Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
권호 표지
DOI QR코드

DOI QR Code

A comparative analysis of odontogenic maxillofacial infections in diabetic and nondiabetic patients: an institutional study

  • Kamat, Rahul D. (Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital) ;
  • Dhupar, Vikas (Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital) ;
  • Akkara, Francis (Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital) ;
  • Shetye, Omkar (Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital)
  • Received : 2015.01.20
  • Accepted : 2015.03.21
  • Published : 2015.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: The increased prevalence of antibiotic resistance is an outcome of evolution. Most patients presenting with odontogenic space infections also have associated systemic co-morbidities such as diabetes mellitus resulting in impaired host defense. The present study aims to compare the odontogenic spaces involved, antibiotic susceptibility of microorganisms, length of hospital stay, and the influence of systemic comorbidities on treatment outcome in diabetic patients. Materials and Methods: A 2-year prospective study from January 2012 to January 2014 was conducted on patients with odontogenic maxillofacial space infections. The patients were divided into two groups based on their glycemic levels. The data were compiled and statistically analyzed. Results: A total of 188 patients were included in the study that underwent surgical incision and drainage, removal of infection source, specimen collection for culture-sensitivity, and evaluation of diabetic status. Sixty-one out of 188 patients were found to be diabetic. The submandibular space was the most commonly involved space, and the most prevalent microorganism was Klebsiella pneumoniae in diabetics and group D Streptococcus in the nondiabetic group. Conclusion: The submandibular space was found to be the most commonly involved space, irrespective of glycemic control. Empiric antibiotic therapy with amoxicillin plus clavulanic acid combined with metronidazole with optimal glycemic control and surgical drainage of infection led to resolution of infection in diabetic as well as nondiabetic patients. The average length of hospital stay was found to be relatively longer in diabetic individuals.

Keywords

References

  1. Storoe W, Haug RH, Lillich TT. The changing face of odontogenic infections. J Oral Maxillofac Surg 2001;59:739-48. https://doi.org/10.1053/joms.2001.24285
  2. Rao DD, Desai A, Kulkarni RD, Gopalkrishnan K, Rao CB. Comparison of maxillofacial space infection in diabetic and nondiabetic patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110:e7-12.
  3. Delamaire M, Maugendre D, Moreno M, Le Goff MC, Allannic H, Genetet B. Impaired leucocyte functions in diabetic patients. Diabet Med 1997;14:29-34. https://doi.org/10.1002/(SICI)1096-9136(199701)14:1<29::AID-DIA300>3.0.CO;2-V
  4. Alexander M, Krishnan B, Shenoy N. Diabetes mellitus and odontogenic infections--an exaggerated risk? Oral Maxillofac Surg 2008;12:129-30. https://doi.org/10.1007/s10006-008-0118-4
  5. Topazian RG, Goldberg MH, Hupp JR. Oral and maxillofacial infections. 4th ed. Philadelphia, PA: W.B. Saunders; 2002.
  6. Huang TT, Tseng FY, Yeh TH, Hsu CJ, Chen YS. Factors affecting the bacteriology of deep neck infection: a retrospective study of 128 patients. Acta Otolaryngol 2006;126:396-401. https://doi.org/10.1080/00016480500395195
  7. Lee JK, Kim HD, Lim SC. Predisposing factors of complicated deep neck infection: an analysis of 158 cases. Yonsei Med J 2007; 48:55-62. https://doi.org/10.3349/ymj.2007.48.1.55
  8. Zheng L, Yang C, Kim E, Zhang W, Cai X, Jiang B, et al. The clinical features of severe multi-space infections of the head and neck in patients with diabetes mellitus compared to non-diabetic patients. Br J Oral Maxillofac Surg 2012;50:757-61. https://doi.org/10.1016/j.bjoms.2012.01.019
  9. Woods R. An assessment of antibiotics for the treatment of pyogenic dental infections. Aust Dent J 1975;20:10-3. https://doi.org/10.1111/j.1834-7819.1975.tb03508.x
  10. Barlett JG. Anaerobes in human infections. In: Finegold SM, ed. Metronidazole proceedings. Amsterdam: Excerpta Medica; 1977.
  11. Rega AJ, Aziz SR, Ziccardi VB. Microbiology and antibiotic sensitivities of head and neck space infections of odontogenic origin. J Oral Maxillofac Surg 2006;64:1377-80. https://doi.org/10.1016/j.joms.2006.05.023
  12. McManus LM, Bloodworth RC, Prihoda TJ, Blodgett JL, Pinckard RN. Agonist-dependent failure of neutrophil function in diabetes correlates with extent of hyperglycemia. J Leukoc Biol 2001;70: 395-404.
  13. Stoeckle M, Kaech C, Trampuz A, Zimmerli W. The role of diabetes mellitus in patients with bloodstream infections. Swiss Med Wkly 2008;138:512-9.
  14. Wang J, Ahani A, Pogrel MA. A five-year retrospective study of odontogenic maxillofacial infections in a large urban public hospital. Int J Oral Maxillofac Surg 2005;34:646-9. https://doi.org/10.1016/j.ijom.2005.03.001
  15. Chang JS, Yoo KH, Yoon SH, Ha J, Jung S, Kook MS, et al. Odontogenic infection involving the secondary fascial space in diabetic and non-diabetic patients: a clinical comparative study. J Korean Assoc Oral Maxillofac Surg 2013;39:175-81. https://doi.org/10.5125/jkaoms.2013.39.4.175
  16. Chang CM, Lu FH, Guo HR, Ko WC. Klebsiella pneumoniae fascial space infections of the head and neck in Taiwan: emphasis on diabetic patients and repetitive infections. J Infect 2005;50:34-40. https://doi.org/10.1016/j.jinf.2003.11.014
  17. Peralta G, Sasnchez MB, Roiz MP, Garrido JC, Teira R, Mateos F. Diabetes does not affect outcome in patients with Enterobacteriaceae bacteremia. BMC Infect Dis 2009;9:94. https://doi.org/10.1186/1471-2334-9-94
  18. Krishnan V, Johnson JV, Helfrick JF. Management of maxillofacial infections: a review of 50 cases. J Oral Maxillofac Surg 1993;51: 868-73; discussion 873-4. https://doi.org/10.1016/S0278-2391(10)80105-3

Cited by

  1. Severe odontogenic infection: An emergency. Case report vol.9, pp.2, 2015, https://doi.org/10.4317/jced.53308
  2. Outcome of Odontogenic Infections in Rural Setup: Our Experience in Management vol.19, pp.1, 2015, https://doi.org/10.1007/s12663-019-01232-x
  3. Length of hospital stay among oral and maxillofacial patients: a retrospective study vol.47, pp.1, 2021, https://doi.org/10.5125/jkaoms.2021.47.1.25
  4. Redrainage in odontogenic orofacial infections: Risk factors and analysis vol.133, pp.1, 2015, https://doi.org/10.1016/j.oooo.2021.05.007