儿童急性牙源性骨髓炎的微生物学方面

Elena E. Halyuta, Svetlana B. Mokhnacheva, Irina G. Dugina, Anastasia D. Kutarenko, Alina A. Fomina
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摘要

目的:确定儿童颌骨急性牙源性炎症过程病原菌的种类组成,确定分离菌群对各类群抗生素的敏感性和耐药性,确定疾病临床病程特征与优势病原菌类型的依赖关系。材料和方法。对900例因颌骨骨髓炎和骨膜炎引起的牙源性脓性病灶的渗出液进行了微生物学分析。结果。65.6%的病例病原为化脓性链球菌或A组溶血链球菌(BHSA),对万古霉素(99%)、氟喹诺酮类(98%)、β -内酰胺类(91%)高度敏感,对大环内酯类药物耐药比例最高(41%)。还分离到翠绿链球菌(6.1%)、肺炎链球菌(4.3%)等;混合菌群(14.3%)。56%的病例表现为发热,38%的病例表现为白细胞增多,57.4%的病例表现为ESR加速。不同链球菌类型组的内源性中毒程度差异无统计学意义。结论。65.6%的病例下颌炎症过程的原因是BHSA,对万古霉素(99%)、氟喹诺酮类药物(98%)、β -内酰胺类药物(91%)高度敏感。
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Microbiological aspects of acute odontogenic osteomyelitis in children
Objective: to determine the species composition of pathogens of acute odontogenic inflammatory processes of the jaws in children, to determine the sensitivity and resistance of the isolated microflora to antibiotics of various groups, as well as to determine the dependence of the characteristics of the clinical course of the disease on the type of dominant pathogen. Material and methods. The analysis of the results of microbiological methods for the study of exudate from purulent odontogenic foci of 900 children, due to periostitis and osteomyelitis of the jaws, was carried out. Results. In 65.6% of cases, the causative agent was Pyogenic streptococcus or group A beta-hemolytic streptococcus (BHSA) ith a high level of sensitivity to vancomycin (99%), fluoroquinolones (98%), beta-lactams (91 %) and the highest percentage of resistance to macrolides (41%). Streptococcus viridans (6.1%), Streptococcus pneumoniae (4.3%) and others were also isolated; mixed microflora (14.3%). The syndrome of endogenous intoxication of the body was manifested in 56% of cases by fever, in 38% by leukocytosis, in 57.4% by accelerated ESR. There was no statistically significant difference in the degree of endogenous intoxication in groups with different types of streptococcus. Conclusions. The cause of the inflammatory process of the jaws in 65.6% of cases was BHSA with a high level of sensitivity to vancomycin (99%), fluoroquinolones (98%), beta-lactams (91 %).
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