閉鎖性の歯槽膿瘍の細菌学的研究
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Forty one dentoalveolar abscesses of endodontic origin were examined bacteriologically. Pus was aspirated, immediately inserted into RTF under a stream of anaerobic gas, sealed tightly with a butyl gum stopper and transferred to the laboratory. The sample was serially diluted and smeared on blood agar plates in duplicate. One plate was incubated anaerobically for 7 days and the other aerobically for 4-7 days. Bacteria were isolated in 32 of 41 cases and the standard number of isolates was 3.3×10<SUP>7</SUP>CFU/m<I>l</I>. Anaerobic bacteria predominated in 30 of the 32cases yielding positive culture. In anaerobic bacteria, gram negative rods were predominant, especially species of <I>Bacteroides</I> were isolated from 30cases, followed by species of <I>Peptostreptococcus</I> (65.6%) and <I>Eubacterium</I> (40.6%). <I>Ps. micros</I> (17 cases), <I>B. intermedius</I> (16cases), <I> B. ruminicola</I> (13 cases), <I>B. bivius</I> (13cases), <I>E. lentum</I> (11 cases), <I>Ps. anaerobius</I> (11cases) and <I>Ps. productus</I> (10cases) were identified as major constituents. These genera and species are similar to those found in a symptomatic periapical pathosis. However, in this experiment, proportional distribution of <I>B. intermedius</I> is quite different from previous data of symptomatic periapical pathosis. <I>B. intermedius</I> was most prevalent and occupied more than 40% of the isolates from 9 cases in this experiment. These results indicate that <I>B. intermedius</I> may exert an important influence on exacerbation of periapical pathosis.<BR>In API ZYNI system, enzymatic activity patterns of <I>B. intermedius</I> and <I>F. nucleatum</I> were the same as those from symptomatic periapical pathosis. In this experiment, however, many isolates produced additional activities. Furthermore, MIC value of various antibiotics against major constituents were higher than those of isolates from periapical pathosis or oral microbial flora. These results suggest that the derivation of bacteria in these cases might be due to persistence of bacteria, but not due to anachoresis.
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