How Does Diabetes Influence the Severity and Microbiological Profile of Odontogenic Maxillofacial Infections? An Observational Study

Author(s): Tahsin Sarwar, Brig.Gen Prof. Md. Abdur Rab, Faria Alam, Md. Miraj Billah, Tasnim Mahmud, Sarwar Alam

Background: Odontogenic maxillofacial infections are common yet serious conditions that can lead to life-threatening complications. Diabetes mellitus (DM) is known to exacerbate the severity of such infections due to its impact on immune function and wound healing. This study aimed to compare the severity, microbiological profile, and clinical outcomes of odontogenic infections in diabetic and non- diabetic patients in Dhaka, Bangladesh.

Methods: A retrospective observational study was conducted at the Department of Oral and Maxillofacial Surgery, Military Dental Center, Dhaka Cantonment. Seventy patients diagnosed with odontogenic infections requiring hospitalization were included, divided into diabetic (n=35) and non-diabetic (n=35) groups. Data on demographics, infection characteristics, microbiological findings, antibiotic susceptibility, and hospital stay duration were analyzed using SPSS version 26. The Chi-square test, independent t-test, and logistic regression were employed to assess statistical significance.

Results: The mean age of participants was 47.95±6.71 years, with a significant difference between groups (p=0.001). Male predominance was noted (70%). Diabetic patients exhibited significantly higher rates of multiple-space infections (31.43% vs. 11.43%; p=0.041) and prolonged hospital stays (18.32±4.78 days vs. 6.24±2.12 days; p<0.001). Microbiological analysis revealed Streptococcus viridans as the predominant organism in non-diabetic patients (31.43%), whereas Klebsiella pneumoniae was more frequent in diabetics (25.71%). Logistic regression analysis identified age, multiple-space infections, and bacterial isolates as significant predictors of prolonged hospitalization.

Conclusion: Diabetic patients with odontogenic infections experience more severe infections, longer hospital stays, and distinct microbiological patterns compared to non- diabetics. These findings emphasize the need for early diagnosis, aggressive management, and tailored antibiotic therapy in diabetic individuals to mitigate complications. Future research should focus on larger, multi-center studies to validate these findings and develop standardized treatment protocols.