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Antibiotic resistance of the bacterial spectrum of deep space head and neck infections in oral and maxillofacial surgery — a retrospective study

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Abstract

Objectives

The aim of this study was to evaluate the current resistance situation concerning routinely used antibiotics for treatment in odontogenic abscesses.

Materials and methods

This retrospective study assessed patients with deep space head and neck infections who were treated by surgical intervention under general anesthesia at our department. The target parameter was the ascertainment of the resistance rates in order to identify the bacterial spectrum, sites in the body, length of inpatient stay, and the age and sex of the patients.

Results

A total of 539 patients, 268 (49.7%) males and 271 (50.3%) females were included in the study. The mean age was 36.5 ± 22.1 years. There was no significant difference between the two sexes with regard to the mean duration of hospitalization (p = 0.574). The predominant bacteria in the aerobic spectrum were streptococci of the viridans group and staphylococci, in the anaerobic spectrum Prevotella and Propionibacteria spp. Rates of resistance to clindamycin were between 34 and 47% in both the facultative and obligate anaerobic spectrum. Increased resistance was likewise found in the facultative anaerobic spectrum, with 94% resistance to ampicillin and 45% to erythromycin.

Conclusion

Due to the increasing levels of resistance to clindamycin, their use in empiric antibiotic treatment for deep space head and neck infections should be viewed critically.

Clinical relevance

Resistance rates continue to increase compared to previous studies. The use of these antibiotic groups in patients with a penicillin allergy needs to be called into question and alternative medications sought.

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Availability of data and materials

The data collected were obtained from the available SAP R3 of Vienna General Hospital and saved in an Excel table in an anonymized form. No formal consent is required for this type of study.

References

  1. Gujrathi AB, Ambulgekar V, Kathait P (2016) Deep neck space infection - a retrospective study of 270 cases at tertiary care center. World J Otorhinolaryngol Head Neck Surg 2(4):208–213

    Article  PubMed  PubMed Central  Google Scholar 

  2. Pesis M, Bar-Droma E, Ilgiyaev A, Givol N (2019) Deep Neck Infections are life threatening infections of dental origin: a presentation and management of selected cases. Isr Med Assoc J 21(12):806–811

    PubMed  Google Scholar 

  3. Boffano P, Roccia F, Pittoni D, Di Dio D, Forni P, Gallesio C (2012) Management of 112 hospitalized patients with spreading odontogenic infections: correlation with DMFT and oral health impact profile 14 indexes. Oral Surg Oral Med Oral Pathol Oral Radiol 113(2):207–213

    Article  PubMed  Google Scholar 

  4. Eckert AW, Maurer P, Wilhelms D, Schubert J (2005) Bacterial spectra and antibiotics in odontogenic infections. Renaissance of the penicillins? Mund Kiefer Gesichtschir 9(6):377–83

    Article  PubMed  Google Scholar 

  5. Heim N, Faron A, Wiedemeyer V, Reich R, Martini M (2017) Microbiology and antibiotic sensitivity of head and neck space infections of odontogenic origin. Differences in inpatient and outpatient management. J Craniomaxillofac Surg. 45(10):1731–5

    Article  PubMed  Google Scholar 

  6. Poeschl PW, Crepaz V, Russmueller G, Seemann R, Hirschl AM, Ewers R (2011) Endodontic pathogens causing deep neck space infections: clinical impact of different sampling techniques and antibiotic susceptibility. J Endod 37(9):1201–1205

    Article  PubMed  Google Scholar 

  7. Stefanopoulos PK, Kolokotronis AE (2004) The clinical significance of anaerobic bacteria in acute orofacial odontogenic infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98(4):398–408

    Article  PubMed  Google Scholar 

  8. Eckert AW, Höhne C, Schubert J (2000) Pathogen spectrum and resistance status of exclusively anaerobic odontogenic infections. Mund Kiefer Gesichtschir 4(3):153–158

    Article  PubMed  Google Scholar 

  9. Huang TT, Tseng FY, Yeh TH, Hsu CJ, Chen YS (2006) Factors affecting the bacteriology of deep neck infection: a retrospective study of 128 patients. Acta Otolaryngol 126(4):396–401

