Evaluation of Antibiotic Sensitivity in Deep Neck Space Infections

G. Singhal, P. Nayak, V. Padiyar, Kanwar Sen, S. Shrivastava
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Abstract

Abstract Background  Deep neck space infections (DNIs) are a major medical concern in the Indian community. Owing to the complex anatomy of the neck spaces and their communication with each other, accurate diagnosis becomes challenging. A thorough knowledge of the anatomy as well as the microbiological profile and antibiotic sensitivity is imperative to institute the appropriate surgical and medical management to the patient. Due to the advent of broad-spectrum antibiotics, the incidence of these infections have declined considerably over the last couple of decades. However, due to the extensive and unregulated use, the incidence of antibiotic resistance has also been increasing at an alarming pace. Materials and Methods  This cross-sectional observational study was conducted in the Department of Otorhinolaryngology at a tertiary care government hospital in an urban area. All patients who presented to the OPD or emergency over a period of 18 months and who fulfilled the eligibility criteria were included in the study. Pus was collected from the abscess, aseptically by needle aspiration using wide bore (18G) needle and transported under all aseptic measures within 24 hours for culture and sensitivity, KOH mount, and detection of AFB. Antibiotic sensitivity testing was done using the Kirby Bauer disc diffusion method and E-test. Results   Staphylococcus aureus as the most common infective organism followed by MRSA in the pediatric age group and Klebsiella pneumoniae in adults. Conclusion  Primary knowledge of individual antibiotic sensitivity is imperative to ensure prompt and adequate treatment of the patient with higher chances of complete resolution, concomitantly minimizing the risk of resistance. Inadequate and delayed treatment may lead to swift progression of the disease with significant morbidity and mortality.
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深颈间隙感染的抗生素敏感性评价
深颈间隙感染(DNIs)是印度社区的主要医疗问题。由于颈部空间的复杂解剖结构及其相互沟通,准确诊断变得具有挑战性。透彻的解剖学知识,以及微生物谱和抗生素敏感性是必要的,以建立适当的手术和医疗管理的病人。由于广谱抗生素的出现,这些感染的发生率在过去几十年里大大下降。然而,由于广泛和不受管制的使用,抗生素耐药性的发生率也以惊人的速度增加。材料和方法本横断面观察性研究在市区三级政府医院耳鼻咽喉科进行。所有在18个月内就诊于门诊或急诊并符合资格标准的患者都被纳入研究。从脓肿处收集脓液,采用宽孔(18G)针无菌抽吸,并在24小时内在所有无菌措施下运输,进行培养和敏感性、KOH mount和AFB检测。采用Kirby Bauer圆盘扩散法和e试验进行抗生素敏感性试验。结果儿童年龄组以金黄色葡萄球菌为主,其次为MRSA,成人以肺炎克雷伯菌为主。结论初步了解个体抗生素敏感性是确保患者及时、充分治疗的必要条件,从而提高患者完全治愈的机会,同时将耐药风险降至最低。治疗不充分和延误可能导致疾病的迅速进展,具有显著的发病率和死亡率。
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32
审稿时长
11 weeks
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