慢性牙周炎患者牙周袋厌氧菌病原学分布特点及抗生素使用指导

Pathogenic distribution characteristics of anaerobic bacteria in periodontal pockets and antibiotic use guidance in patients with chronic periodontitis

目的了解慢性牙周炎患者牙周袋内厌氧菌病原学分布特点及抗生素耐药情况,为抗生素的合理应用提供指导。方法选取我院收治的130例慢性牙周炎患者为研究对象,对患者牙周袋内的致病菌进行分离培养,并鉴定分离菌株对阿莫西林、甲硝唑等10种常用抗生素的敏感性。结果本组患者共分离出320株致病菌,主要致病菌分别是牙龈卟啉单胞菌(25.94%)、产黑色素普雷沃菌(20.31%)和伴放线嗜血杆菌(14.06%)。主要致病菌株对阿莫西林和阿莫西林克拉维酸钾全部敏感,对甲硝唑、奥硝唑及替硝唑的敏感性均>90.00%,对阿奇霉素、克林霉素及米诺环素的敏感性均>50.00%,对红霉素和青霉素的敏感性均<20.00%。结论牙龈卟啉单胞菌、产黑色素普雷沃菌、伴放线嗜血杆菌等厌氧菌是慢性牙周炎病变的主要致病菌株,主要致病菌株对阿莫西林、阿莫西林克拉维酸钾全部敏感,上述药物可作为临床治疗的首选。

Objective To explore the pathogenic distribution characteristics and antibiotic resistance of anaerobic bacteria in periodontal pockets of patients with chronic periodontitis,and to provide guidance for the rational application of antibiotics.Methods A total of 130 patients with chronic periodontitis in our hospital were selected as the study objects.The pathogenic bacteria in periodontal pockets of patients were isolated and cultured,and the susceptibility of the isolated strains to 10 commonly used antibiotics such as amoxicillin and metronidazole were identified.Results A total of 320 pathogenic bacteria were isolated.The main pathogenic bacteria were Porphyromonas gingivalis(25.94%),Prevotella melanogenes(20.31%)and Haemophilus actinophilus(14.06%).The main pathogenic strains were all sensitive to amoxicillin,amoxicillin and clavulanate potassium,and the sensitivity to metronidazole,ornidazole and tinidazole were >90%,sensitivity to azithromycin,clindamycin and minocycline were >50%,sensitivity to penicillin and erythromycin were<20%.Conclusion Porphyromonas gingivalis,Prevotella melaninogenes,Haemophilus actinophilus and other anaerobic bacteria are the main pathogenic bacteria of chronic periodontitis.The main pathogenic bacteria are sensitive to amoxicillin,amoxicillin and clavulanate potassium.These drugs can be used as the first choice for clinical treatment.