Aerobic microbiology and culture sensitivity of head and neck space infection of odontogenic origin.
BACKGROUND
Head and neck space infections source, age, gender, tooth involved, fascial spaces involved, microbiological study of aerobic flora, and antibiotic susceptibilities.


OBJECTIVE
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.


METHODS
Prospective study in 100 patients.


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.


METHODS
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 viridanswas the highest isolate in 47% cases among Gram-positive bacteria, and in Gram-negative,Klebsiella pneumoniaewas 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 effectivein vitrothan older narrow spectrum antibiotics.
Department of Dentistry, Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Pauri Garhwal, Uttarakhand, India.
Amit
A
Shah
Department of Maxillofacial Surgery, Uttaranchal Dental and Medical Research Institute, Dehradun, Uttarakhand, India.
Vikas
V
Ramola
Department of Oral and Maxillofacial Surgery, Seema Dental College, Rishikesh, Uttarakhand, India.
Vijay
V
Nautiyal
Antibiotic resistance; culture and sensitivity; odontogenic infection; orofacial space infections; oromicrobial flora