Evidence map›Paper›PMID 42029983›Full record

ArticleOral and maxillofacial surgery2026

Cultured microbial community complexity is associated with antimicrobial resistance and Enterobacterales enrichment in adult odontogenic infections.

Alina Marie Schmitz, N L Kern, H Ward, M Sauerbrey, F Mrosk, O Wagendorf, S Nahles, C Rendenbach, N Neckel, M Heiland and 1 more

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Article in Oral and maxillofacial surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Alina Marie SchmitzDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, Berlin, 13353, Germany. alina-marie.schmitz@charite.de.
N L KernDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, Berlin, 13353, Germany.
H WardDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, Berlin, 13353, Germany.
M SauerbreyDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, Berlin, 13353, Germany.
F MroskDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, Berlin, 13353, Germany.
O WagendorfDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, Berlin, 13353, Germany.
S NahlesDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, Berlin, 13353, Germany.
C RendenbachDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, Berlin, 13353, Germany.
N NeckelDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, Berlin, 13353, Germany.
M HeilandDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, Berlin, 13353, Germany.
S KoerdtDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, Berlin, 13353, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOdontogenic infections are polymicrobial entities with increasing antimicrobial resistance. Although immunosuppression is commonly considered a major risk factor for resistant and complex infections, concepts from microbial ecology suggest that community complexity itself may be associated with distinct microbial phenotype and susceptibility patterns.

methodsWe performed a retrospective cohort study of consecutive patients undergoing surgical treatment for odontogenic infections at a tertiary maxillofacial center between 2017 and 2022. Intraoperative specimens were processed using standardized aerobic and anaerobic culture protocols. Primary outcomes were polymicrobial infection, Enterobacterales detection, and antimicrobial resistance; MRSA and Candida spp. were secondary outcomes. Immunosuppression was defined by systemic immunosuppressive therapy, chemotherapy, solid organ transplantation, or HIV infection. Cultured microbial community complexity was operationalized as the number of distinct pathogens detected by routine culture in each patient.

resultsAmong 695 included patients, polymicrobial infection was detected in 62.0% and antimicrobial resistance in 40.6%, without differences by immune status. Enterobacterales were more frequently detected in immunosuppressed patients (13.9% vs. 3.9%). Unsupervised clustering of pathogen profiles did not segregate by immune status. High microbial complexity was associated with a distinct microbiological profile associated with near-universal polymicrobial infection (97.2% vs. 55.3%), increased antimicrobial resistance (72.9% vs. 34.8%), and marked Enterobacterales enrichment (19.6% vs. 2.9%) (all p < 0.001). In fully adjusted models, higher cultural microbial complexity showed the strongest adjusted association with all adverse microbiological outcomes, whereas no independent association was observed for the broad immunosuppression variable used in this study. Dose–response analyses demonstrated a graded increase in Enterobacterales detection and antimicrobial resistance with rising pathogen burden.

conclusionsIn this retrospective cohort of surgically treated odontogenic infections, higher cultured microbial complexity was strongly associated with polymicrobial infection, Enterobacterales detection, and antimicrobial resistance. These findings support support further investigation of community-level microbiological features for future risk stratification approaches.

Indexed as

CoinfectionDrug Resistance, BacterialEnterobacteriaceaeMicrobiotaAdultDrug Resistance, MicrobialEnterobacteriaceae InfectionsFemaleHumansImmunocompromised HostMaleMiddle AgedRetrospective StudiesAntimicrobial resistanceImmunosuppresisonMicrobial complexityOdontogenic infectionPolymicrobial infection

Identifiers

PMID42029983
PMCPMC13109227

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.