Involvement of resistant bacteria in the severity of refractory osteonecrosis of the jaw.
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| Titel: | Involvement of resistant bacteria in the severity of refractory osteonecrosis of the jaw. |
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| Autoren: | Kusumoto J; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. chivalry_2727@dent.kagoshima-u.ac.jp.; Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate school of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. chivalry_2727@dent.kagoshima-u.ac.jp., Muraki Y; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan., Iwata E; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.; Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan., Matsumura M; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.; Department of Oral Surgery, Konan Medical Center, Kobe, Japan., Furudoi S; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.; Department of Oral Surgery, Konan Medical Center, Kobe, Japan., Akashi M; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. |
| Quelle: | Clinical oral investigations [Clin Oral Investig] 2025 Sep 16; Vol. 29 (10), pp. 454. Date of Electronic Publication: 2025 Sep 16. |
| Publikationsart: | Journal Article |
| Sprache: | English |
| Info zur Zeitschrift: | Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 9707115 Publication Model: Electronic Cited Medium: Internet ISSN: 1436-3771 (Electronic) Linking ISSN: 14326981 NLM ISO Abbreviation: Clin Oral Investig Subsets: MEDLINE |
| Imprint Name(s): | Publication: Berlin : Springer-Verlag Original Publication: Berlin : Springer, c1997- |
| MeSH-Schlagworte: | Drug Resistance, Bacterial* , Jaw Diseases*/microbiology , Jaw Diseases*/surgery , Osteonecrosis*/microbiology, Humans ; Female ; Male ; Aged ; Middle Aged ; Anti-Bacterial Agents/therapeutic use ; Aged, 80 and over ; Adult ; Severity of Illness Index ; Retrospective Studies ; Microbial Sensitivity Tests |
| Abstract: | Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Purpose: Osteoradionecrosis (ORN) and medication-related osteonecrosis of the jaw (MRONJ) are relatively rare and refractory, and there is no consensus regarding the bacteria associated with their development. This study was conducted to identify the bacteria associated with refractory ORN and MRONJ, including severe cases. Methods: Patients who underwent surgery for osteonecrosis of the jaw were included in this study. Bacterial culture specimens were obtained from tissue as deeply as possible. Severe cases of ORN and MRONJ were defined as stage IV of Lyon's classification and stage III of the AAOMS classification, respectively. Demographic data, clinical features, antimicrobials usage, and bacteria detected were analysed to determine the factors associated with severe disease. Results: Seventy-seven patients (ORN, n = 22; MRONJ, n = 55) were analysed. Penicillins were the most commonly used antimicrobials. A total of 311 bacterial strains were detected in tissue culture (detection rate = 100%). Streptococcus spp. were the most common bacteria (37.0%), followed by anaerobes (33.8%). Gram-negative rods were detected in 10.3% of the patients, antimicrobial-resistant bacteria in 78.4%, and ampicillin resistance in 60.8%. Factors associated with severe disease were ampicillin resistance and malignancy in MRONJ, with odds ratios of 8.74 (95% confidence interval, 1.20-63.4; p = 0.032) and 13.5 (1.09-168, p = 0.043), respectively. Enterobacter spp. were detected only in severe cases. Conclusion: Bacteria associated with osteonecrosis of the jaw are similar in composition to those responsible for common odontogenic infections, but with a higher proportion of gram-negative rods. Ampicillin-resistant bacteria, including Enterobacter spp., are implicated in severe disease. (© 2025. The Author(s).) |
