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首页> 外文期刊>Otolaryngology--head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery >Sinogenic orbital and subperiosteal abscesses: microbiology and methicillin-resistant Staphylococcus aureus incidence.
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Sinogenic orbital and subperiosteal abscesses: microbiology and methicillin-resistant Staphylococcus aureus incidence.

机译：中国性眼眶和骨膜下脓肿：微生物学和耐甲氧西林金黄色葡萄球菌的发生率。

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OBJECTIVE: To assess the current bacteriology and the incidence of methicillin-resistant Staphylococcus aureus in orbital and subperiosteal abscesses of paranasal sinus disease origin. STUDY DESIGN: Case series with chart review. SETTING: An otolaryngology and ophthalmology specialty hospital. SUBJECTS AND METHODS: Fifty-three patients were treated between 1994 and 2008 for orbital or subperiosteal abscess and paranasal sinusitis, confirmed by imaging and surgical intervention; 46 had operative culture specimens and comprise the study cohort. RESULTS: The mean patient age was 28 years; one third were younger than 18. Nearly twice as many patients had subperiosteal (n = 30) as had orbital abscesses (n = 16). In 12 patients (26%), cultures were negative or grew only skin flora contaminants (coagulase-negative staphylococci, diphtheroids, and Propionibacterium acnes). Fifteen patients (33%) grew more than one pathogen. Streptococci were isolated in 17 of the 46 cases (37%), S. aureus in 13 (28.3%), gram-negative bacilli in eight (17.4%), and anaerobes in nine (19.6%). Methicillin-resistant S. aureus accounted for three (23.1%) of the S. aureus isolates and 6.5 percent of the total cases. CONCLUSION: Abscess cultures grew a mixture of bacteria, including gram-positive cocci, gram-negative bacilli, and anaerobes. Although streptococci were the most common genus of bacteria isolated, S. aureus was the single most common pathogen recovered and one fourth of these cases were methicillin-resistant S. aureus. Given the significant morbidity that may result from inadequate treatment, an antibiotic active against methicillin-resistant S. aureus should be included in the initial broad-spectrum antimicrobial treatment regimen of orbital and subperiosteal abscesses of sinusitis origin until culture results are available.
机译：目的：评估鼻咽窦源性疾病的眼眶和骨膜下脓肿的耐细菌性和耐甲氧西林金黄色葡萄球菌的发生率。研究设计：带有图表审查的案例系列。地点：耳鼻咽喉科和专科医院。对象与方法：1994年至2008年，经影像学和外科手术证实，有53例患者因眼眶或骨膜下脓肿和鼻旁鼻窦炎而接受治疗; 46名具有手术培养标本，组成研究队列。结果：平均患者年龄为28岁;三分之一的人小于18岁。骨膜下（n = 30）的患者几乎是眼眶脓肿（n = 16）的两倍。在12名患者中（26％），培养物为阴性或仅生长皮肤菌群污染物（凝固酶阴性葡萄球菌，双环类和痤疮丙酸杆菌）。 15名患者（33％）生长的病原体不止一种。在46例病例中，有17例（37％）分离出链球菌，在13例中（28.3％）分离出金黄色葡萄球菌，在8例中（17.4％）分离出革兰氏阴性杆菌，在9例中（19.6％）分离出了厌氧菌。耐甲氧西林的金黄色葡萄球菌占金黄色葡萄球菌分离株的三（23.1％），占总病例数的6.5％。结论：脓肿培养物生长出细菌混合物，包括革兰氏阳性球菌，革兰氏阴性杆菌和厌氧菌。尽管链球菌是最常见的分离细菌，但金黄色葡萄球菌是唯一最常见的病原体，其中四分之一是耐甲氧西林的金黄色葡萄球菌。鉴于治疗不充分可能会导致很高的发病率，对鼻窦炎的眼眶和骨膜下脓肿的最初广谱抗菌治疗方案应包括对甲氧西林耐药金黄色葡萄球菌有活性的抗生素，直到获得培养结果为止。

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