    Article  PubMed  Google Scholar 

  10. Ridder GJ, Technau-Ihling K, Sander A, Boedeker CC (2005) Spectrum and management of deep neck space infections: an 8-year experience of 234 cases. Otolaryngol Head Neck Surg 133(5):709–714

    Article  PubMed  Google Scholar 

  11. Siqueira JF, Rôças IN (2013) Microbiology and treatment of acute apical abscesses. Clin Microbiol Rev 26(2):255–273

    Article  PubMed  PubMed Central  Google Scholar 

  12. Rega AJ, Aziz SR, Ziccardi VB (2006) Microbiology and antibiotic sensitivities of head and neck space infections of odontogenic origin. J Oral Maxillofac Surg 64(9):1377–1380

    Article  PubMed  Google Scholar 

  13. Hawkey PM (2000) Mechanisms of resistance to antibiotics. Intensive Care Med 26(Suppl 1):9–13

    Article  Google Scholar 

  14. Lewis MA, Parkhurst CL, Douglas CW, Martin MV, Absi EG, Bishop PA et al (1995) Prevalence of penicillin resistant bacteria in acute suppurative oral infection. J Antimicrob Chemother 35(6):785–791

    Article  PubMed  Google Scholar 

  15. Heim N, Berger M, Wiedemeyer V, Reich R, Martini M (2019) A mathematical approach improves the predictability of length of hospitalization due to acute odontogenic infection: a retrospective investigation of 303 patients. J Craniomaxillofac Surg 47(2):334–340

    Article  PubMed  Google Scholar 

  16. Poeschl PW, Spusta L, Russmueller G, Seemann R, Hirschl A, Poeschl E et al (2010) Antibiotic susceptibility and resistance of the odontogenic microbiological spectrum and its clinical impact on severe deep space head and neck infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 110(2):151–156

    Article  PubMed  Google Scholar 

  17. Parhiscar A, Har-El G (2001) Deep neck abscess: a retrospective review of 210 cases. Ann Otol Rhinol Laryngol 110(11):1051–1054

    Article  PubMed  Google Scholar 

  18. Kim MK, Nalliah RP, Lee MK, Allareddy V (2012) Factors associated with length of stay and hospital charges for patients hospitalized with mouth cellulitis. Oral Surg Oral Med Oral Pathol Oral Radiol 113(1):21–28

    Article  PubMed  Google Scholar 

  19. Peters ES, Fong B, Wormuth DW, Sonis ST (1996) Risk factors affecting hospital length of stay in patients with odontogenic maxillofacial infections. J Oral Maxillofac Surg. 54(12):1386–91 (discussion 91-2)

    Article  PubMed  Google Scholar 

  20. Celakovsky P, Kalfert D, Smatanova K, Tucek L, Cermakova E, Mejzlik J et al (2015) Bacteriology of deep neck infections: analysis of 634 patients. Aust Dent J 60(2):212–215

    Article  PubMed  Google Scholar 

  21. Doll C, Carl F, Neumann K, Voss JO, Hartwig S, Waluga R et al (2018) Odontogenic abscess-related emergency hospital admissions: a retrospective data analysis of 120 children and young people requiring surgical drainage. Biomed Res Int 2018:3504727

    Article  PubMed  PubMed Central  Google Scholar 

  22. Zirk M, Buller J, Goeddertz P, Rothamel D, Dreiseidler T, Zöller JE et al (2016) Empiric systemic antibiotics for hospitalized patients with severe odontogenic infections. J Craniomaxillofac Surg 44(8):1081–1088

    Article  PubMed  Google Scholar 

  23. Fleming P, Feigal RJ, Kaplan EL, Liljemark WF, Little JW (1990) The development of penicillin-resistant oral streptococci after repeated penicillin prophylaxis. Oral Surg Oral Med Oral Pathol 70(4):440–444

    Article  PubMed  Google Scholar 

  24. Bush K, Jacoby GA (2010) Updated functional classification of beta-lactamases. Antimicrob Agents Chemother 54(3):969–976

