Antimicrobial Resistance and the Spectrum of Pathogens in Dental and Oral-Maxillofacial Infections in Hospitals and Dental Practices in Germany

Abstract

Data on microbiological profiles in odontogenic infections are scarce. This study aimed to analyze the spectrum of pathogens and antimicrobial resistance in clinical isolates from dental and oral-maxillofacial clinical settings in Germany. We analyzed 20,645 clinical isolates (dental practices: n = 5,733; hospitals: n = 14,912) from patients with odontogenic infections using data (2012–2019) from the German Antimicrobial-Resistance-Surveillance (ARS) system. A total of 224 different species from 73 genera were found in clinical isolates from dental practices, and 329 different species from 97 genera were identified in isolates from hospital patients. In both hospitals and dental practices Streptococcus spp. (33 and 36%, respectively) and Staphylococcus spp. (21 and 12%, respectively) were the most frequently isolated microorganisms. In Streptococcus spp. isolates from hospitals, penicillin and aminopenicillin resistance proportions were 8.0% (95%CI 4.7–14.9%) and 6.9% (95%CI 4.7–9.9%), respectively. Substantially lower resistance proportions of penicillin and aminopenicillin were observed in dental practices [2.6% (95%CI 1.4–4.7%) and 2.1% (95%CI 1.1–4.0%), respectively]. Among Staphylococcus aureus isolates from hospital patients methicillin resistance proportions were 12.0% (95%CI 9.7–14.8%), which was higher than in isolates from dental practices (5.8% (95%CI 4.1–8.1%)]. High clindamycin and macrolide resistance proportions (>17%) were observed in Streptococcus spp. and Staphylococcus aureus isolates. In Klebsiella spp. isolates carbapenem resistance proportions were <1%. In sum, substantial antibiotic resistance was observed in isolates from odontogenic infections, which calls for strengthened efforts in antibiotic stewardship and infection prevention and control measures in both hospitals and dental practices.

Phenotypic Characterization and Antibiogram of Non-Oral Bacteria Isolates from Patients Attending Dental Clinic at Federal College of Dental Technology and Therapy Medical Center Enugu

“…The increased carriage could be accrued to the inability to maintain or adhere to proper oral hygiene due to poor oral health. These results were similar to the high prevalence documented data in Germany 72.2% and India 77% [25,26] but varied from the low carriage rate reported in Chile 17.6%, Brazil 31.2%, Latin-American 34.4% [27,28,29] and in two studies 26.6% and 34.5% in Jos and Ogun state Nigeria [20,21]. The reasons for these observed variations can be accrued to the differences in the socio-economic status of the studied population, geographical regions, sample size, and method employed for bacteria characterization.…”

Staphylococcus aureus Isolated from the Oral Cavity: Phage Susceptibility in Relation to Antibiotic Resistance

“…Our Polish Reference Center for Staphylococci is a leading center for bacteriophage typing of S. aureus strains involved in various infections, with considerable achievements in this field [ 12 , 13 , 14 , 15 , 16 ]. Recently, the oral cavity has gained attention as a reservoir of antibiotic-resistant S. aureus strains and a source of their spread to other anatomical regions [ 17 , 18 , 19 ]. However, the knowledge of the sensitivity of oral S. aureus to bacteriophages and the potential therapeutic application of the latter are fairly limited.…”

Evaluation of Preventive Treatment Protocols for Patients under Antiresorptive Therapy Undergoing Tooth Extraction at a Swiss University Clinic

“…Geographical localization seems to play a significant role in this heterogeneity. For instance, Clindamycin remains one of the most frequently prescribed antibiotic agents in Germany and is part of the recommended list of antibiotics in the German AWMF guidelines, whereas in other countries, other antibiotic agents are more commonly used [13,16,27]. In addition, the co-administration of different antibiotic agents has been proposed for ARONJ prevention [13].…”