Bi-institutional analysis of microbiological spectrum and therapeutic management of parotid abscesses.

IF 2.4 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Head & Face Medicine Pub Date : 2024-07-12 DOI:10.1186/s13005-024-00438-w

Marcel Mayer, Julia Esser, Sarah Victoria Walker, Sami Shabli, Axel Lechner, Martin Canis, Jens Peter Klussmann, Lisa Nachtsheim, Philipp Wolber

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引用次数: 0

Abstract

Background: A parotid abscess (PA) is a complication of an acute bacterial parotitis with a potentially life-threatening course. To date, data on the diagnosis and therapy of PA is sparse and mostly consists of case reports or case series. Therefore, this study aimed at comprehensively analyzing the microbiological spectrum and the therapeutic management in a bi-institutional setting.

Methods: A retrospective clinical chart review was performed to identify all patients surgically treated for PA at two tertiary care centers in Germany. Data on demographics, clinical management and microbiological data including species identification, pathogenicity, type of antibiotic therapy, adjustment of antibiotics, antibiotic sensitivity testing, and smear test results were extracted. Intervention-related variables and etiology were analyzed for their statistical association with outcome variables.

Results: Overall, 85 patients were included. Most patients (92.9%) underwent surgical incision. Around half of the patients (45.9%) were treated under local anesthesia. No facial nerve palsy was observed. The most frequently detected pathogens were Streptococci (n = 23), followed by Staphylococcus aureus (n = 6) including one case of methicillin-resistant Staphylococcus aureus. Most patients (68.2%) received an aminopenicillin ± beta-lactamase inhibitor as empiric antibiotic therapy. In 6 cases the antibiotic therapy was modified after receiving the antibiogram. Four patients (5.2%) presented with recurrent PA. Etiology was idiopathic (42.4%), followed by tumorous (12.9%), obstructive, and immunosuppressive (each 11.8%). Patients with a dental focus (p = 0.007) had a longer duration of hospitalization.

Conclusion: The results show that the surgical therapy of PA under local anesthesia is safe. A dental examination should routinely be performed to rule out a dental focus. Obtaining a microbiological specimen in order to modify antibiotic therapy if necessary and a histopathological specimen to rule out a tumorous etiology is obligate.

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腮腺脓肿微生物谱和治疗方法的双机构分析。

背景：腮腺脓肿（PA）是急性细菌性腮腺炎的一种并发症，病程可能危及生命。迄今为止，有关腮腺脓肿诊断和治疗的数据很少，且大多为病例报告或系列病例。因此，本研究旨在全面分析双机构环境中的微生物谱和治疗方法：方法：对德国两家三级医疗中心所有接受过 PA 手术治疗的患者进行回顾性临床病历审查。提取了人口统计学、临床管理和微生物学数据，包括物种鉴定、致病性、抗生素治疗类型、抗生素调整、抗生素敏感性检测和涂片检测结果。对干预相关变量和病因与结果变量的统计学关联进行了分析：共纳入 85 名患者。大多数患者（92.9%）接受了手术切开。约半数患者（45.9%）在局部麻醉下接受治疗。未发现面神经麻痹。最常检测到的病原体是链球菌（23 例），其次是金黄色葡萄球菌（6 例），包括一例耐甲氧西林金黄色葡萄球菌。大多数患者（68.2%）接受了氨青霉素±β-内酰胺酶抑制剂作为经验性抗生素治疗。有 6 例患者在接受抗生素图谱检查后修改了抗生素疗法。4 名患者（5.2%）出现复发性 PA。病因是特发性（42.4%），其次是肿瘤性（12.9%）、阻塞性和免疫抑制性（各占 11.8%）。有牙科病灶的患者（P = 0.007）住院时间更长：结果表明，局部麻醉下的 PA 手术治疗是安全的。应常规进行牙科检查以排除牙源性病灶。获取微生物标本以便在必要时调整抗生素治疗，获取组织病理学标本以排除肿瘤病因是必须的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head & Face Medicine DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

4.70

自引率

3.30%

发文量

审稿时长

>12 weeks

期刊介绍： Head & Face Medicine is a multidisciplinary open access journal that publishes basic and clinical research concerning all aspects of cranial, facial and oral conditions. The journal covers all aspects of cranial, facial and oral diseases and their management. It has been designed as a multidisciplinary journal for clinicians and researchers involved in the diagnostic and therapeutic aspects of diseases which affect the human head and face. The journal is wide-ranging, covering the development, aetiology, epidemiology and therapy of head and face diseases to the basic science that underlies these diseases. Management of head and face diseases includes all aspects of surgical and non-surgical treatments including psychopharmacological therapies.