Anaerobic bacteria in 118 patients with deep-space head and neck infections from the University Hospital of Maxillofacial Surgery, Sofia, Bulgaria

Abstract

Anaerobic bacteria in 118 patients with deepspace head and neck infections from the University Hospital of Maxillofacial Surgery, Sofia, Bulgaria The aim of this study was to assess the incidence and susceptibility to antibacterial agents of anaerobic strains in 118 patients with head and neck abscesses (31) and cellulitis (87).Odontogenic infection was the most common identified source, occurring in 73 (77?7 %) of 94 patients. The incidence of anaerobes in abscesses and cellulitis was 71 and 75?9 %, respectively, and that in patients before (31 patients) and after (87) the start of empirical treatment was 80?6 and 72?4 %, respectively. The detection rates of anaerobes in patients with odontogenic and other sources of infection were 82?2 and 71?4 %, respectively. In total, 174 anaerobic strains were found. The predominant bacteria were Prevotella (49 strains), Fusobacterium species (22), Actinomyces spp. (21), anaerobic cocci (20) and Eubacterium spp. (18). Bacteroides fragilis strains were isolated from 7 (5?9 %) specimens. The detection rate of Fusobacterium strains from non-treated patients (32?2 %) was higher than that from treated patients (13?8 %). Resistance rates to clindamycin and metronidazole of Gram-negative anaerobes were 5?4 and 2?5 %, respectively, and those of Gram-positive species were 4?5 and 58?3 %, respectively. One Prevotella strain was intermediately susceptible to ampicillin/sulbactam. In conclusion, the start of empirical treatment could influence the frequency or rate of isolation of Fusobacterium species. The involvement of the Bacteroides fragilis group in some head and neck infections should be considered.

Clinical features of deep neck infection: analysis of 77 patients

“…Pathogens that cause DNI show various levels of antibiotic resistance--thus, infection may not respond to therapy, and complications may occur. Boyanevo et al [12] reported 74% anaerobic reproduction and 2.5-58.3% resistance to clindamycin and metronidazole in these strains. Considering these high resistance rates, antibiotic regimens must be updated in the near future.…”

Bacteriology of deep neck infections: analysis of 634 patients

“…In the pre‐antibiotic era, most DNI resulted from pharyngotonsillar infections. Contemporary studies described dental infection as the most commonly identified source of DNI . Dental infection is typically associated with higher incidence of anaerobic bacteria compared to infections of non‐dental aetiology …”

Occurrence and Pattern of Antibiotic Resistance among Dental Plaque Bacteria from Gingivitis Patients and Their Clinical Correlation

“…Among the agents used against obligate anaerobic isolates, Chloramphenicol and Clindamycin were effective (62.5%) with an unexpected high resistance to Metronidazole (75%). A lower resistance rate to Clindamycin than metronidazole among Gram-negative anaerobes was also found by Boyanova et al (2006) (25) . However, metronidazole was described by Saini et al (2003) (21) as the drug of choice against anaerobes.…”