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Antibiotic Sensitivity Patterns of Aerobic Bacterial Agents in Post-Surgical Orofacial Infections

Barasa GB1, Butt F1, Onyango JF1, Mutua FM2, Dimba E1

  1. School of Dental Sciences, University of Nairobi

  2. School of Medicine, University of Nairobi

Correspondence to: Dr. Godfrey Bwire Barasa, P.O Box 66994-00200 Nairobi, Kenya. Email: bwire22@yahoo. Com



Background: There is no data on the bacteriology of postsurgical orofacial infections at our institutions. Uncontrolled use of antibiotics may lead to development of resistance with the resultant increase in morbidity and cost of treatment. We aimed to determine the aerobic bacterial agents and antibiotic sensitivity of post-surgical infections in the orofacial region.

Methodology: Patients were evaluated for post-surgical wound infection from the 5th to 30th post-operative day. In cases where a surgical implant was placed the period of review was extended for up twelve months. The specimens were collected using sterile swabs and transported to the microbiology laboratory within two hours of collection. The specimens were then analyzed for bacteriology according to the standard bacteriological techniques. A wide range of antibiotics including those commonly used to treat orofacial infections were tested for sensitivity against the isolates obtained using the disk diffusion test (Kirby-Bauer procedure, using CLSI protocols).

Results: Staphylococcus aureus accounted for 40% of the isolates followed by Klebsiella species (23%) and the Pseudomonas species (19%). Amoxycillin/clavulinic acid, the 2nd and 3rd generation cephalosporins were effective against most of the bacterial infections from the orofacial region.

Conclusion: Staphylococcus aureus, Klebsiella, and Pseudomonas species are the commonest isolates from the oral facial region. Antibiotics which showed adequate efficacy against them were the augmented Penicillins and newer generations Cephalosporins.

Key Words: Oro-facial infection, Post-surgical, Antibiotics

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Although antibiotics have played a major role in the treatment of infection, uncontrolled use has led to alarming rates of development of resistance with a resultant increase in morbidity and cost (1). One area where antibiotic use is often applied is in the control of post-operative wound infection. Although most prescriptions are usually on an empirical basis, regular culture and sensitivity tests should be undertaken to give guidelines on antibiotic regimes reasonable for empirical treatment as well as the updates on the prevailing sensitivity and resistance patterns within specific healthcare institutions. The ideal drug is that which is safe for that specific patient, specific to that infecting microorganism, readily available, affordable and can be given in a reliable and convenient form. The widely used Centre for Disease Control (CDC) and Prevention criteria define surgical site infections (SSIs) as infections related to the operative procedure that occurs at or near the surgical incision within 30 days of an operative procedure or within one year if an implant is left in place. The clinical criteria used to define SSI include any of the following: a purulent exudate draining from a surgical site, a positive fluid culture obtained from a surgical site that was closed primarily, the surgeon’s diagnosis of infection and a surgical site that requires reopening (2–4). Wound infection refers to the presence of replicating microorganisms within a wound that cause host injury. Features of an infected wound include increased exudate, swelling, erythema, pain, increased local temperature and peri-wound cellulitis (4). The aim of the study was to determine the aerobic bacterial agents and antibiotic