Metronidazole Resistance in Anaerobes Isolated from Patient with Oral and Maxillofacial Infections Attending Muhimbili National Hospital, Dar-Es-Salaam, Tanzania

Abstract

Background: Oro-facial infections, mostly bacterial infections, are among the most commonly encountered problems in the oral and maxillofacial surgical practice world over. These infections if not properly diagnosed and treated usually result in significant morbidity and are often fatal. The infection is caused by both aerobic and anaerobic microorganism where as treatment is given using broad spectrum antibiotics mostly common combination of Amoxicillin and Metronidazole. Metronidazole is commonly targeted drug for anaerobes, however recently the anaerobes have shown resistance to this drug. The aim of this study was to isolate and identify anaerobes associated with oral and maxillofacial infection and their susceptibility pattern to Metronidazole in patients attending Muhimbili National Hospital, Dar-es-salaam, Tanzania.Method: Seventy (70) samples were collected from patients with various forms of oral facial and infections that consented and were recruited for the study. The samples were processed for isolation and identification of bacteria as per standard microbiological techniques. The antimicrobial susceptibility was done by E-test (Biomerieux) methods as per CLSI guidelines.Results: Anaerobes were isolated in 83% of oral and maxillofacial cases. Anaerobes were found to be over 99% sensitive to metronidazole while some isolated showed approximately 40% resistance to Metronidazole. Majority of isolated anaerobes display good sensitivity. Conclusion:Resistance to Metronidazole observed in this study and also presence of anaerobes in these patients showed that there is a need to isolate anaerobes especially in patient with severe oral and maxillofacial infections and study their antimicrobial susceptibility pattern for better management.

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“…This finding is in conflict with some studies which have found it effective in treating anaerobic infections including skin and soft tissues [ 52 ]. However, in Tanzania, metronidazole had a questionable activity in treating wound infection when compared to other studies, especially in bacteria isolated from the head and neck and other parts of the body [ 53 ].…”