發(fā)布時(shí)間：2018-06-12 21:50

  本文選題：正畸治療 + 口腔感染　； 參考：《中國(guó)藥房》2017年32期

【摘要】：目的:為臨床合理用藥和耐藥菌防治提供參考。方法:選擇某院2011年7月-2016年7月經(jīng)正畸治療后發(fā)生口腔感染的患者148例,對(duì)其病原菌的分布及耐藥情況進(jìn)行回顧性分析。結(jié)果:148例口腔感染患者共送檢臨床標(biāo)本275份,其中陽(yáng)性標(biāo)本209份,陽(yáng)性率為76.00%。共檢出病原菌332株,包括革蘭氏陽(yáng)性菌85株(占25.60%)和革蘭氏陰性菌247株(占74.40%)。分離數(shù)量排名前7位的菌種依次為伴放線放線桿菌(54株,占16.27%)、牙齦卟啉單胞菌(41株,占12.35%)、福賽坦氏菌(37株,占11.14%)、口腔鏈球菌(33株,占9.94%)、肺炎克雷伯菌(30株,占9.04%)、金黃色葡萄球菌(26株,占7.83%)和銅綠假單胞菌(25株,占7.53%)。金黃色葡萄球菌對(duì)青霉素G、慶大霉素、環(huán)丙沙星、苯唑西林和四環(huán)素的耐藥率均較高(耐藥率50%),但對(duì)萬(wàn)古霉素和替考拉寧敏感(耐藥率均為0);糞腸球菌對(duì)青霉素G、紅霉素和苯唑西林的耐藥率均較高(耐藥率50%),但對(duì)萬(wàn)古霉素和利福平敏感(耐藥率均為0);肺炎克雷伯菌對(duì)慶大霉素、環(huán)丙沙星、左氧氟沙星和頭孢唑林的耐藥率均較高(耐藥率50%),但對(duì)亞胺培南、頭孢他啶、頭孢吡肟、氨芐西林鈉舒巴坦鈉和阿莫西林克拉維酸鉀較為敏感(耐藥率10%);銅綠假單胞菌對(duì)慶大霉素和左氧氟沙星的耐藥率≥80%,但對(duì)氨曲南較為敏感(耐藥率為8.00%);大腸埃希菌對(duì)哌拉西林的耐藥率為84.21%,但對(duì)亞胺培南和氨芐西林鈉舒巴坦鈉較為敏感(耐藥率均為5.26%)。結(jié)論:正畸治療后口腔感染的病原菌種類多樣,以革蘭氏陰性菌為主,其耐藥情況不容樂(lè)觀。對(duì)主要病原菌敏感性較高的藥物包括萬(wàn)古霉素、亞胺培南、含酶抑制劑復(fù)合制劑等。臨床應(yīng)重視病原菌培養(yǎng)和藥敏試驗(yàn),并根據(jù)藥敏試驗(yàn)結(jié)果針對(duì)性地選擇抗菌藥物,以提高抗菌效果、延緩耐藥菌的產(chǎn)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，

本文編號(hào)：2011203