Microbial spectrum of head and neck space infections at the Maxillo-facial clinic at Livingstone hospital

Introduction and background Head and neck space infections remain one of the most commonly encountered conditions at Maxillo-Facial clinics, countrywide. These infections are regularly treated by antibiotics, surgical incision and drainage. Pus aspirates are a vital diagnostic tool, as they permit the micro-organism/s to be identified. This leads to the utilization of appropriate antibiotics, resulting in rapid recovery and shorter hospital stays by the patients. Objective The study was a review of the microbial spectrum of the head and neck space infections seen at the Maxillo Facial clinic at Livingstone Hospital in the Eastern Cape. The period of the study was from the 1 January 2012 to 31 December 2016. Materials and methods The result sheets of pus aspirates and swabs from patients presenting with head and neck space infection were analysed and information regarding age, gender, aetiology, fascial space involved, microorganisms isolated and antibiotic sensitivity was gathered. Results Aspirates and swabs were collected from a hundred and forty five patients. Most patients were males, between the ages of 21 – 40 years. The most common cause of head and neck infections was non-odontogenic in origin, while the fascial space most commonly implicated was the submandibular space. The principal microorganisms identified were gram positive facultative anaerobes.Bacteroides species and Staphylococcus aureus displayed sensitivity to clindamycin and amoxicillin with clavulanic acid. Viridans streptococci were sensitive to both penicillin and clindamycin. Conclusion Bacteroides species were the most commonly isolated bacteria, followed by Viridans streptococci and Staphylococcus aureus. Although Clindamycin was found to be effective against the most commonly isolated microorganisms in this study, this antibiotic should be reserved for severe penicillin resistant infections to curtail the increasing resistance reported in literature.
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Science in Dentistry: Oral Pathology Port Elizabeth, 2019