DEMOGRAPHIC DISTRIBUTION, ETIOLOGICAL BACTERIAL SPECTRUM AND ANTIBACTERIAL TREATMENT OF PATIENTS WITH ODONTOGENIC ABSCESSES AND PHLEGMONS OF THE HEAD AND NECK

Yanko Yankov, Lyuben Stoev
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Abstract

Background: Odontogenic abscesses are the most common pathology in maxillofacial surgery. Their frequency is significantly higher in people with poor social status. Materials and methods: The study retrospectively included 81 patients with odontogenic abscesses and phlegmons of the head and neck, hospitalized and operated on as an emergency case. Incision wound secretion for microbiological examination and preparation of an antibiogram were taken from each of them as a standard routine procedure. Results and discussion: The most affected are young patients (till 44 years), followed by patients in middle age (45-59 years). The reason for this is that with age, teeth gradually fall out of the dentition of mature individuals, and with this, the possibility of the occurrence of odontogenic infections decreases. The lower jaw is more affected. A mixed resident microflora comprising more than one bacterial species is isolated in 62% of all patients. Gram-positive bacteria isolated in the samples of the studied patients were coagulase-negative staphylococci (Staphylococcus coagulase negative, CNS), Staphylococcus aureus, Streptococcus anginosus and Streptococcus viridans. Gram-negative bacteria were Escherichia coli, Enterobacter cloacae and Stenotrophomonas maltophilia. Obligate anaerobes were found in only one sample. The isolated fungi were Candida albicans and Candidanonalbicans. Conclusion: In the studied group of patients with odontogenic abscesses, Gram-positive bacteria In the studied group of patients with odontogenic abscesses, Gram-positive bacteria were 2.5 times more than Gram-negative. Single antibacterial therapy is preferable for patients with small-area odontogenic abscesses, while triple antibacterial therapy is recommended for large-area odontogenic abscesses and their phlegmonous forms.
头颈部牙源性脓肿和痰患者的人口分布、病原菌谱和抗菌治疗
背景:牙源性脓肿是颌面外科最常见的病症。在社会地位较低的人群中,其发病率明显较高。材料与方法:该研究回顾性纳入了 81 名头颈部牙源性脓肿和痰患者,他们均为住院急诊手术患者。作为标准常规程序,从每位患者的切口伤口处提取分泌物进行微生物学检查,并制作抗生素图谱。结果与讨论受影响最大的是年轻患者(44 岁以下),其次是中年患者(45-59 岁)。原因是随着年龄的增长,成熟个体的牙齿会逐渐脱落,发生牙源性感染的可能性也随之降低。下颌受到的影响更大。在所有患者中,有 62% 分离出由一种以上细菌种类组成的混合常驻微生物菌群。在所研究的患者样本中分离到的革兰氏阳性细菌有凝固酶阴性葡萄球菌(凝固酶阴性葡萄球菌,CNS)、金黄色葡萄球菌、茴链球菌和病毒链球菌。革兰氏阴性菌有大肠杆菌、泄殖腔肠杆菌和嗜麦芽僵菌。只有一个样本中发现了厌氧菌。分离出的真菌为白色念珠菌和黑念珠菌。结论在所研究的牙源性脓肿患者群体中,革兰氏阳性菌是革兰氏阴性菌的 2.5 倍。小面积牙源性脓肿患者宜采用单一抗菌疗法,而大面积牙源性脓肿及其痰液型脓肿则建议采用三联抗菌疗法。
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