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ESKAPE pathogens: Emerging isolates in odontogenic orofacial infections
P S Tripthi1, Rakshita Kumar1, Padmaraj Hegde1
1Nitte (Deemed to Be University), AB Shetty Memorial Institute of Dental Sciences (ABSMIDS), Department of Oral and Maxillofacial Surgery, Mangalore, India.
Journal of Oral Biology and Craniofacial Research
|August 11, 2026
Summary
ESKAPE pathogens are common in orofacial infections and show high resistance to many antibiotics. Imipenem and clindamycin are effective against these resistant bacteria, highlighting the need for targeted treatment strategies.
Area of Science:
- Infectious Diseases
- Microbiology
- Oral and Maxillofacial Surgery
Background:
- Odontogenic orofacial infections are complex due to a wide range of microbes.
- The increasing prevalence of multidrug-resistant organisms (MDROs), including ESKAPE pathogens, complicates treatment.
- Limited data exists on ESKAPE pathogen prevalence and resistance in orofacial space infections.
Purpose of the Study:
- To determine the occurrence of ESKAPE pathogens in odontogenic orofacial infections.
- To assess the antimicrobial susceptibility patterns of these pathogens.
- To guide effective treatment strategies for these challenging infections.
Main Methods:
- Prospective enrollment of 132 patients with oral and maxillofacial infections from August 2019 to June 2022.
- Collection and culture of pus samples using sterile swabs.
- Bacterial identification and antimicrobial susceptibility testing performed with the VITEK 2-Compact system.
Main Results:
- ESKAPE pathogens were identified in 21.97% of samples, with Enterobacter species being most frequent.
- High resistance rates were observed for amoxicillin-clavulanic acid (62.07%), cefuroxime (62.5%), and trimethoprim-sulfamethoxazole (68.42%).
- Linezolid, ertapenem, and clindamycin showed 100% susceptibility; imipenem had 86.96% susceptibility (p≤0.05). Acinetobacter baumannii was fully resistant.
Conclusions:
- ESKAPE pathogens are a significant factor in odontogenic orofacial infections, displaying substantial antibiotic resistance.
- Culture-based therapy is crucial, with imipenem showing promise for resistant infections.
- Enhanced antibiotic stewardship and ongoing surveillance are vital for managing MDROs in maxillofacial infections.
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