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.

Keywords: Antibiotic resistance; culture and sensitivity; odontogenic infection; orofacial space infections; oromicrobial flora.

Figure 1

Distribution of cases according to age

Figure 2

Distribution of cases according to type of microbial isolate

Figure 3

Relative efficacy of different antibiotics against all microbes