ArticleAnnals of clinical microbiology and antimicrobials2025
Enterobacterales abundance in oral cancer patients and elevated clindamycin resistance rates in head and neck infections at a Hungarian Tertiary Hospital.
Article in Annals of clinical microbiology and antimicrobials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Optimising perioperative antimicrobial stewardship for Class I incisions: a clinical pharmacist-led multidisciplinary intervention and outcomes.Frontiers in cellular and infection microbiology · 2026Article
- Risk factors for the emergence of multidrug-resistant bacteria in patients with head and neck infections: a retrospective analysis.Frontiers in oral health · 2026Article
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Abstract
backgroundOral bacteria have been associated with several systemic diseases, and studies have highlighted their potential role in carcinogenesis. A biofilm is considered an antimicrobial resistance gene reservoir, and the oral cavity provides an excellent environment for biofilm formation. The aim of this study was to evaluate the pathogen spectrum and antimicrobial resistance rates of clinical isolates from head and neck infections in the Hungarian population.
methodsA total of 5185 bacterial isolates were analyzed from 1978 patients between 2018 and 2023. Antimicrobial resistance rates were reported according to the EUCAST guidelines. The primary diagnoses of the patients were categorized into three major groups: abscesses, necrotizing lesions and surgical site infections of patients treated for malignant tumors. Pearson's chi-square test was used to compare the percentages of bacteria in the different patient groups.
resultsThe most frequently isolated bacteria were Streptococcus (18.8%) and Prevotella spp. (13.5%), followed by Staphylococcus (13.2%) and Fusobacterium spp. (9.1%). Differences in the pathogen spectrum of three patient groups ('abscess', 'necrosis' and 'tumor') were also evaluated. Compared with the other two patient groups, cancer patients had significantly greater percentages of Enterobacter spp., Enterococcus spp., Pseudomonas spp. and beta-hemolytic streptococci. Substantial resistance rates to clindamycin were observed for Prevotella, Streptococcus and Staphylococcus spp. at 40.9% (95% CI [37.3-44.7%]), 34.8% (95% CI [31.8-37.9%]) and 32.3% (95% CI [28.8-35.9%]), respectively. The percentage of methicillin-resistant Staphylococcus aureus isolates was 13.8% (95% CI [9.2-19.5%]). The percentage of vancomycin-resistant Enterococcus spp. isolates was 2.8% (95% CI [0.6-8.0%]), and the percentages of extended-spectrum beta-lactamase-producing E. coli and Klebsiella spp. isolates were 1% (95% CI [0.02-5.6%]) and 2.6% (95% CI [0.8-5.9%]), respectively.
conclusionOur evaluation revealed high percentages of Enterobacterales in patients with diseases such as osteonecrosis or oral cancer. Further investigation of the role of the oral microbiota and its potential impact on the morbidity of patients with advanced disease is needed. Substantial antimicrobial resistance rates, particularly to clindamycin, pose a major concern for treating bacterial infections in the head and neck region.
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