SO SÁNH ĐẶC ĐIỂM VI KHUẨN GÂY BỆNH Ở NGƯỜI BỆNH NHIỄM TRÙNG CỔ SÂU CÓ VÀ KHÔNG CÓ ĐÁI THÁO ĐƯỜNG TẠI KHOA TAI MŨI HỌNG BỆNH VIỆN ĐẠI HỌC Y DƯỢC THÀNH PHỐ HỒ CHÍ MINH

Abstract

Background: Deep neck infections are otolaryngological emergencies that may lead to serious complications such as mediastinitis, sepsis, and airway obstruction. The presence of comorbidities, particularly diabetes mellitus, complicates treatment. Several studies have shown that the pathogenic bacterial strains may differ between diabetic and non-diabetic patients, significantly influencing antibiotic selection. Objective: To investigate and compare the bacterial isolates from deep neck abscesses in patients with and without diabetes mellitus. Subjects – Methods: This descriptive case series included 136 patients aged 18 years and older, diagnosed with deep neck infections and indicated for abscess drainage at the Department of Otolaryngology, University Medical Center Ho Chi Minh City, from January 2020 to July 2023. Pus samples from abscesses were collected for bacterial culture and antibiotic susceptibility testing. Results: Among the patients, 50.7% had diabetes mellitus. Klebsiella pneumoniae was the most commonly isolated organism (50.8%), significantly more frequent in the diabetic group compared to the non-diabetic group (7%) (p = 0.0001). Streptococcus species were most prevalent among non-diabetic patients (48,8%). Infections with Streptococcus spp. and Staphylococcus aureus were also significantly more common in the non-diabetic group (p = 0.008 and p = 0.039, respectively). Anaerobic bacteria were found in both groups. There was no significant difference in bacterial distribution across different anatomical neck spaces (parotid space, submandibular space and spaces extending through the neck)
Conclusion: Klebsiella pneumoniae was the predominant pathogen in patients with diabetes mellitus, while Streptococcus spp. and Staphylococcus aureus were more frequently isolated from non-diabetic patients. These findings highlight the importance of individualising antibiotic therapy based on diabetic status.