구강악안면 감염 환자에서 흡인법을 이용하여 조사한 세균감염 양상

조현영; 김일규; 장금수; 백민규; 박승훈; 박종원; 조정현

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구강악안면 감염 환자에서 흡인법을 이용하여 조사한 세균감염 양상
BACTERIOLOGIC FEATURES INVESTIGAED BY ASPIRATION TECHNIQUE IN ORAL AND MAXILLOFACIAL INFECTIONS

대한구강악안면외과학회지 2008년 34권 5호 p.562 ~ 570

조현영, 김일규, 장금수, 백민규, 박승훈, 박종원, 조정현,

소속 상세정보

조현영 ( Cho Hyun-Young ) - 인하대학교 의과대학 구강악안면외과학교실
김일규 ( Kim Il-Kyu ) - 인하대학교 의과대학 구강악안면외과학교실
장금수 ( Chang Keum-Soo ) - 인하대학교 의과대학 구강악안면외과학교실
백민규 ( Baek Min-Kyu ) - 인하대학교 의과대학 구강악안면외과학교실
박승훈 ( Park Seung-Hoon ) - 인하대학교 의과대학 구강악안면외과학교실
박종원 ( Park Jong-Won ) - 인하대학교 의과대학 구강악안면외과학교실
조정현 ( Cho Jung-Hyun ) - 인하대학교 의과대학 구강악안면외과학교실

KMID : 0355620080340050562

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.