口腔颌面部间隙感染病原菌分布特点、耐药性情况及感染的相关危险因素分析

Analysis of Pathogen Distribution,Drug Resistance and Related Risk Factors of Oral and Maxillofacial Space Infection in 106 Cases

目的探讨106例口腔颌面部间隙感染病原菌分布特点、耐药性情况及其危险因素。方法选择2019年1月至2021年12月本院收治的106例口腔颌面部间隙感染患者,采集感染部位分泌物进行病原菌培养、鉴定与药敏试验,分析其病原菌分布特点、耐药性情况。另选取106例非口腔颌面部间隙感染患者设为对照组,分析其感染的相关危险因素。结果106例感染患者中共分离出174株病原菌,其中革兰阳性菌87株,革兰阴性菌82株,真菌5株;主要革兰阴性菌中对左氧氟沙星、氨苄西林耐药率较高,均高于60.0%,对亚胺培南耐药率较低,均低于25.0%;主要革兰阳性菌中表皮葡萄球菌对青霉素、头孢噻肟耐药率较高,均高于75.0%;金黄色葡萄球菌对青霉素、氨苄西林耐药率较高,均高于85.0%;两者对亚胺培南耐药率偏低,均低于25.0%;多因素分析显示:年龄≥60岁、合并低蛋白血症、糖尿病是口腔颌面部间隙感染发生的高危因素(P<0.05)。结论口腔颌面部间隙感染病原菌以革兰阳性菌为主,不同病原菌耐药率存在一定的差异,且年龄≥60岁、合并低蛋白血症、合并糖尿病是其发生的高危因素。

Objective To investigate the distribution,drug resistance and risk factors of pathogenic bacteria in 106 cases of oral and maxillofacial space infection.Methods 106 patients with oral and maxillofacial space infection admitted to our hospital from January 2019 to December 2021 were selected,and the secretion of the infected site was collected for pathogenic bacteria culture,identification and drug sensitivity test,and the distribution characteristics and drug resistance of the pathogenic bacteria were analyzed.Another 106 patients with non oral maxillofacial space infection were selected as the control group,and the related risk factors of infection were analyzed.Results A total of 174 pathogens were isolated from 106 infected patients,including 87 gram-positive bacteria,82 gram-negative bacteria and 5 fungi;Among the main gram-negative bacteria,the resistance rate to levofloxacin and ampicillin was higher than 60.0%,and the resistance rate to imipenem was lower than 25.0%;Among the main Gram positive bacteria,Staphylococcus epidermidis had a high resistance rate to penicillin and cefotaxime,which was higher than 75.0%;The resistance rate of Staphylococcus aureus to penicillin and ampicillin was higher than 85.0%;The resistance rate of both to imipenem was lower than 25.0%;Multivariate analysis showed that age≥60 years,hypoproteinemia and diabetes were the high risk factors for oral and maxillofacial space infection(P<0.05).Conclusion The pathogens of oral and maxillofacial space infection are mainly gram-positive bacteria,and the drug resistance rate of different pathogens is different.Age≥60 years old,combined with hypoproteinemia,and combined with diabetes are the high-risk factors for its occurrence.