面部间隙感染89例病原学及耐药性分析

王海云1, 周龙女1, 朱虹2   

  1. 1.上海交通大学医学院附属第九人民医院 急诊科,上海 200011;
    2.上海交通大学医学院附属第九人民医院·临床医学院 临床教研室,上海 200011;
  • 收稿日期:2017-03-13 修回日期:2017-06-06 出版日期:2017-11-20 发布日期:2017-12-21
  • 通讯作者: 朱虹,E-mail: zhuhong1096@126.com
  • 作者简介:王海云（1981-）,硕士,主治医师,E-mail:haiyunjy@126.com

Analysis on pathogenic microorganism and drug-resistance of severe oral and maxillofacial infections in ICU

WANG Hai-yun1, ZHOU Long-nv1, ZHU Hong2   

  1. 1.Department of Emergency, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
    2.Shanghai Ninth People's Hospital, College of Clinical Medicine, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2017-03-13 Revised:2017-06-06 Online:2017-11-20 Published:2017-12-21

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摘要： 目的 了解ICU中重症口腔颌面部间隙感染患者的病原菌分布及耐药性特征,为临床合理使用抗菌药物提供依据。方法 选取2010年1月—2016年12月收治入我院急诊ICU的89例重症口腔颌面部间隙感染患者作为研究对象,取其感染部位的脓液标本进行培养及病原菌鉴定,并进行药物敏感性试验。结果 89份送检标本中共分离出130株病原菌,其中革兰阴性（G-）菌66株,占50.77%;革兰阳性（G+）菌59株,占45.38%;真菌5株,占3.85%。药敏试验结果显示,肺炎克雷伯菌、大肠埃希氏菌对亚胺培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦敏感度较高,普雷沃菌对甲硝唑、亚胺培南、头孢哌酮/舒巴坦敏感度较高,金黄色葡萄球菌、草绿色链球菌、粪肠球菌对利奈唑胺、万古霉素、替加环素敏感度较高;多数致病菌耐多种抗生素。结论 ICU中重症口腔颌面部间隙感染以G-菌为主,多数致病菌呈多重耐药,在临床治疗时,应合理使用抗生素,以防止细菌耐药。

关键词: 口腔颌面部, 间隙感染, 重症, 病原学, 耐药性

Abstract: PURPOSE： To investigate the pathogenic distribution and drug resistance characteristics of severe oral and maxillofacial infections in ICU, and to provide evidence for clinical rational use of antibiotics. METHODS: Eight-nine patients with severe oral and maxillofacial infections in ICU were chosen from January, 2010 to December, 2016. The strains from each patient were cultured and identified respectively. Each stain was used to test drug susceptibility. RESULTS: One hundred and thirty strains of pathogenic bacteria were isolated from 89 patients , including 66 strains of gram-negative bacteria,accounting for 50.77%; 59 strains of gram-positive bacteria, accounting for 45.38%; 5 strains of fungi,accounting for 3.85%. Drug susceptibility test showed that the Klebsiella pneumoniae and Escherichia coli were susceptible to imipenem, sulbactam and cefoperazone and tazobactam sodium. Prevotella was susceptible to metronidazole imipenem and sulbactam and cefoperazone. Staphylococcus aureus, Viridans Streptococci and Enterococcus were susceptible to linezolid and vancomycin. Most pathogens were resistant to many antibiotics. CONCLUSIONS: Severe oral and maxillofacial infections in ICU were mainly caused by gram-negative bacteria. Most pathogenic bacteria are resistant to many antibiotics, which suggests that more reasonable use of drug should be performed to prevent drug resistance in clinical treatment.

Key words: Oral and maxillofacial region, Space infection, Severe case, Pathogenic microorganism, Drug resistance

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