Abstract
Recently, treatment for MRSA (methicillin resistant Staphylococcus aureus) infection has been discussed because of resistance to many kinds of antibiotics. In the maxillofacial region, especially nasal, oral cavity and pharyngeal space, MRSA reduced indigenous bacteria in anatomical bases. It is well known that the cancer patient easily becomes immunocompromised due to chemotherapy, radiation therapy and surgical treatments. An active treatment using vancomycine and other treatments are often required for the postoperative patients with MRSA following reconstructive surgery. In this report, a clinical study on MRSA infection for oral cancer patients treated in our department is presented. The subject were 17 cases with oral cancers, (11 males and 6 females), 7 tongue cancers, 4 oral floors, 3 buccal mucosas, 2 lower gingivas and 1 lower lip in each primary sites, mean age of 63.9 years, ranged 44 to 78 years, from 1995 to 1998. During this period, MRSA infection ratio was 1 to 2% among all hospitalized patients, but 6% of all oral cancer patients were cultured. About 70% of these oral cancer patients were more than 60 years old. Most cancers were advanced tumor over T3 in size, and reconsouction by pedicled or vasuclarized major flaps was done after cancer ablation. Many kind and long period antibiotics were needed in order to care for operated wounds when surgical treatment was employed for the cancer radicality, and most MRSA infections were complicated in these patients. For two patients, MRSA eliminated by isodin and GM cream placed directly on the wound might couse percutaneous infection. Only one of 5 patients responded to administration of vancomycine but others did not respond to MRSA.
