Prevalence and Antimicrobial Resistance of Deep Neck Space Infections (DNSIs) in Patients at Combined Military Hospital (CMH), Muzaffarabad, Azad Jammu & Kashmir

Abstract

Abstract: Background: Deep neck infections are one of the major threats for cellulitis and abscess in the head and neck region which may have various origins. Therefore, it is required to have microbes identified and anti-microbial sensitivity to be established which may lead to better therapeutic decisions and patient outcomes.

Objective: This study aimed to determine the clinical presentation, the bacterial agents involved, and the antimicrobial sensitivity patterns of microorganisms associated with DNSI in our hospital patients.

Materials and Methods: A cross-sectional study was conducted at the ENT department of Combined Military Hospital, Muzaffarabad, from April to October 2022 (Ethical Approval No. DME-469). The 115 patients, aged between 18 and 60 years, who were of DNSI, were included in the study. Data collection involved detailed patient history, a physical examination, a microbiological study of pus, and a CT scan. In terms of the data analysis, SPSS was utilized.

Result: Mean age of patients included were 39.8 ± 12.1 years with male to female ration being 1.6:1. Symptoms that were most frequently reported in the cases with dysphagia (29.6%) and sore throat (29.6%). The preferred site of abscess formation was the parapharynx (38.3%). Streptococci were the predominant isolates (40%) to be recovered from the patients, followed by anaerobes (30.4%) and Staphylococci (29.6%). The isolates were highly susceptible to the combination of amoxicillin/clavulanic acid and chloramphenicol.

Conclusion: This study emphasizes that Streptococcus is the most frequently encountered pathogen for DNSI and therefore, early diagnosis and targeted antibiotic therapy of DNSI are very important. It is recommended to use the empirical treatment of amoxicillin/clavulanic acid or chloramphenicol.