Osteomyelitis of the jaw: resistance to clindamycin in patients with prior antibiotics exposure

Pigrau, Carles; Almirante, Benito; Rodríguez, Dolors; Larrosa, Nieves; Bescos, S.; Raspall, G.; Pahissa, A.

doi:10.1007/s10096-008-0626-z

Cited by 32 publications

(21 citation statements)

References 40 publications

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“…Controlled drug delivery by means of implantable nanoparticles has been shown to produce local concentrations of the released drug well beyond the MIC levels and is considered a more effective means of delivery compared to intravenous route for specific applications that include lowly vascular tissues, including those comprising bone 31–34. Although CL resistance does occur in S aureus 35 as well as among patients with osteomyelitis and with prior antibiotics exposure,36 the antibacterial assessment reported hereby suggests that the application of antibiotic‐loaded CAP particles analyzed would not be any more likely than the traditional therapy to result in spontaneous drug resistance during treatment.…”

Section: Resultsmentioning

confidence: 99%

Association study of IL10 and IL23R–IL12RB2 in Iranian patients with Behçet's disease

Xavier¹,

Shahram²,

Davatchi³

et al. 2012

Arthritis & Rheumatism

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Objective. Independent replication of the findings from genome-wide association studies (GWAS) remains the gold standard for results validation. Our aim was to test the association of Behçet's disease (BD) with the interleukin-10 gene (IL10) and the IL-23 receptor-IL-12 receptor ␤2 (IL23R-IL12RB2) locus, each of which has been previously identified as a risk factor for BD in 2 different GWAS.Methods. Six haplotype-tagging single-nucleotide polymorphisms (SNPs) in IL10 and 42 in IL23R-IL12RB2 were genotyped in 973 Iranian patients with BD and 637 non-BD controls. Population stratification was assessed using a panel of 86 ancestry-informative markers.Results. Subtle evidence of population stratification was found in our data set. In IL10, rs1518111 was nominally associated with BD before and after adjustment for population stratification (odds ratio [OR] for T allele 1.20, 95% confidence interval [95% CI] 1.02-1.40, unadjusted P [P unadj ] ‫؍‬ 2.53 ؋ 10 ؊2 ; adjusted P [P adj ] ‫؍‬ 1.43 ؋ 10 ؊2 ), and rs1554286 demonstrated a trend toward association (P unadj ‫؍‬ 6.14 ؋ 10 ؊2 ; P adj ‫؍‬ 3.21 ؋ 10 ؊2 ). Six SNPs in IL23R-IL12RB2 were found to be associated with BD after Bonferroni correction for multiple testing, the most significant of which were rs17375018 (OR for G allele 1.51, 95% CI 1.27-1.78, P unadj ‫؍‬ 1.93 ؋ 10 ؊6 ), rs7517847 (OR for T allele 1.48, 95% CI 1.26-1.74, P unadj ‫؍‬ 1.23 ؋ 10 ؊6 ), and rs924080 (OR for T allele 1.29, 95% CI 1.20-1.39, P ‫؍‬ 1.78 ؋ 10 ؊5 ). SNPs rs10489629, rs1343151, and rs1495965 were also significantly associated with BD in all tests performed. Results of meta-analyses of our data combined with data from other populations further confirmed the role of rs1518111, rs17375018, rs7517847, and rs924080 in the risk of BD, but no epistatic interactions between IL10 and IL23R-IL12RB2 were detected. Results of imputation analysis highlighted the importance of IL23R regulatory regions in the susceptibility to BD.Conclusion. These findings independently confirm, extend, and refine the association of BD with IL10 and IL23R-IL12RB2. These associations warrant further validation and investigation in patients with BD, as they may have implications for the development of novel therapies (e.g., immunosuppressive therapy targeted at IL-23p19).

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Section: Resultsmentioning

confidence: 99%

Association study of IL10 and IL23R–IL12RB2 in Iranian patients with Behçet's disease

Xavier¹,

Shahram²,

Davatchi³

et al. 2012

Arthritis & Rheumatism

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“…Long-term abuse of antibiotics results in drug resistance, gradually increasing the challenges of treating infectious diseases [24,25]. This study showed that the recurrence rate and incidence of life-threatening complications for patients with pre-admission antibiotic administration were significantly higher.…”

Section: Discussionmentioning

confidence: 97%

“…For patients without pre-admission antibiotic administration, only 4.9% had life-threatening complications, and 8.5% had disease recurrence. Pre-admission antibiotic administration without consultation leads to bacterial resistance to antibiotics, allowing residual bacteria to remain, which increases the risk of CSOJ recurrence when the patient’s immunity reduces [25]. The time from the onset of symptoms to presentation for those who had pre-admission antibiotic administration was longer than that for those who did not receive antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of recurrence and life-threatening complications for patients hospitalized with chronic suppurative osteomyelitis of the jaw

