Prevalence of Methicillin and β−Lactamase Resistant Pathogens Associated with Oral and Periodontal Disease of Children in Mymensingh, Bangladesh

Abstract

Oral and periodontal diseases (OPD) is considered one of the main problems of dentistry worldwide. This study aimed to estimate the prevalence of oral and periodontal pathogenic bacteria along with their antimicrobial resistance pattern in 131 children patients aged between 4–10 years who attended in Mymensingh Medical College Hospital during October 2019 to March 2020. OPD pathogens were identified through isolation, cultural and biochemical properties, and nucleic acid detection. The isolates were subjected to antimicrobial susceptibility to 12 antibiotics commonly used in dentistry. In addition, the isolates were analyzed molecularly for the presence of six virulence and three antibacterial resistance genes. Five pathogens were identified, of which Staphylococcus aureus (S. aureus) (49%) and S. salivarius (46%) were noticed frequently; other bacteria included S. mutans (16.8%), S. sobrinus (0.8%) and L. fermentum (13.7%). The virulence genes—clumping factor A (clfA) was detected in 62.5% isolates of S. aureus, and gelatinase enzyme E (gelE) gene was detected in 5% isolates of S. salivarius, while other virulence genes were not detected. All the tested isolates were multidrug-resistant. The overall prevalence of MDR S. aureus, Streptococcus spp. and L. fermentum was 92.2%, 95.1% and 100%, respectively. It was observed that a high proportion of isolates were found resistant to 5–8 antibiotics. A majority of S. aureus, Streptococcus spp., and L. fermentum isolates tested positive for the β−lactamase resistance genes blaTEM and cfxA, as well as the methicillin resistance gene mecA. Phylogenetically, the resistance genes showed variable genetic character among Bangladeshi bacterial pathogens. In conclusion, S. aureus and S. salivarius were major OPD pathogens in patients attended in Mymensingh Medical College Hospital of Bangladesh, and most were Beta-lactam and methicillin resistant.

Antimicrobial resistance and virulence of subgingival staphylococci isolated from periodontal health and diseases

“…Very similar antimicrobial susceptibility profiles of oral staphylococci 8 , 55 , 61 – 63 , including isolates from periodontitis patients 13 , 22 , 48 , 51 have been reported. Fortunately, MDR was relatively low (12%) in our oral isolates compared to the high rates (> 20%) reported from other countries 49 , 55 , 61 , 64 . The overall detection of the mecA gene (10.5%) was consistent with the 9% rate of cefoxitin (methicillin) resistance.…”

“…Thus, increased resistance to penicillins, low carriage of mecA and high susceptibility to amoxicillin-clavulanic acid may suggest the predominance of other beta-lactam resistance mechanisms, such as the production of beta-lactamases encoded by bla Z genes, or the existence of other MR genes 57 , 59 , 65 . Carriage rates of mecA in oral staphylococci have been shown to range from 6 to 21% in most studies 8 , 14 , 22 , 49 , 55 , 63 , although no detection 48 , 50 or very high frequencies are also reported in different populations 61 , 64 , 66 . Regardless of these variations or significant associations with periodontitis, these data support the oral cavity and the dental biofilm as potential reservoirs of beta-lactam resistance genes 57 , 59 .…”

“…S. epidermidis and S. aureus were the predominant species detected. The frequency of staphylococci in the oral cavity may vary significantly among studies due to the distinct methods employed for their detection 8 , 10 – 12 , 19 , 47 – 49 . Investigators have reported a high prevalence of these microorganisms, specially S. epidermidis and S. aureus , in the dental plaque 13 – 15 , 17 – 22 , 31 , 50 , 51 ; however, only a few found a significant association between these species and periodontitis 14 , 16 , 31 .…”

Effectiveness of Bromelain Mouthrinse in Gingival Inflammation and Bacterial Plaque Among Adolescents: A Randomized Clinical Trial

“…[2][3][4] Caries, halitosis, gingivitis, and angular cheilitis are all pathological conditions caused by a colony of opportunistic bacteria. 5 Examples of bacteria that are always found in the oral cavity are the group Streptococcus (Streptococcus mutans, Streptococcus sanguis, Streptococcus salivarius, Lactobacillus sp). 6 Dental plaque is a thin, paleyellow biofilm that forms naturally on the teeth.…”