Bacteriological Study Of Oral And Maxillofacial Infections With Special Reference To Anaerobes

Abstract

INTRODUCTION: Most of the Oral and Maxillofacial infections are of odontogenic origin which arises as a sequel to caries, trauma and peridontitis. Morbidity seen with it shows how an ignored or ill treated decayed tooth can turn into a life threatening condition. Bacteriological flora of these infections are considered to be mixed with both aerobes and anaerobes. OBJECTIVE: 1. To isolate and identify aerobes and anaerobes from oral and maxillofacial infections. 2. To perform antibiotic susceptibility pattern of the isolates from oral and maxillofacial infections. MATERIALS AND METHODS: The study was carried out from January 2012- December 2012 in the Department of Microbiology, Jawaharlal Nehru Medical College, Belgaum. The study was conducted on 50 patients who had moderate to severe oral and maxillofacial infection with abscess in the orofacial region. Pus was aspirated and collected in freshly prepared thioglycollate broth. Isolation, Identification of aerobes and anaerobes was done employing standard bacteriological methods. Antibiotic susceptibility of anaerobes was carried out by using agar dilution methods. RESULTS: Among the 50 cases, 33(66%) were females and 17 (34%) males. Submandibular space was most commonly involved 23 (46%) followed by buccal space in 10 (20%). Polymicrobial infection was present in majority of cases 36 (72%) as compared to monomicrobial 14 (28%).Mixed infection involving both aerobes and anaerobes was present in 27 (54%) cases. Out of total 41 (75.9%) anaerobic isolates, anaerobic streptococci was most common anaerobes (44%) followed by Porphyromonas (16.27%). Among aerobic isolates Staphylococcus aureus was the commonest aerobes 16 (39%) followed by Streptococcus pyogens 9 (21.9%). All anaerobic isolates were found to be sensitive to metronidazole with MIC range of 0.5-2μ/ml. While 28 (65.11%) anaerobic isolates were sensitive to clindamycin and 6 (13.9%) resistant. CONCLUSION: Microbiological flora of orofacial abscess consists of complex mixture of aerobic and anaerobic bacteria and polymicrobial in nature. Aerobic isolates had a high sensitivity to Ciprofloxocin, Amoxyclave and cephalosporins. All anaerobic isolates was found to be sensitive to metronidazole while 28 (65.11%) were susceptible to clindamycin. As anaerobes are emerging as major causes of oral and maxillofacial infections, their identification and antibiotic susceptibility have assumed importance. The emergence of resistance pattern in anaerobes as reported by many studies is also reflected in this study. Hence knowing the susceptibility pattern of these pathogenic bacteria will help in appropriate and effective treatment and thereby prevent complications.