Chen

Wei

et al. 2013

BMC Infect Dis

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BackgroundClinically, recurrence and life-threatening complications are challenging problems for chronic suppurative osteomyelitis of the jaw (CSOJ), but there is no quantitative analysis or report about the causes of or risk factors for the two problems to date. Doctors identify the causes or risk factors only through clinical experience. We performed a retrospective study of 322 patients with CSOJ to quantificationally analysed the risk factors for the abovementioned two problems by logistic regression analysis.MethodsA retrospective study of 322 patients hospitalized with CSOJ was performed. The socio-demographic and clinical characteristics were recorded. The risk factors for the above two problems were analyzed by logistic regression analysis. Frequency and percentage were used to indicate descriptive research factors. A univariate logistic regression analysis was performed to calculate the odds ratio (OR) and to identify independent risk factors. The independent risk factors were further identified by multivariate logistic regression analysis.ResultsAn age from 6–12 years or > 65 years, pre-admission antibiotic administration, a lesion at the mandibular ramus, concurrent maxillofacial space infection (MSI), and conservation of pathogenic teeth were found to be risk factors for recurrence. An age > 65 years, admission temperature > 39 degree Celsius, admission white blood cell (WBC) count >15×109/L, pre-admission antibiotic administration, concurrent MSI, pre-existing diabetes, and respiratory difficulty were found to be risk factors for life-threatening complications.ConclusionsThe results indicate that doctors should remain mindful of the risk factors listed above, and the management of CSOJ should be increasingly aggressive when the above risk factors are present, especially when the lesion is located at the mandibular ramus. In addition, pathogenic teeth must be extracted, and antibiotics should be administered properly.Trial registrationClinicaltrials.gov (NCT01670422)

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“…The anatomic characteristics of the maxillofacial region, the close proximity to the sinuses, and the microbiotic flora of the oral cavity and air passages differentiate the course and behaviour of jaw osteomyelitis from that of the long bones. The ratio of the frequency of mandibular osteomyelitis to that of maxillary osteomyelitis has been reported to be 3:1, 5:1, 9:1, 17:1 and 45:1. This predilection for the mandible may be attributed to the abundant blood supply and to the morphology of the maxillary bone, such as the thin cortical plates and the relative paucity of medullary tissue.…”

Section: Introductionmentioning

confidence: 99%

Escherichia coli and Enterococcus spp. isolation in maxillary osteomyelitis: a case report and literature review with special consideration of immunocompetent individuals

et al. 2013

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The occurrence of maxillary osteomyelitis is rare in immunologically normal hosts. The nature of such infections is mainly polymicrobial, commonly attributable to micro-organisms present in the oral cavity. A case of acute maxillary osteomyelitis with Escherichia coli and Enterococcus spp. infection is described in an otherwise healthy young female. Cases of maxillary osteomyelitis reported in immunocompetent individuals lacking any predisposing factors are also reviewed. The lesion presented as a painful bone swelling and incomplete wound healing after tooth extraction, showing radiolucency with irregular borders. The isolated microbial species were E. coli and Enterococcus spp. Contamination from an extra-oral source through the wound may be implicated in the pathogenesis. A combination of surgical and antibiotic treatment proved to be successful. Nine maxillary osteomyelitis cases have been reported in the literature in immunocompetent individuals. Isolation of enteric bacteria was not described in any of those cases. Osteomyelitis should be included in the differential diagnosis of maxillary osteolytic lesions even in healthy individuals. The microbiological diagnosis is important for the antimicrobial intervention. This review shows that the main causative infectious agents in osteomyelitis remain unclear, as various bacteria have been reported to be involved. Clinical relevanceThis report brings the total number of maxillary osteomyelitis cases affecting immunocompetent individuals reported in the English literature to 10. Despite its infrequent occurrence, this inflammatory condition is relevant to clinicians, as the identification of the microbial species in osteomyelitis is essential for the appropriate selection of treatment due to the risk of the infection spreading to the neighboring anatomic structures.

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Osteomyelitis of the jaw: resistance to clindamycin in patients with prior antibiotics exposure

Cited by 32 publications

References 40 publications

Association study of IL10 and IL23R–IL12RB2 in Iranian patients with Behçet's disease

Association study of IL10 and IL23R–IL12RB2 in Iranian patients with Behçet's disease

Risk factors of recurrence and life-threatening complications for patients hospitalized with chronic suppurative osteomyelitis of the jaw

Escherichia coli and Enterococcus spp. isolation in maxillary osteomyelitis: a case report and literature review with special consideration of immunocompetent individuals

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