An analysis of contributing factors of head and neck space infections of odontogenic origin: A long-term retrospective clinical study (including COVID-19 pandemic period).

J Jung, Y Oh, S Cha, J Ohe
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Abstract

Background: The purpose of this study is to investigate predisposing factors for the head and neck infections (HNIs), regarding to the demographic data, anatomical spaces, microbiology and antibiotic sensitivity for affected patients.

Material and methods: A 13-year of retrospective study evaluating 470 patients with HNIs, treated as inpatient management in the Department of Oral and Maxillofacial Surgery of KyungHee University school of Dentistry, Seoul, Korea, from January 2009 to February 2022. Statistical analysis of demographic, time-related, anatomic, microbiologic, and treatment variables were investigated for each patient.

Results: The frequency of HNIs was significantly higher in 50's in males, followed by 70's in females. High Severity score (SS) were significantly associated with increased LOH (Length of hospital stay) and LOM (Length of medication), while LOH showed more intensive relationship compared with LOM. The most frequently involved space in abscess was submandibular space, though incidence and severity of HNIs shows declining tendency throughout 13-year research. Streptococcus viridans was the most predominant species isolated from pus culture growth, and a combination of ampicillin and sulbactam was the 1st choice of antibiotics intravenously. According to the comparison analysis between recommended antibiotics from resistance testing result and clinically administered antibiotics, final coincidence rate was estimated about 55%.

Conclusions: Due to HNIs being multifactorial, predicting progression and management of HNIs is still a challenge for oral and maxillofacial surgeons. The present study showed several predisposing factors of SHNIs and their correlations, which could contribute to earlier diagnosis and more effective treatment planning for clinicians, thereby leading to the improvement of prognosis for patients, ultimately.

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牙源性头颈部间隙感染的诱因分析:一项长期回顾性临床研究(包括新冠肺炎大流行期)。
背景:本研究的目的是从人口统计学数据、解剖空间、微生物学和受影响患者的抗生素敏感性等方面调查头颈部感染(HNIs)的易感因素。材料和方法:一项为期13年的回顾性研究,评估了2009年1月至2022年2月在韩国首尔庆熙大学牙科学院口腔颌面外科接受住院管理的470名HNI患者。对每位患者的人口学、时间相关、解剖学、微生物学和治疗变量进行统计分析。结果:HNIs的发生频率在男性50岁时明显较高,其次是女性70岁。高严重程度评分(SS)与LOH(住院时间)和LOM(用药时间)的增加显著相关,而与LOM相比,LOH表现出更密切的关系。脓肿最常累及的间隙是下颌下间隙,尽管在13年的研究中,HNIs的发生率和严重程度呈下降趋势。绿色链球菌是从脓液培养生长中分离出的最主要的菌种,氨苄青霉素和舒巴坦联用是静脉注射抗生素的首选。根据耐药性检测结果推荐的抗生素与临床使用的抗生素的比较分析,最终符合率估计约为55%。结论:由于HNIs是多因素的,预测HNIs的进展和管理仍然是口腔颌面外科医生的挑战。本研究显示了SHNIs的几个易感因素及其相关性,这有助于临床医生早期诊断和更有效的治疗计划,从而最终改善患者的预后。
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来源期刊
CiteScore
4.50
自引率
0.00%
发文量
52
期刊介绍: 1. Oral Medicine and Pathology: Clinicopathological as well as medical or surgical management aspects of diseases affecting oral mucosa, salivary glands, maxillary bones, as well as orofacial neurological disorders, and systemic conditions with an impact on the oral cavity. 2. Oral Surgery: Surgical management aspects of diseases affecting oral mucosa, salivary glands, maxillary bones, teeth, implants, oral surgical procedures. Surgical management of diseases affecting head and neck areas. 3. Medically compromised patients in Dentistry: Articles discussing medical problems in Odontology will also be included, with a special focus on the clinico-odontological management of medically compromised patients, and considerations regarding high-risk or disabled patients. 4. Implantology 5. Periodontology
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