β‐ラクタマーゼ産生菌が重症化，難治化に関与したと考えられる顎骨骨髄炎の２例

Abstract

We encountered two patients with severe refractory osteomyelitis of jaw caused by β-lactamase-producing bacteria. The first was a 52-year-old man with chronic osteomyelitis of the maxilla. He had undergone an operation for a cyst in the left side of the maxillary bone. After operation, he had received antibiotics and irrigation of the wound in the maxilla. However, severe osteomyelitis of the maxilla occurred and spread to left maxillary sinus. The second patient was a 52-year-old man with acute osteomyelitis of the mandible. Poor wound-healing after tooth extraction was identified as cause of osteomyelitis. Although he had received two operations and antimicrobial therapy to control the infection, the osteomyelitis spread. Remarkably, β-lactamase-producing bacteria were isolated from both cases.β-lactamases are a prime mechanism of resistance to β-lactam antibiotics. We speculated that the presence of such bacteria might have contributed to both cases osteomyelitis. Our experience with these cases suggests that antibiotic therapy should be selected on the basis of microbiological laboratory data when treating osteomyelitis of the jaw.