The changing face of odontogenic infections

Purpose: The purpose of this investigation was to compare characteristics o f patients hospitalized with odontogenic infections during the 1980s to tho se of the 1990s. Patients and Methods: This study was a retrospective record review that com pared 2 cohorts of patients admitted to the same institution during two 81- month periods, one decade apart. Admission criteria were face or neck swell ing suggesting abscess or cellulitis and one or more of the following: temp erature above 38 degreesC, white blood cell (WBC) count greater than 10.8 x 10(3)/muL, or concern about airway compromise. Characteristics reviewed we re age, gender, race, admission temperature, admission WBC count, fascial s pace(s) involved, tooth of etiology, duration of hospitalization, and bacte ria isolated. Data were compared for statistical significance (P < .05). Results: No significant differences were found between the 2 cohorts for ag e, gender, race, admission temperature, admission WBC count, space involvem ent, or length of stay (P < .05). One tooth (mandibular left first molar) o f 52 was involved more frequently in the 1990 group (P < .03), Gram-positiv e cocci were isolated significantly more frequently from the 1990s patients than from the 1980s patients (P < .03). There were also significant differ ences(P < .02) between cohorts in the isolation frequency of individual gen era, such as alpha-hemolytic Streptococci, coagulase negative staphylococci , Stapylococcus epidermidis, Bacteroides melanogenicus, beta-lactamase posi tive Bacteroides, Eikenella corrodens, and Neisseria species. Eighty-one pe rcent of the bacteria cultured from the 1990s patients were resistant to on e or more common antibiotics; 47% of these organisms were Staphylococcus au reus. Conclusion: No clinically significant differences existed in the characteri stics of patients hospitalized with odontogenic infections between the 1980 s and the 1990s. Although there were differences in the type and prevalence of bacteria isolated, this was probably a result of changes in nomenclatur e, identification protocols, and isolation techniques. (C) 2001 American As sociation of Oral and Maxillofacial Surgeons.