| References: | Oral Dis. 2022 Oct;28(7):2015-2025. (PMID: 34273905) Clin Infect Dis. 2012 Jun;54(12):e132-73. (PMID: 22619242) Infection. 2019 Dec;47(6):1037-1045. (PMID: 31605309) Radiother Oncol. 2004 Nov;73(2):119-31. (PMID: 15542158) J Infect Chemother. 2020 Sep;26(9):882-889. (PMID: 32591324) BMJ Public Health. 2025 Apr 05;3(1):e002009. (PMID: 40196437) Oral Maxillofac Surg. 2018 Mar;22(1):59-63. (PMID: 29224060) Med Oral Patol Oral Cir Bucal. 2022 Nov 1;27(6):e539-e549. (PMID: 36243999) Diabetes Metab Res Rev. 2020 Mar;36 Suppl 1:e3280. (PMID: 32176444) J Oral Maxillofac Surg. 2021 Aug;79(8):1683-1688. (PMID: 33529608) J Craniomaxillofac Surg. 2017 Aug;45(8):1183-1189. (PMID: 28684074) J Oral Maxillofac Surg. 2022 Jun;80(6):1094-1102. (PMID: 35405094) Eur J Clin Microbiol Infect Dis. 2009 Apr;28(4):317-23. (PMID: 18797941) J Stomatol Oral Maxillofac Surg. 2021 Nov;122(5):499-504. (PMID: 32827811) J Transl Med. 2019 Mar 4;17(1):69. (PMID: 30832685) Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Apr;123(4):436-444. (PMID: 28159588) BMC Infect Dis. 2022 Dec 12;22(1):931. (PMID: 36503406) Oral Maxillofac Surg. 2018 Dec;22(4):369-378. (PMID: 30327979) Clin Oral Investig. 2021 May;25(5):2801-2809. (PMID: 33006027) J Craniomaxillofac Surg. 2015 Jul;43(6):837-46. (PMID: 25939311) J Oral Maxillofac Surg. 2022 May;80(5):920-943. (PMID: 35300956) J Craniomaxillofac Surg. 2017 Mar;45(3):357-363. (PMID: 28162845) Int Dent J. 2018 Feb;68(1):22-30. (PMID: 28649774) Head Neck. 2011 Nov;33(11):1600-5. (PMID: 21484922) J Oral Maxillofac Surg. 2024 Dec;82(12):1585-1595. (PMID: 39208868) Br J Oral Maxillofac Surg. 2014 May;52(5):392-5. (PMID: 24725905) Ear Nose Throat J. 2017 Jun;96(6):E29-E32. (PMID: 28636739) BMC Oral Health. 2021 Jan 7;21(1):20. (PMID: 33413262) Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Aug;110(2):151-6. (PMID: 20346713) J Oral Maxillofac Res. 2023 Dec 31;14(4):e1. (PMID: 38222882) J Maxillofac Oral Surg. 2023 Jun;22(2):344-351. (PMID: 37122785) Int J Oral Maxillofac Surg. 2019 Jan;48(1):17-22. (PMID: 30054185) |
| Contributed Indexing: | Keywords: Ampicillin; Antimicrobial resistance; Gram-negative rod; Medication-related osteonecrosis of the jaw; Microorganism; Osteoradionecrosis of the jaw |
| Substance Nomenclature: | 0 (Anti-Bacterial Agents) |
| Entry Date(s): | Date Created: 20250916 Date Completed: 20250916 Latest Revision: 20251018 |
| Update Code: | 20251018 |
| PubMed Central ID: | PMC12441049 |
| DOI: | 10.1007/s00784-025-06547-3 |
| PMID: | 40956356 |
| Datenbank: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstract: | Competing Interests: Declarations. Competing interests: The authors declare no competing interests.<br />Purpose: Osteoradionecrosis (ORN) and medication-related osteonecrosis of the jaw (MRONJ) are relatively rare and refractory, and there is no consensus regarding the bacteria associated with their development. This study was conducted to identify the bacteria associated with refractory ORN and MRONJ, including severe cases.<br />Methods: Patients who underwent surgery for osteonecrosis of the jaw were included in this study. Bacterial culture specimens were obtained from tissue as deeply as possible. Severe cases of ORN and MRONJ were defined as stage IV of Lyon's classification and stage III of the AAOMS classification, respectively. Demographic data, clinical features, antimicrobials usage, and bacteria detected were analysed to determine the factors associated with severe disease.<br />Results: Seventy-seven patients (ORN, n = 22; MRONJ, n = 55) were analysed. Penicillins were the most commonly used antimicrobials. A total of 311 bacterial strains were detected in tissue culture (detection rate = 100%). Streptococcus spp. were the most common bacteria (37.0%), followed by anaerobes (33.8%). Gram-negative rods were detected in 10.3% of the patients, antimicrobial-resistant bacteria in 78.4%, and ampicillin resistance in 60.8%. Factors associated with severe disease were ampicillin resistance and malignancy in MRONJ, with odds ratios of 8.74 (95% confidence interval, 1.20-63.4; p = 0.032) and 13.5 (1.09-168, p = 0.043), respectively. Enterobacter spp. were detected only in severe cases.<br />Conclusion: Bacteria associated with osteonecrosis of the jaw are similar in composition to those responsible for common odontogenic infections, but with a higher proportion of gram-negative rods. Ampicillin-resistant bacteria, including Enterobacter spp., are implicated in severe disease.<br /> (© 2025. The Author(s).) |
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| ISSN: | 1436-3771 |
| DOI: | 10.1007/s00784-025-06547-3 |