title: Characteristics of pyogenic odontogenic infection in patients attending Mulago Hospital, Uganda: a cross-sectional study.
abstract: BACKGROUND
  Predisposing factors of pyogenic odontogenic infection include dental caries, pericoronitis, periodontitis, trauma to the dentition and the supporting structures or complications of dental procedures. The infections are usually polymicrobial involving normal endogenous flora. We characterised pyogenic odontogenic infection in patients attending Mulago Hospital, Uganda.
  
  
  RESULTS
  Of the 130 patients, 62 (47.7%) were female. The most frequently involved fascial spaces were: the buccal, 52 (25.4%); submasseteric, 46 (22.4%) and the submandibular space, 36 (17.5%). Dental caries was the most prevalent predisposing factor, particularly of the lower third molar teeth. Viridans Streptococci Group and Staphylococcus aureus were the most frequent bacterial isolates: 23.5% and 19.4%, respectively. All Viridans Streptococci isolates were resistant to penicillin G, sulfamethoxazole/trimethoprim (cotrimoxazole), ampicillin and tetracycline, but susceptible to vancomycin. All Staphylococcus aureus strains were resistant to cotrimoxazole and ampicillin while retaining susceptibility to vancomycin, cefotaxime, linezolid, moxifloxacin and amoxicillin/clavulanate. Thirty five (26.9%) patients were HIV infected and the HIV status did not significantly influence the pattern of odontogenic infection.
  
  
  CONCLUSIONS
  Dental caries was the most prevalent predisposing factor for pyogenic odontogenic infection. High prevalence of bacterial resistance to ampicillin and cotrimoxazole suggests the need for regular antibiotic susceptibility tests of isolates and rational use of antibiotics in the management of these infections. Prevention requires strengthening of oral health in the community.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Mulago Hospital, Kampala, Uganda. kityamuwesirichard@yahoo.com.
authors.forename: Richard
authors.initials: R
authors.lastname: Kityamuwesi
authors.affiliation: Department of Dentistry, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda. muwazilm@gmail.com.
authors.forename: Louis
authors.initials: L
authors.lastname: Muwaz
authors.affiliation: Department of Dentistry, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda. arabat@chs.mak.ac.ug.
authors.forename: Arabat
authors.initials: A
authors.lastname: Kasangaki
authors.affiliation: Department of Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda. jumbic@hotmail.com.
authors.forename: Henry
authors.initials: H
authors.lastname: Kajumbula
authors.affiliation: Department of Dentistry, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda. mrwenyonyi@chs.mak.ac.ug.
authors.forename: Charles Mugisha
authors.initials: CM
authors.lastname: Rwenyonyi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D060085:Coinfection; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D005260:Female; D006678:HIV / Q000502:physiology; D015658:HIV Infections / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D006761:Hospitals; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010518:Periodontitis / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000254:growth & development / Q000302:isolation & purification; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014454:Uganda / Q000453:epidemiology; D034363:Viridans Streptococci / Q000187:drug effects / Q000254:growth & development / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D000667:Ampicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination