Anaerobic bacteria in dentoalveolar infections.
ABSTRACT The bacteriology of 57 dentoalveolar infections was studied using optimal techniques to collect, transport and process specimens. There was an average of 4 bacterial species per specimen, and only 1/3 of the specimens held aerobes. Among the aerobic bacteria, streptococci dominated and among the anaerobes the Gram-negative rods, Bacteroides ruminicola and Fusobacterium nucleatum, were most frequently isolated followed by Gram-positive cocci, in particular Streptococcus intermedius. All aerobic isolates were resistant to penicillins but sensitive to clindamycin and tinidazole. The other anaerobic isolates were sensitive to penicillins but showed varying susceptibility to erythromycin and doxycycline. Tinidazole was effective against all anaerobic Gram-negative rods. The presence of volatile fatty acids in pus from dentoalveolar infections was found to be of presumptive value for the diagnosis of anaerobic infections. Direct gas-liquid chromatographic analysis of pus is recommended as a routine procedure for preliminary diagnosis of anaerobic dentoalveolar infections.
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ABSTRACT: Spreading odontogenic infections (SOI) are the commonest type of serious infections encountered in the orofacial region. A prospective multi-centre study was conducted in the West of Scotland to investigate the contributing role of social, systemic and microbial factors in the pathogenesis of SOI. Twenty-five patients with severe odontogenic infections were recruited over a period of six months. At admission, clinical assessment included temperature rise, haematological and biochemical investigations. Demographic data, social and past medical histories were obtained. Microbiology samples were collected to identify causative microorganisms and the clinical management of each infection was recorded. Most infections were associated with teeth or roots. Eighty percent of the patients were tobacco smokers and 72% came from deprived areas. Five patients were intravenous drug users, four admitted chronic alcohol abuse, six had underlying systemic disorders and two were at high risk of malnutrition. A raised C-reactive protein at admission was a useful indicator of the severity of infection. Inappropriate prior antibiotic treatment in the absence of surgical drainage was common. Microbiology results showed a predominance of strict anaerobes, notably anaerobic streptococci, Prevotella and Fusobacterium species. SOIs remain surprisingly common and our present pilot study showed a particular association with social deprivation and tobacco smoking. Further elucidation of the role of malnutrition in SOI would be of interest. Molecular characterisation of the microflora associated with SOI may help to highlight whether bacterial factors play a role in converting a localised dentoalveolar abscess into a serious, spreading odontogenic infection.Sultan Qaboos University medical journal 12/2009; 9(3):296-304.
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ABSTRACT: This paper aim to assess the anatomical spaces of head and neck region and causative microorganisms responsible for infections, evaluate the resistance of antibiotics used in treatment and compare the findings with previously reported microbial flora in the orofacial infection. Forty-two patients were recorded. All underwent surgical incision and drainage, received antibiotics cover, and had culture and sensitivity test performed for gram positive and gram negative aerobes. There were 33 male (78.57 %) and 9 female (21.42 %). Out of the 42 patients 28 (66.66 %) presented with single space involvement. The submandibular space was the most frequent location for single space abscess (28.12 %). Fourteen patients presented with multiple space involvement, with a total of 64 spaces being involved. Forty microorganisms were isolated. There were 28 aerobes and 10 anaerobes. Two fungi were also identified. The most common bacteria isolated were Staphylococcus aureus, Klebsiella, Escherichia coli, Peptostreptococcus. The key issue here, which needs to be remembered, is that antibiotics alone cannot resolve odontogenic infection satisfactorily. Quick recovery of patients results with proper basic management comprising of early drainage/decompression which is equally important.Journal of Maxillofacial and Oral Surgery 03/2014;
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ABSTRACT: Purpose: To detect predominant bacteria associated with radicular cysts and discuss in light of the literature. Clinical materials were obtained from 35 radicular cysts by aspiration. Cultures were made from clinical materials by modern laboratory techniques, they underwent microbiologic analysis. The following are microorganisms isolated from cultures: Streptococcus milleri Group (SMG) (23.8%) [Streptococcus constellatus (19.1%) and Streptococcus anginosus (4.7%)], Streptococcus sanguis (14.3%), Streptococcus mitis (4.7%), Streptococcus cremoris (4.7%), Peptostreptococcus pevotii (4.7%), Prevotella buccae (4.7%), Prevotella intermedia (4.7%), Actinomyces meyeri (4.7%), Actinomyces viscosus (4.7%), Propionibacterium propionicum (4.7%), Bacteroides capillosus (4.7%), Staphylococcus hominis (4.7%), Rothia denticariosa (4.7%), Gemella haemolysans (4.7%), and Fusobacterium nucleatum (4.7%). Results of this study demonstrated that radicular cysts show a great variety of anaerobic and facultative anaerobic bacterial flora. It was observed that all isolated microorganisms were the types commonly found in oral flora. Although no specific microorganism was found, Streptococcus spp. bacteria (47.5%) -- especially SMG (23.8%) -- were predominantly found in the microorganisms isolated. Furthermore, radicular cysts might be polymicrobial originated. Although radicular cyst is an inflammatory cyst, some radicular cyst fluids might be sterile.Head & Face Medicine 09/2013; 9(1):25. · 0.98 Impact Factor