Microbiology and antibiotic sensitivities of head and neck space infections of odontogenic origin.
OBJECTIVE
The purpose of this study is to assess the anatomical spaces and causative micro-organisms responsible for deep fascial space head and neck infections and evaluate the resistance of antibiotics used in the treatment of these infections.


METHODS
A 6-year retrospective study evaluated hospital records of 103 patients. All patients in this study underwent surgical incision and drainage, received IV antibiotics, and had culture and sensitivity performed. Patient demographics reviewed were gender, age, involved fascial space(s), micro-organisms identified and antibiotic resistance from culture and sensitivity testing.


RESULTS
There were 56 male (54%) and 47 (46%) female patients. The submandibular space was the most frequent location for a single space abscess (30%), followed by the buccal space (27.5%) and the lateral pharyngeal space (12.5%). Sixty-three patients presented with multiple space involvement, totaling 142 spaces involved. A total of 269 bacterial strains were isolated from 103 patients. The bacteria were found to be 63.5% gram-positive. Gram-positive cocci were isolated 57.7% of specimens and gram-negative rods were isolated in 33% of cultures. There were 178 aerobes (65.7%) and 91 anaerobes (34.3%) isolated. The most common bacteria isolated were Viridans streptococci, Provetella, Staphylococci, and Peptostreptococcus. Culture and sensitivities were reviewed on 101 patients.


CONCLUSIONS
Patients who underwent surgical incision and drainage in the operating room had a tendency for involvement of multiple space abscesses with the submandibular space, submental, and lateral pharyngeal spaces effected most frequently. Cultures and sensitivities commonly showed greater growth in aerobes (65.7%) than in anaerobes. Gram positive cocci and gram negative rods had the greatest growth percentage in cultures.
Rega
Anthony J
AJ
Department of Oral and Maxillofacial Surgery, University of Medicine and Dentistry of New Jersey, Newark, NJ 07103-2400, USA.
Aziz
Shahid R
SR
Ziccardi
Vincent B
VB
D000038:Abscess / Q000188:drug therapy / Q000382:microbiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects*; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D016866:Bacteroidaceae Infections / Q000188:drug therapy / Q000382:microbiology; D002648:Child; D004322:Drainage; D024881:Drug Resistance, Bacterial; D005260:Female; D005491:Focal Infection, Dental / Q000188:drug therapy / Q000382:microbiology*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D006257:Head / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000188:drug therapy / Q000382:microbiology; D009333:Neck / Q000382:microbiology*; D010462:Peptostreptococcus / Q000187:drug effects; D010608:Pharyngeal Diseases / Q000188:drug therapy / Q000382:microbiology; D018720:Prevotella / Q000187:drug effects; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology; D013290:Streptococcal Infections / Q000188:drug therapy / Q000382:microbiology
D000900:Anti-Bacterial Agents