Incidence of Anaerobic Bacteria in 118 Patients with Deep-space Head and Neck Infections from the People’s University Hospital of Maxillofacial Surgery, Bhopal, India

Abstract

Aim: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). Materials and methods:In total, 118 pus specimens from 118 consecutive patients with abscesses (31 cases) and cellulitis (87) of the head and neck were evaluated from 2006 to the end of 2011. The patients were admitted to the University Hospital of Maxillofacial Surgery, Bhopal, India, and comprised 76 men and 42 women: Four children, 103 adults and 11 elderly people.Results: Anaerobic bacteria (174 strains within 18 genera) were found in 88 (74.6%) of the 118 specimens. Anaerobes only were present in 23 (19.5%) specimens, aerobic/facultative bacteria only in 20 (16.9%) and mixed aerobic/anaerobic flora in 65 (55.1%). No growth was detected in 10 (8.5%) specimens. Two or more anaerobes per specimen were found in 56 (63.6%) of the specimens yielding anaerobes. The incidence of isolation of anaerobes from patients with identified odontogenic sources of infection was 82.2% (60 of 73 cases) and that in patients with other sources of infection was 71.4% (15 of 21, p > 0.20). 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.

Aerobic and Anaerobic Bacterial Profile of Deep Space Head and Neck Infections in a Tertiary Care Hospital in Kerala

“…Other studies have reported a higher incidence of polymicrobial infections. In the study conducted by Kanishka guru et al 8 polymicrobial infection was found in 55.1% of the specimens. According to the study by Shih-Wei Yang et al, Fifty-one out of 89 positive cultures were polymicrobial (57.3%).…”

“…Majority of the previous studies showed a higher rate of culture positivity. In the study conducted by Kanishka guru et al 8 91.5% were culture positive and only 8.5% were culture negative. Another study by Brito TP et al 3 reported 84.5% as culture positive and 14.5% as culture negative.…”

Infra - Temporal &Temporal Abscess – Retrograde Infection from Mandibular Molars

“…In relation to the lower head of the external pterygoid muscle the pterygoid venous plexus lies in the fossa. The posterior wall of the maxilla which forms the anterior boundary of this space is paper-thin and pierced by two or three small foramina which transmit the posterior superior alveolar vessels and nerves 4,5 . Uncontrolled and untreated mandibular odontogenic infections rarely spread superiorly to the infratemporal and temporal fossa There is three basic patterns of spread of infection from the masticatory space to temporal space has been identify.…”

“…Steroids has been routinely prescribed for the treatment of arthritis and neuritis where as both drainage and antibiotics usage are used for the treatment of nasopharyngeal and infratemporal fossa abscess. If the steroid prescribing to a patient who has infratemporal fossa abscesses, infection will spread to the vital neighboring tissues hence in is required to perform a proper diagnosis for such infection [4][5][6] . To conclude with, infratemporal and temporal fossa infection are rare and is not commonly seen by clinicians and might be easily misdiagnosed.…”

Anaerobic Infections

“…Most (63%) specimens yielding anaerobes yielded more than one and more than 82% of patients with odontogenic sources had specimens that included anaerobes; the most common anaerobes isolated were Gram-positive bacilli (48%), Prevotella (28%), anaerobic Gram-positive cocci (15%), Fusobacterium (13%) and the B. fragilis group (4%) [36]. Most (63%) specimens yielding anaerobes yielded more than one and more than 82% of patients with odontogenic sources had specimens that included anaerobes; the most common anaerobes isolated were Gram-positive bacilli (48%), Prevotella (28%), anaerobic Gram-positive cocci (15%), Fusobacterium (13%) and the B. fragilis group (4%) [36].…”