Identification of Aerobic Organisms Associated with Oral and Maxillofacial Surgery: a Study in Bangladesh

Abstract

Objective: To determine the predisposing factors for oral and maxillofacial infections, identify the causative organisms and establish the sensitivity patterns of isolated pathogens in patients undergoing oral and maxillofacial surgery.Patients and Methods: 183 patients who underwent oral and maxillofacial surgeries were studied during the period between July 2004 and June 2006. Specimens were collected from the deepest part of the abscess using a sterile cotton swab, which was then kept in a sterile test tube, or using a disposable plastic syringe that was immediately transported to the laboratory for aerobic culture. Antimicrobial sensitivity testing was performed using the disc diffusion technique by Kirby-Bauer method.Results: Of the 183 patients with orofacial infections, 82 (44.8%) were positive for pathogens on culture. The predominant pathogens isolated belonged to the Streptococcus species (42; 51.2%; apart from Streptococcus pneumoniae [2; 2.4%]) followed by Staphylococcus aureus (15; 18.3%), Pseudomonas species (12; 14.6%), Escherichia coli (6; 7.3%), and Proteus species (5; 6.1%). Of the 42 strains of streptococci, 14 strains belonged to viridans streptococci (33.3%), 11 to Group G (26.2%), 10 to Group A (23.8%), and 7 to Group C (16.7%). Of the 9 antibiotics tested, penicillin, amoxicillinclavulanic acid, and ciprofloxacin had excellent activities against the isolates.Conclusion: Streptococcus species and Staphylococcus aureus were the main causative organisms of oral and maxillofacial infections. Low socioeconomic status and poor oral hygiene were the key predisposing factors for orofacial morbidity. Penicillin and amoxicillin-clavulanic acid, as tested in the study, remain the drugs of choice for infections following oral and maxillofacial surgery.