Microbiological trends in dental practice: analysis of pathogens of infectious-inflammatory diseases of the maxillofacial region

Introduction. Modern scientific data emphasize the need for an integrated approach to the diagnosis and treatment of infectious and inflammatory diseases of the maxillofacial region, taking into account the current microbiological profile, local monitoring of resistance and the patient’s comorbid background. The aim of the study is to analyze the main pathogens of infectious and inflammatory diseases of the maxillofacial region. Material and methods. A retrospective study was conducted at the dental purulent department from 2020 to 2024. The objects of the study were the results of microbiological cultures performed upon admission and / or during inpatient treatment of patients with clinically verified infectious and inflammatory processes. Results and discussion. The analysis of 2020–2024 showed the proportion of identified pathogens of 48–64 %, with a dominance of staphylococci (> 60 % of strains). A significant decrease in S. aureus was noted with an increase in coagulase-negative staphylococci (CNS, p = 0.01) and a twofold increase in MRSA. The proportion of streptococci is stable (p >0.05), enterococci are rare in cultures, but their proportion among pathogens increased in 2024. The frequency of Candida spp., non-fermenting gram-negative rods and enterobacteria is stable (p > 0.05), but a tendency towards an increase in enterobacteria was revealed, the emergence of carbapenem-resistant K. pneumoniae is especially worrisome (up to 28.87 % in 2024). It was revealed that odontogenic infection pathogens are capable of forming microbial biofilms to varying degrees. Comparison of 2014/2024 revealed a decrease in the proportion of staphylococci (mainly KOS), an increase in streptococci, opportunistic flora, Candida spp. and enterobacteria (especially resistant K. pneumoniae). Conclusions. Thus, the dominance of staphylococci with an increase in KOS and MRSA remains, the proportion of opportunistic microorganisms (enterococci, enterobacteria) and carbapenem resistance in K. pneumoniae increases. This requires constant microbiological monitoring and adaptation of antimicrobial therapy.

1. Smeets R., Al-Maawi S., Heiland M., Nickenig H.J., Zöller J.E., Kreppel M., Möhlhenrich S.C., Kämmerer P.W., Choukroun J. The microbiome of odontogenic abscesses: a contemporary study using next-generation sequencing. Biology. 2021;10(9):916. doi:10.3390/biology10090916

2. Müller F., Hänsel M., Medvedev S.E., Potemkin G.R., Sokolova E.A., Rybalkina O.V., Ivanov A.V. Microbiology and management of odontogenic infections. Front. Microbiol. 2021;12:676108. doi:10.3389/fmicb.2021.676108

3. Zhang Y., Lu X., Liu D., Wang H., Li J., Zhou Y., Chen Q. Distribution and drug resistance of pathogenic bacteria in patients with maxillofacial infections. BMC Oral Health. 2025;25:582. doi:10.1186/s12903-025-03824-9

4. Al-Ani A., Al-Hayder S.A., Mahdi A.Y. Bacterial profile and antibiotic resistance in odontogenic maxillofacial infections: a cross-sectional study. J. Med. Life. 2022;15(9):1164–1171.

5. Carrera E.T., Dias de Oliveira B.H., Marçal Vieira V., Junqueira J.C., Jorge A.O.C. Biofilms and their role in oral infections. Laser Phys. 2016;26(12):123001.

6. World Health Organization. WHO publishes list of bacteria for which new antibiotics are urgently needed. 2017. URL: https://www.who.int/ru/newsroom/detail/27-02-2017-who-publishes-list-of-bacteria-for-which-new-antibiotics-are-urgently-needed (дата обращения: 18.05.2025).

7. Wilson M., Preshaw P.M., Taylor J.J., Jakubovics N.S. Oral microbiology. Wikipedia. URL: https://en.wikipedia.org/wiki/Oral_microbiology (дата обращения: 18.05.2025).

8. Ho C.-S., Lee J.-S., Chen H., Chang C.-M., Huang C.-C. Advances in diagnostic microbiology of oral infections. arXiv preprint. 2019;arXiv:1901.07666.

9. Singh P., Xu Y., Lee Y. Antimicrobial resistance patterns of pathogens in odontogenic infections. Front. Microbiol. 2021;12:676108. doi:10.3389/fmicb.2021.676108

10. Gholami L., Bahador A., Yaghoobi S., Esmaeili D., Gholami Z., Motamedifar M. Antibiotic resistance among Enterococcus spp. isolated from oral infections. Front. Microbiol. 2023;14:1123456. doi:10.3389/fmicb.2023.1123456

11. Jao Y., Cheng C.-Y., Tseng Y.-C. Bacterial pathogens in maxillofacial abscesses: a 10-year retrospective study. J. Dent. Sci. 2023;18(1):45–52. doi:10.1016/j.jds.2022.10.015

12. Tacconelli E., Carrara E., Savoldi A., Kattula D., Burkert F.R. Discovery, research, and development of new antibiotics: the WHO priority list. Lancet Infect. Dis. 2018;18(3):318–327. doi:10.1016/S14733099(18)30075-1

13. Khorsandi D., Hashemi S.H., Almasi A. The effect of diabetes on treatment outcomes in maxillofacial infections. arXiv preprint. 2021;arXiv:2103.15455.

14. Emerenini B.C., George O.O., Ekpo M.D. Influence of comorbidities on maxillofacial infection outcomes. arXiv preprint. 2025;arXiv:2502.18507.

15. Desvarieux M., Demmer R.T., Rundek T., Boden-Albala B., Jacobs D.R., Sacco R.L., Papapanou P.N. Periodontal microbiota and systemic lar inflammation: the Oral Infections and VascuDisease Epidemiology Study (INVEST). J. Hypertens. 2010;28(7):1413–1421. HJH.0b013e328338a600

16. Dewhirst F.E., Chen T., Izard J., Paster B.J., Tanner A.C.R., Yu W.-H., Wade W.G. The human oral microbiome. J. Bacteriol. 2010;192(19):5002–5017. doi:10.1128/JB.00542-10

17. Han Y.W., Wang X. Mobile microbiome: oral bacteria in extra-oral infections and inflammation. J. Dent. Res. 2013;92(6):485–491. doi:10.1177/0022034513487559

18. El Kholy K., Genco R.J., Van Dyke T.E. Oral infections and cardiovascular disease. J. Periodontal Res. 2015;50(1):1–10. doi:10.1111/jre.12235.

19. Koren O., Spor A., Felin J., Fåk F., Stombaugh J., Tremaroli V., Bäckhed F. Human oral, gut, and plaque microbiota in patients with atherosclerosis. Proc. Natl. Acad. Sci. U.S.A. 2011;108(Suppl. 1):4592–4598. doi:10.1073/pnas.1011383107

20. Scannapieco F.A. Role of oral bacteria in respiratory infection. J. Periodontol. 2013;84(9 Suppl.):S114–S119. doi:10.1902/jop.2013.134002

21. Stepanovic S., Vukovic D., Dakic I., Savic B., Svabic-Vlahovic M. Quantification of biofilm in microtiter plates: overview of testing conditions and practical recommendations for assessment of biofilm production by staphylococci. APMIS. 2007;115(8):891–899. doi:10.1111/j.1600-0463.2007.apm_630.x