Analysis of Pathogen Distribution, Drug Resistance, and Risk Factors in Patients With Hemifacial Microsomia After Mandibular Distraction Osteogenesis

BACKGROUND: Hemifacial microsomia is the second most common congenital craniofacial syndrome. Delayed intervention may negatively impact the growth of infants and the psychological development of children and adults. Currently, mandibular distraction osteogenesis (MDO) remains a mainstay procedure for correcting the deformity and delivering successful outcomes. METHODS: The pathogens that caused postoperative infection after MDO between January 2011 and June 2024 were retrospectively analyzed. The distribution and antibiotic sensitivity of the major pathogens were determined. The risk factors for postoperative infection following MDO from January 2019 to June 2024 were also assessed using univariate analysis. RESULTS: Gram-positive bacteria comprised a large proportion (79.2%) of infections following MDO. Staphylococcus aureus strains (12 of 14 infections) were the most common after MDO using the extraoral approach, while Coagulase-negative Staphylococci strains (4 of 10 infections) were the most common using the intraoral approach. S. aureus was highly sensitive to levofloxacin, chloramphenicol, gentamicin, vancomycin, and linezolid and highly resistant to penicillin, clindamycin, and erythromycin. All S. aureus strains were 100% sensitive to chloramphenicol, vancomycin, and linezolid. Surgery using an extraoral distractor was related to a high possibility of postoperative infection from January 2019 to June 2024. CONCLUSIONS: Gram-positive bacteria are the major cause of infections following MDO, among which S. aureus accounting for the majority of cases. The distractor insertion approach was identified as a risk factor for postoperative infection from January 2019 to June 2024, indicating that using an extraoral approach has a higher infection risk than the intraoral approach.