某院2011-2016年正畸治疗后口腔感染患者病原菌分布及耐药性分析

发布时间：2018-06-12 21:50

  本文选题：正畸治疗 + 口腔感染　； 参考：《中国药房》2017年32期

【摘要】：目的:为临床合理用药和耐药菌防治提供参考。方法:选择某院2011年7月-2016年7月经正畸治疗后发生口腔感染的患者148例,对其病原菌的分布及耐药情况进行回顾性分析。结果:148例口腔感染患者共送检临床标本275份,其中阳性标本209份,阳性率为76.00%。共检出病原菌332株,包括革兰氏阳性菌85株(占25.60%)和革兰氏阴性菌247株(占74.40%)。分离数量排名前7位的菌种依次为伴放线放线杆菌(54株,占16.27%)、牙龈卟啉单胞菌(41株,占12.35%)、福赛坦氏菌(37株,占11.14%)、口腔链球菌(33株,占9.94%)、肺炎克雷伯菌(30株,占9.04%)、金黄色葡萄球菌(26株,占7.83%)和铜绿假单胞菌(25株,占7.53%)。金黄色葡萄球菌对青霉素G、庆大霉素、环丙沙星、苯唑西林和四环素的耐药率均较高(耐药率50%),但对万古霉素和替考拉宁敏感(耐药率均为0);粪肠球菌对青霉素G、红霉素和苯唑西林的耐药率均较高(耐药率50%),但对万古霉素和利福平敏感(耐药率均为0);肺炎克雷伯菌对庆大霉素、环丙沙星、左氧氟沙星和头孢唑林的耐药率均较高(耐药率50%),但对亚胺培南、头孢他啶、头孢吡肟、氨苄西林钠舒巴坦钠和阿莫西林克拉维酸钾较为敏感(耐药率10%);铜绿假单胞菌对庆大霉素和左氧氟沙星的耐药率≥80%,但对氨曲南较为敏感(耐药率为8.00%);大肠埃希菌对哌拉西林的耐药率为84.21%,但对亚胺培南和氨苄西林钠舒巴坦钠较为敏感(耐药率均为5.26%)。结论:正畸治疗后口腔感染的病原菌种类多样,以革兰氏阴性菌为主,其耐药情况不容乐观。对主要病原菌敏感性较高的药物包括万古霉素、亚胺培南、含酶抑制剂复合制剂等。临床应重视病原菌培养和药敏试验,并根据药敏试验结果针对性地选择抗菌药物,以提高抗菌效果、延缓耐药菌的产生。
[Abstract]:Objective: to provide reference for rational drug use and prevention and treatment of drug resistant bacteria. Methods: 148 patients with oral infection after orthodontic treatment from July 2011 to July 2016 were selected and the distribution of pathogens and drug resistance were analyzed retrospectively. Results 275 clinical specimens were collected from 148 patients with oral infection, 209 of them were positive, the positive rate was 76.00. 332 strains of pathogenic bacteria were detected, including 85 Gram-positive strains (25.60%) and 247 Gram-negative bacteria (74.4040%). Among them, 54 strains were actinomycetes, accounting for 16.27%, 41 strains were Porphyromonas gingivalis (12.35%), 37 strains were Forsythia, and 11.14% were Streptococcus oryzae, 33 strains were Streptococcus oral, 9.94% were Klebsiella pneumoniae, 30 strains were Klebsiella pneumoniae. There were 26 strains of Staphylococcus aureus (7.83%) and 25 strains of Pseudomonas aeruginosa (7.53%). Staphylococcus aureus for penicillin G, gentamicin, ciprofloxacin, The drug resistance rates of oxacillin and tetracycline were higher (50%), but sensitive to vancomycin and teicoplanin (0%) and Enterococcus faecalis to penicillin G, erythromycin and oxacillin (50%), but the drug resistance rate of Enterococcus faecalis to penicillin G, erythromycin and oxacillin was higher than that of enterococcus faecalis (50%), but it was sensitive to vancomycin and teicoplanin. Sensitive to vancomycin and rifampicin (0%), Klebsiella pneumoniae to gentamicin, Ciprofloxacin, levofloxacin and cefazolin had higher drug resistance rates (50%), but had higher resistance to imipenem, ceftazidime, cefepime, ceftazidime, ciprofloxacin and cefazolin. Ampicillin sodium sulbactam sodium and amoxicillin potassium clavulanate were more sensitive (resistance rate was 10%; Pseudomonas aeruginosa resistance rate to gentamicin and levofloxacin 鈮，

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