MAXILLOFACIAL FRACTURES AT THE TIME OF HARDWARE REMOVAL: AETIOLOGY, SURGICAL THERAPY, IDENTIFICATION OF POSTOPERATIVE INFECTIONS, AND ANTIBIOTIC PATTERN OF ISOLATES

Lutf Mohammed Al-Rahbi; Hend Naji Al-Sabri; Ahmed Abdulah Al-Ashwal; Hassan Abdulwahab Al-Shamahy

doi:10.22270/ujpr.v10i6.1453

Lutf Mohammed Al-Rahbi Department of Oral and Maxillo-Facial Surgery, Faculty of Dentistry, Sana’a University, Republic of Yemen. Yemen Medical Specialist Council, Ministry of Health and population, Yemen.
Hend Naji Al-Sabri Yemen Medical Specialist Council, Ministry of Health and population, Yemen.
Ahmed Abdulah Al-Ashwal Department of Oral and Maxillo-Facial Surgery, Faculty of Dentistry, Sana’a University, Republic of Yemen. Yemen Medical Specialist Council, Ministry of Health and population, Yemen.
Hassan Abdulwahab Al-Shamahy Department of Basic Sciences, Faculty of Dentistry, Sana’a University, Republic of Yemen. Medical Microbiology and Clinical Immunology Department, Faculty of Medicine and Health Sciences, Sana’a University.

10.22270/ujpr.v10i6.1453

Keywords:

Antibiotic pattern, bacterial causes, hardware removal, mandibular fracture, maxillofacial fractures, postoperative infections

Abstract

Background and Aims: A mandibular fracture, or jaw fracture, typically occurs at two sites in about 60% of cases, potentially limiting mouth opening and causing gum bleeding and misalignment of teeth. This study aimed to identify the bacterial causes of postoperative infections, the aetiology of fractures, surgical treatment, and the antibiotic resistance profile of bacteria from patients with maxillofacial fractures at the Military Hospital in Sana'a, Yemen.

Materials and Methods: The Department of Oral and Maxillofacial Surgery at the Military Hospital in Sana'a, Yemen, treated thirty patients with maxillofacial fractures from January to December 2024. They used fracture fixation hardware and conducted follow-ups six months post-surgery. The study assessed the incidence of postoperative bacterial infections at surgical sites after hardware removal, employing standard microbiological techniques for isolate identification and the Kirby-Bauer method for antibiotic susceptibility testing, alongside collecting clinical and demographic data from participants.

Results: Most fractures were open compound fractures (56.7%), all of which were mandibular fractures. For 60% of patients, open reduction internal fixation (ORIF) was the most frequently used surgical procedure. Staphylococcus aureus accounted for 27 (90%) of all isolates from surgical sites, with Klebsiella pneumoniae coming in second at 30%. Three instances (10%) had no bacterial growth. Amoxicillin, augmentin, aztreonam, cefotaxime, cefoxitin, ceftazidime, piperacillin, ceftriaxone, and doxycycline did not work at all against isolates of S. aureus.

Conclusion: According to the survey, individuals aged 20 to 24 represented 56.7% of cases, primarily due to gunshot wounds. The bacterium S. aureus, noted for its significant multidrug resistance, was the most commonly isolated pathogen. Vancomycin emerged as the most effective treatment for Staphylococcus aureus infections.