구강악안면 감염 환자에서 흡인법을 이용하여 조사한 세균감염 양상
Bacteriologic Features Investigaed by Aspiration technique in Oral and Maxillofacial Infections
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Abstract
Most purulent maxillofacial infections are of odontogenic origin. Treatment of infection includes the surgical intervention, such as incision and drainage, and adjunctive treatment. The use of high-dose antibiotics is also indicated. The choice of an antibiotics should be based on the knowledge of the usual causative microbes and the results of antibacterial sensitivity test. We have undertaken clinical studies on 119 patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from January 2000 to December 2007. Many anaerobic microbes are killed quickly when exposed to oxygen. Thus the needle aspiration techniques and the transfer under inert gas were used when culturing. The aim of this study was to obtain informations for the bacteriologic features and the effective antimicrobial therapy against maxillofaical odontogenic infections. The obtained results were as follows: 1. The most frequent causes of infections were odontogenic (88.3%), and in odontogenic cause, pulpal infections were the most common causes(53.8%). 2. The buccal and submandibular spaces (respectively 23.5%) were the most frequent involved fascial spaces, followed by masticator spaces (14.3%). 3. The most common underlying medical problems were diabetes (17.6%), however the relation with prognosis was not discovered. 4. The complications were the expiry, mediastinitis, necrotizing fasciitis, orbital abscess, and osteomyelitis. 5. The most common admission periods were 1-2 weeks, and the most patients were discharged within 3 weeks. However, patients who admitted over 5 weeks were about 10%. 6. A total of 99 bacterial strains (1.1 strains per abscess) was isolated from 93 patients (78.2%). The most common bacterium isolated was Streptococcus viridans (46.2%), followed by β-hemolytic group streptococcus (10.1%). 7. Penicillins (penicillin G 58.3%, oxacillin 80.0%, ampicillin 80.0%) have slightly lower sensitivity. Thus we recommend the antibiotics, such as glycopeptides (teicoplanin 100%, vancomycin 100%) and quinolones (ciprofloxacin 90.0%) which have high susceptibility in cases in which peni cillin therapy failed or severe infections.
참고문헌 (27)
- Har-El G, "Changing trends in deep neck abscess. A retrospective study of 110 patients", Oral Surg Oral Med Oral Pathol, 77, pp.446~450 (1994)
- 김일규, "구강악안면 영역의 치성 감염 환자에 대한 세균학적 연구", 대한악안면성형재건외과학회지, 22, pp.420~429 (2000)
- 주현호, "구강 악안면 근막간극 감염에 관한 임상통계학적 분석", 대한구강악안면외과학회지, 26, pp.490~496 (2000)
- 이원혁, "최근 5년간 치성감염으로 인한 구강악안면부 근막간극에 발생한 농양환자의 임상 통계학적 검토", 대한구강악안면외과학회지, 30(6), pp.497~503 (2004), 대한구강악안면외과학회
- 장소정, "최근 5년간 구강악안면 감염 환자의 임상통계학적 연구", 대한구강악안면외과학회지, 32(5), pp.401~409 (2006), 대한구강악안면외과학회
- Yonetsu K, "Deep facial infections of odontogenic origin: CT assessment of pathways of space involvement", AJNR Am J Neuroradiol, 19, pp.123~128 (1998)
- Miller WD, "A prospective, blinded comparison of clinical examination and computed tomography in deep neck infections", Laryngoscope, 109, pp.1873~1879 (1999)
- Matt BH, "Delineation of a deep abscess with magnetic resonance imaging", Ann Otol Rhinol Laryngol, 96, pp.615~617 (1987)
- Renzo M, "Francesco M: Descending necrotizing mediastinitis: Ten years’experience", Ear Nose Throat J, 83, pp.774~780 (2004)
- Neena C, "Anil KR: Descending necrotizing mediastinitis: Trends in a developing country", Ear Nose Throat J, 84, pp.242~248 (2005)
- Wong TY, "Cervical Necrotizing Fasciitis of Odontogenic Origin. A Report of 11 Cases", J Oral Maxillofac Surg, 58, pp.1347~1352 (2000)
- Peterson LJ, "Microbiology of head and neck infections", Oral Maxillofac Surg Clin North Am, 3, pp.247~257 (1991)
- Kuriyama T, "Bacteriologic features and antimicrobial susceptibility in isolates from orofacial odontogenic infections", Oral Surg Oral Med Oral Pathol, 90, pp.600~608 (2000)
- Kuriyama T, "Bacteriology and antimicrobial susceptibility of gram-positive cocci isloated from pus specimens of orofacial odontogenic infections", Oral Microbiology Immunology, 17, pp.132~135 (2002)
- James QS, "Antibiotic therapy-managing odontogenic infections", Dent Clin N Am, 46, pp.623~633 (2002)
- 김일규, "두경 안면부 괴사성 근막염 : 증례보고", 대한구강악안면외과학회지, 28(1), pp.74~80 (2002), 대한구강악안면외과학회
- 김일규, "치성 감염에 의한 뇌 농양", 대한구강악안면외과학회지, 32(2), pp.174~178 (2006), 대한구강악안면외과학회
- Sethi DS, "Deep neck abscess-changing trends", J Laryngol Otol, 108, pp.138~143 (1994)
- 김선국, "구강악안면 감염 질환에서 배양된 세균의 양상과 항생제 감수성", 대한구강악안면외과학회지, 31(4), pp.322~328 (2005), 대한구강악안면외과학회
- Anthony JR, "Vincent BZ: Microbiology and Antibiotic Sensitivities of Head and Neck Space Infections of Odontogenic Origin", J Oral Maxillofac Surg, 64, pp.1377~1380 (2006)
- Peterson LJ, "Contemporary management of deep infections of the neck", J Oral Maxillofac Surg, 51, pp.226~231 (1993)
- Dietrich RL, "Considerations in the Management of Maxillofacial Infections in the Pregnant Patient", J Oral Maxillofac Surg, 54, pp.474~485 (1996)
- Seija Y, "Differences Between Patients With or Without the Need for Intensive Care Due to Severe Odontogenic Infections", J Oral Maxillofac Surg, 59, pp.867~872 (2001)
- Itzhak B, "Microbiology and Management of Peritonsillar, Retropharyngeal, and Parapharyngeal Abscesses", J Oral Maxillofac Surg, 62, pp.1545~1550 (2004)
- Lewis MAO, "Quantitative bacteriology of acute dento-alveolar abscesses", J Med Microbiol, 21, pp.101~104 (1986)
- Heimdahl A, "Clinical appearance of Orofacial Infections of Odontogenic Origin in Relation to Microbiological Findings", J Clin Microbiol, 22, pp.299~302 (1985)
- Baker KA, "The management of odontogenic infections. A rationale for appropriate chemotherapy", Dent Clin North Am, 38, pp.689~706 (1994)