    Article  PubMed  Google Scholar 

  25. Flynn TR, Shanti RM, Levi MH, Adamo AK, Kraut RA, Trieger N (2006) Severe odontogenic infections, part 1: prospective report. J Oral Maxillofac Surg 64(7):1093–1103

    Article  PubMed  Google Scholar 

  26. Sato FR, Hajala FA, Freire Filho FW, Moreira RW, de Moraes M (2009) Eight-year retrospective study of odontogenic origin infections in a postgraduation program on oral and maxillofacial surgery. J Oral Maxillofac Surg 67(5):1092–1097

    Article  PubMed  Google Scholar 

  27. Diz Dios P, Tomás Carmona I, Limeres Posse J, Medina Henríquez J, Fernández Feijoo J, Alvarez FM (2006) Comparative efficacies of amoxicillin, clindamycin, and moxifloxacin in prevention of bacteremia following dental extractions. Antimicrob Agents Chemother 50(9):2996–3002

    Article  PubMed  PubMed Central  Google Scholar 

  28. Morganroth J, Wang Y, Thorn M, Kumagai Y, Harris S, Stockbridge N et al (2015) Moxifloxacin-induced QTc interval prolongations in healthy male Japanese and Caucasian volunteers: a direct comparison in a thorough QT study. Br J Clin Pharmacol 80(3):446–459

    Article  PubMed  PubMed Central  Google Scholar 

  29. Täubel J, Prasad K, Rosano G, Ferber G, Wibberley H, Cole ST et al (2020) Effects of the fluoroquinolones moxifloxacin and levofloxacin on the QT subintervals: sex differences in ventricular repolarization. J Clin Pharmacol 60(3):400–408

    Article  PubMed  Google Scholar 

  30. Gorelik E, Masarwa R, Perlman A, Rotshild V, Abbasi M, Muszkat M et al (2019) Fluoroquinolones and cardiovascular risk: a systematic review, meta-analysis and network meta-analysis. Drug Saf 42(4):529–538

    Article  PubMed  Google Scholar 

  31. Meng L, Huang J, Jia Y, Huang H, Qiu F, Sun S (2019) Assessing fluoroquinolone-associated aortic aneurysm and dissection: data mining of the public version of the FDA adverse event reporting system. Int J Clin Pract 73(5):e13331

    Article  PubMed  Google Scholar 

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Funding

The study was funded by the Department of Oral & Maxillofacial Surgery, Medical University of Vienna, Austria.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Campus Virchow-Klinikum, Charité – University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Simon Bigus

  2. Department of Oral and Maxillofacial Surgery, University Hospital Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria

    Günter Russmüller

  3. Department of Laboratory Medicine, University Hospital Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria

    Peter Starzengruber

  4. Austrian Public Health Insurance, Wienerbergstrasse 13, 1100, Vienna, Austria

    Hannah Reitter

  5. Linz, Austria

    Christoph Lukas Sacher

Authors
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  4. Hannah Reitter
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  5. Christoph Lukas Sacher
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Contributions

Simon Bigus wrote the main manuscript text, compiled the statistics, and prepared all figures and tables. Günter Russmüller made preliminary corrections. Peter Starzengruber wrote about culture and susceptibility testing. Hannah Reitter collected all the data. Christoph Lukas Sacher conceived the idea, wrote the application for the ethics committee, and edited the manuscript. All five authors reviewed the manuscript.

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Competing interests

The authors declare no competing interests.

Ethical approval

This paper does not include any studies with human participants or animals conducted by any of the authors. The Ethics Committee of the Medical University of Vienna, Austria, has reviewed our research proposal and has granted us permission to analyze the data. (EK—Nr: 1783/2019).

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The authors declare no competing interests.

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Bigus, S., Russmüller, G., Starzengruber, P. et al. Antibiotic resistance of the bacterial spectrum of deep space head and neck infections in oral and maxillofacial surgery — a retrospective study. Clin Oral Invest 27, 4687–4693 (2023). https://doi.org/10.1007/s00784-023-05095-y

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  • DOI: https://doi.org/10.1007/s00784-023-05095-y

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