Aerobic bacterial agents and antibiotic Sensitivity of post-surgical orofacial Infections at the Kenyatta national Hospital and university of Nairobi dental Hospital

Abstract

Main objective: The aim of this study was to determine the aerobic bacterial agents and antibiotic sensitivity of post-surgical infections in the orofacial region. Methodology: clinical case evaluation and laboratory investigation of microbial sensitivity to antibiotics. Clinical methods: Patients were evaluated for post-surgical wound infection from the 5th post-operative day up to the 30th post-operative day unless a surgical implant was in situ when the period was extended to up to a year. The specimens were collected using sterile swabs and transported to the microbiology laboratory within 2 hours of collection. Laboratory methods: The specimens were then analysed 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 (Bauer-Kirby procedure, using CLSI protocols). Results: Both gram-negative and positive bacteria were isolated. Staphylococcus aureus formed 40% of the isolates followed by Klebsiella species (23%) and the Pseudomonas species (l9%).Amoxycillin/clavulinic acid, the 2nd and 3rd generation cephalosporins were effective against most of the bacteria. Enterobacteriaceae showed high susceptibility to levofloxacin and carbapenems. The Pseudomonas species was highly susceptible to the 3rd generation cephalosporins and carbapenems. Conclusion: The bacteria isolated in the infected surgical site wounds in the oro-facial region are Staphylococcus aureus, Klebsiella species, and Pseudomonas species with augmented penicillins and newer generations of cephalosporins still being effective against them.Cabapenems remained highly effective against a large variety of bacteria.