Evidence map›Paper›PMID 40227323›Full record

ArticleOral and maxillofacial surgery2025

Swabs versus native specimens in severe head and neck infections: a prospective pilot study and suggestions for clinical management.

Norbert Neckel, Christin Ohm, Oliver Wagendorf, Ulrike Kielburg, Daniel Tröltzsch, Jonas Wüster, Saskia Preißner, Francesca Ronchi, Benedicta Beck-Broichsitter, Max Heiland and 1 more

Abstract readComparative StudyLetter
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In one paragraph

Article in Oral and maxillofacial surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. The Prevalence and Drug Susceptibility ofAntibiotics (Basel, Switzerland) · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Norbert NeckelDepartment of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany. norbert.neckel@charite.de.ORCID http://orcid.org/0000-0002-5477-623X
Christin OhmDepartment of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.
Oliver WagendorfDepartment of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.
Ulrike KielburgDepartment of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.
Daniel TröltzschDepartment of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.
Jonas WüsterDepartment of Oral- and Craniomaxillofacial Surgery, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany.
Saskia PreißnerDepartment of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.
Francesca RonchiInstitute of Microbiology, Infectious Diseases and Immunology (I-MIDI), Charité-Universitätsmedizin Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.
Benedicta Beck-BroichsitterDepartment of Oral and Maxillofacial Surgery, Katharinenhospital Klinikum Stuttgart, Kriegsbergstraße 60, 70174, Stuttgart, Germany.
Max HeilandDepartment of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.
Susanne NahlesDepartment of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionHead and neck infections, particularly odontogenic infections, can lead to serious complications if not properly managed. While swabs are commonly used for microbial identification, their reliability in polymicrobial infections is debated. This study evaluates the advantages of native tissue samples over swabs in the management of severe head and neck infections. MATERIAL AND

methodsThis prospective cohort study included patients with severe acute head and neck infections requiring hospitalization, surgical drainage, and microbiologic analysis. Swabs and native tissue/fluid samples were collected for pathogen cultivation, Gram staining, and resistance testing. Clinical data, infection characteristics, and antimicrobial resistance profiles were analyzed using descriptive and inferential statistics.

results60 patients, 55% male (45.7 years) and 45% female (48.1 years) were analyzed. After antibiotic treatment, CRP and leukocyte levels decreased significantly, with higher CRP correlating with longer hospital stays. ICU admission correlated with hospital stay > 7 days. More Actinomyces and fungal species were identified in native tissue samples and more Streptococci in swabs. Antibiotic resistance, especially to clindamycin (1/3 of the cases), was associated with longer hospital and ICU stays. Clindamycin resistance correlated with increased ICU admission, while metronidazole resistance (10% of the cases) was associated with longer ICU stays. ICU admission was also associated with higher Cormack-Lehane scores.

conclusionSevere head and neck infections require a comprehensive multidisciplinary approach. Native tissue should be obtained whenever possible. While microbiological findings varied between sampling methods, native samples may provide a broader spectrum of detected pathogens, which could be relevant for infection management. Given the increasing resistance to clindamycin, its indications should be critically re-evaluated. The implementation of targeted antimicrobial strategies and a risk-based classification system may help optimize patient management and improve outcomes.

Indexed as

HeadNeckAdultAgedAnti-Bacterial AgentsFemaleHumansLength of StayMaleMiddle AgedPilot ProjectsProspective StudiesAnti-Bacterial Agents

Identifiers

PMID40227323
PMCPMC11996990

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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 Socratic graph.