Aerobic microbiology and culture sensitivity of head and neck space infection of odontogenic origin

Abstract

Context:Head and neck space infections source, age, gender, tooth involved, fascial spaces involved, microbiological study of aerobic flora, and antibiotic susceptibilities.Aims:The aim of the present study is to identify causative aerobic microorganisms responsible for deep fascial spaces of head and neck infections and evaluate the resistance of antibiotics used in the treatment of such.Settings and Design:Prospective study in 100 patients.Materials and Methods:This prospective study was conducted on 100 patients who reported in the outpatient department and fulfilled the inclusion criteria to study aerobic microbiology and antibiotic sensitivity in head and neck space infection of odontogenic origin. Pus sample was obtained either by aspiration or by swab stick from the involved spaces, and culture and sensitivity tests were performed.Statistical Analysis Used:Chi-square test and level of significance.Results:Result showed aerobic Gram-positive isolates were 73% and aerobic Gram-negative isolates were 18%. Nine percent cases showed no growth. Streptococcus viridans was the highest isolate in 47% cases among Gram-positive bacteria, and in Gram-negative, Klebsiella pneumoniae was the highest isolate of total cases 11%. Amoxicillin showed resistance (48.4%) as compared to other antibiotics such as ceftriaxone, carbenicillin, amikacin, and imipenem had significantly higher sensitivity.Conclusions:Amoxicillin with clavulanic acid showed (64.8%) efficacy for all organisms isolated, whereas ceftriaxone showed (82.4%) efficacy and could be used in odontogenic infections for both Gram-positive and Gram-negative microorganisms. Substitution of third generation cephalosporin for amoxicillin in the empirical management of deep fascial space infections can also be used. Carbenicillin, amikacin, and imipenem showed (93.4%) sensitivity against all microorganisms and should be reserved for more severe infection. Newer and broad-spectrum antibiotics are more effective in vitro than older narrow spectrum antibiotics.

Odontogenic Head and Neck Region Infections Requiring Hospitalization: An 18-Month Retrospective Analysis

“…The most common locations of odontogenic infections according to Shah et al were the SMD (30%), B (20%), SM (15%), and SL spaces (10%). The least frequent were the PPH (8%), CF (5%), M (4%), and PM spaces (2%) [ 40 ]. Mathew et al investigated 137 patients with an odontogenic infection in the head and neck region and reported that the most common location was the SMD space (69.3%) [ 41 ].…”

“…Mathew et al investigated 137 patients with an odontogenic infection in the head and neck region and reported that the most common location was the SMD space (69.3%) [ 41 ]. Odontogenic infections may occupy several sites in the head and neck region, and the SMD space is usually the first site occupied [ 35 , 40 , 41 ].…”

Klinikiniai Faktoriai, Sąlygojantys Odontogeninės Kilmės Celiulito Komplikavimąsi

“…Jų atsiradimas priklauso nuo anatominių ir imuninių organizmo savybių bei patogeno virulentiškumo [6,7]. Dažniausiai tai polimikrobinė infekcija, sukelta Viridans grupės streptokokų, auksinio stafilokoko ir/ar anaerobinių, gramneigiamų mikroorganizmų [7][8][9][10].…”

“…Nesuteikus reikiamos pagalbos, patogenas gali išplisti į bet kurį organą, sukeldamas gyvybei pavojingas būkles: sepsį, sepsinį šoką, mediastinitą, meningitą, kaverninio sinuso trombozę, smegenų abscesą ir kitas patologijas. Įvairių autorių duomenimis, ypač pabrė- [7,8,[13][14][15][16].…”

Pattern of deep neck space infections at a tertiary hospital, Kathmandu, Nepal

“…and Klebsiella pnuemoniae. 8 Submandibular space is the commonest space to be affected. 9 The presence of co-morbid conditions like diabetes mellitus, fistulas, cysts, HIV infection and immunosuppression attribute to formation of abscess.…”