Distribution of Pathogenic Bacteria and Antimicrobial Resistance After Plastic Surgery of L-Shaped Zygomatic Osteotomy

BACKGROUND: The zygomatic bone forms the prominence of the midface and determines human facial attractiveness. A facial contour with a prominent zygoma causes a disproportion between the midface and the superior-inferior dimensions of the face. This study aimed to retrospectively analyze infections after L-shaped zygomatic osteotomy. METHODS: Between January 2011 and December 2021, after L-shaped zygomatic osteotomy alone or after L-shaped zygomatic osteotomy combined with mandibular angle reduction, microbial strains from patients who underwent relevant surgeries were collected, identified, and counted using WHONET 5.6. Data regarding surgical techniques, time of occurrence of postoperative infection, and other clinical details were also collected. RESULTS: A total of 17 patients were included in the study. Among them, 11 gram-negative bacteria were detected, with Pseudomonas aeruginosa (4/11) and Enterobacter aerogenes (3/11) accounting for the majority. There were also 6 gram-positive bacteria, including 5 strains of Staphylococcus (3 strains of Staphylococcus aureus and 2 strains of Staphylococcus epidermidis) and 1 strain of Abiotrophia adiacens. P. aeruginosa was highly sensitive to levofloxacin, gentamicin, amikacin, piperacillin/tazobactam, cefepime, imipenem, ceftazidime, and ciprofloxacin. E. aerogenes exhibited 100% sensitivity to all antibiotics listed. Staphylococcus strains were highly sensitive to cefoxitin, gentamicin, tetracycline, vancomycin, chloramphenicol, and linezolid, and highly resistant to clindamycin and erythromycin. CONCLUSIONS: Gram-negative bacteria were the major cause of infection after L-shaped zygomatic osteotomy, and P. aeruginosa was the most common. Approximately 88.2% of infections occurred within 10 days after the surgery, and 70.6% of the infections occurred before the removal of titanium miniplates and screws.