Original Article

The clinico-microbiological pattern of orofacial space infections in patients attending a tertiary hospital in Tanzania


Emmanuel Festo Motega1, Jeremiah Robert Moshy2, Sima E. Rugarabamu3, Karpal Singh Sohal2, Sira Stanslaus Owibingire2

1Dental Department, Bugando Medical Centre, Mwanza, Tanzania
2Department of Oral and Maxillofacial Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
3Department of Immunology and Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania


Abstract


Background: Fascial space infections in the orofacial region have plagued humans for centuries. The majority of these infections are of odontogenic origin and are polymicrobial in nature. This study aimed at determining the clinical and microbiological pattern of orofacial space infections in patients attending a tertiary hospital in Tanzania.
Methods: This was a cross-sectional hospital-based study that included patients with pyogenic orofacial space infections. Data on the demographic pattern of the patients, clinical presentations of the disease, and results of culture and sensitivity tests were collected. For analysis, when more than two spaces were involved, the case was classified as multiple space infection. The number of microbial isolates was grouped into no isolate, monomicrobial, and polymicrobial. The significance level was set at p <0.05.
Results: The study consisted of 60 patients of whom 51.7% were males. The mean age was 33 17.3 years. A painful swelling was the chief complaint of the majority of patients. Odontogenic causes of fascial space infection accounted for the majority (81.7%) of the cases. In most (66.7%) patients, multiple fascial spaces were involved, and the submandibular space was the frequently affected space. The most frequently isolated microbes were Streptococcus viridans and coagulase-negative Staphylococcus. The drug susceptibility test of different isolates to antibiotic agents revealed that clindamycin and amoxicillin + clavulanate were effective against both aerobes and anaerobes.
Conclusions: The young individuals and males were more affected. Most of the fascial space infections affect multiple spaces, commonly submandibular space. Streptococcus viridans and coagulase-negative Staphylococcus have frequently encountered isolates. Clindamycin was the most effective drug with a wide spectrum of activity against both aerobes and anaerobes.

Keywords: abscess; antimicrobial; orofacial; Tanzania