심경부 감염 환자의 세균 동정 및 항생제 감수성의 변화
Assessment of Change in Microbiology and Antibiotic Sensitivity of Deep Neck Infection Over 10 Years
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Background and Objectives Treatment using systemic antibiotic administration and surgicaldrainage has been the common treatment modality for deep neck infection. This studycompared the changing pattern of isolated pathogens to recommend the best empirical antibioticsfor deep neck infection. Subjects and Method Reviewed retrospectively were medical charts of 131 patients who,confirmed with deep neck infection, underwent surgical drainage for pus cultures at EwhaWomans University Medical Center between January, 2009 and July, 2019. We analyzed thechanging pattern of isolated pathogens and antibiotic susceptibility tests using their pus cultures. Results Streptococcus viridans was the most commonly isolated organism (35.1%), followedby Klebsiella pneumonia (13.7%) and Staphylococcus aureus (4.6%). The isolation rate of Streptococcusviridans increased in the recent 10 years [p=0.016, odds ratio (OR)=3.417]. Antibioticsusceptibility tests showed that all pathogens were resistant to ampicillin, but susceptible toampicillin/sulbactam and cephalosporin. The isolation rate of clindamycin resistant pathogenswas increased with statistical significance (p=0.020, OR=8.076). Conclusion Antibiotics effective against both Streptococcus viridans and Klebsiella pneumoniashould be used as the first-line of treatment for deep neck infection. Ampicillin/sulbactamor amoxicillin/clavulanic acid were sufficient to treat deep neck infection empirically regardlessof age or underlying diseases.
Abstract
Background and Objectives Treatment using systemic antibiotic administration and surgicaldrainage has been the common treatment modality for deep neck infection. This studycompared the changing pattern of isolated pathogens to recommend the best empirical antibioticsfor deep neck infection. Subjects and Method Reviewed retrospectively were medical charts of 131 patients who,confirmed with deep neck infection, underwent surgical drainage for pus cultures at EwhaWomans University Medical Center between January, 2009 and July, 2019. We analyzed thechanging pattern of isolated pathogens and antibiotic susceptibility tests using their pus cultures. Results Streptococcus viridans was the most commonly isolated organism (35.1%), followedby Klebsiella pneumonia (13.7%) and Staphylococcus aureus (4.6%). The isolation rate of Streptococcusviridans increased in the recent 10 years [p=0.016, odds ratio (OR)=3.417]. Antibioticsusceptibility tests showed that all pathogens were resistant to ampicillin, but susceptible toampicillin/sulbactam and cephalosporin. The isolation rate of clindamycin resistant pathogenswas increased with statistical significance (p=0.020, OR=8.076). Conclusion Antibiotics effective against both Streptococcus viridans and Klebsiella pneumoniashould be used as the first-line of treatment for deep neck infection. Ampicillin/sulbactamor amoxicillin/clavulanic acid were sufficient to treat deep neck infection empirically regardlessof age or underlying diseases.
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