ISOLATION AND AND ANTIBIOGRAM OF BACTERIAL AND FUNGAL AGENTS FROM PATIENTS ATTENDING DENTAL CLINIC AT GENERAL HOSPITAL AKWANGA

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ISOLATION AND AND ANTIBIOGRAM OF BACTERIAL AND FUNGAL AGENTS FROM PATIENTS ATTENDING DENTAL CLINIC AT GENERAL HOSPITAL AKWANGA

Abstract:

This study investigates the prevalence and antibiotic susceptibility patterns of bacterial and fungal agents isolated from patients seeking dental care at General Hospital Akwanga. Dental infections represent a significant health concern, and understanding the microbial etiology and antibiotic resistance profiles is crucial for effective treatment and infection control measures.

A comprehensive analysis was conducted on samples collected from patients presenting with various dental conditions, including caries, periodontitis, and oral abscesses. Bacterial and fungal isolates were identified using standard microbiological techniques and confirmed through biochemical assays and molecular methods.

The results reveal a diverse spectrum of bacterial and fungal pathogens implicated in dental infections, with common isolates including Streptococcus spp., Staphylococcus aureus, Candida albicans, and Aspergillus spp. Furthermore, the antibiotic susceptibility testing demonstrated varying degrees of resistance among the isolates, emphasizing the emergence of multidrug-resistant strains in dental settings.

This abstract highlights the importance of continuous surveillance of microbial flora and antibiotic resistance patterns in dental clinics to guide empirical therapy and prevent treatment failures. Additionally, it underscores the necessity for prudent antibiotic prescribing practices and implementation of infection control measures to mitigate the spread of antimicrobial resistance within dental healthcare settings.

Overall, this study contributes valuable insights into the epidemiology of dental infections and provides essential data for formulating effective treatment strategies and promoting antimicrobial stewardship in dental practice.

CHAPTER ONE:

INTRODUCTION

1.1 Background

The prevalence of oral infections caused by bacterial and fungal agents remains a significant public health concern worldwide. Dental clinics serve as essential facilities for diagnosing and treating these infections, contributing to the overall health and well-being of individuals. Understanding the microbial profile and antimicrobial susceptibility patterns of isolates from dental patients is crucial for guiding effective treatment strategies and controlling the spread of antimicrobial resistance.

The environment in the human oral cavity (water, nutrients, epithelial debris and as well as a moderate temperature) supports the growth and survival of a wide range of microorganisms, including bacteria, yeasts, viruses and occasional protozoans, with bacteria predominantly residing in the microflora. The prominent bacteria commonly found in the mouth include several genera such as: Streptococcus, Lactobacillus, Lactococcus, Enterococcus, Staphylococcus, Corynebacterium, Veillonella and Bacteroids. These numerous bacterial species undergo intense interspecies competition to form multispecies biofilm structure.

The mouth’s mucous membranes are often

sterile at birth, but can be contaminated within 4 – 12 hours by passing through the birth canal. After birth, Streptococcus viridians became the most prominent member of the oral cavity’s resident flora and remained so for life [7]. The organism is thought to have originated in mother and birth attendants’ respiratory tracts [8]. Aerobic and anaerobic Staphylococcus, Neisseriae, Moraxella catarrahalis, Diptheroids and

occasionally Lactobacilli are added to the oral microbial flora early in life, before the eruption of the teeth [8]. When teeth begin to erupt, however, anaerobic spirochete species such as Prevotella species, in particular Prevotella melaninogenica, Fusobacterium species, Rothia species and Capnocytophage species, together with some anaerobic Vibros and Lactobacilli, are found in the oral cavity. Actinomyces species are usually present in tonsillae tissue and gingivae in adults along with this load of bacteria [9].

Oral and dental problem such as tooth decay, tooth erosion, tooth sensitivity, tooth ache, calculus, gingivitis, periodontitis and plaque is common among many and it has been associated with poor oral hygiene [10]. The dental plaque for instance is a dense, nonmineralized, complex mass of bacterial colonies that live in a gel-intermixing matrix and adheres to the tooth. It contains bacterial cells, salivary polymers and bacterial extracellular products. The dental plaque begins to accumulate within 24 hours without regular tooth brushing. The dental plaque has an extrapolysaccharide that surrounds it and protects it from the penetration of an antibiotic. Plaque accumulation can be stimulated by increased production of gingival cervical fluid that contains growth factors of various bacteria including Gram negative anaerobes such as Porphyromonas gingivalis, Prevotella melaninogenica and Fusobacterium nucleatum.

Furthermore; enteric bacteria can pose a potential threat and danger to children with inadequate and poor toilet hygiene by penetrating the body through the mouth as a result of nail biting and can lead to various oral cavity infections. Since oral health is integral to general health and is essential to the overall health and wellbeing of all individuals, the early identification of oral disease may contribute to the early diagnosis and treatment for a number of systemic diseases. It is therefore, important to determine the bacterial profile of the mouth and the antibiogram as panacea for treatment of oral diseases.

To the best of our knowledge, no work has been done on the assessment of oral bacterial profile and antibiogram of Adult Patients receiving dental Care at Babcock University Teaching Hospital, Ilishan-Remo Ogun State. Besides the need to determine the oral bacterial profile of dental patients, it is very important to determine the antibiotic sensitivity pattern of these oral bacterial pathogens due to emergence and reemergence of antibiotic resistance among bacterial population. This will guide empirical therapy for oral infection and dental problems. This will reduce the number of hospital visits, cost of treatment and risk of treatment failure. Also, identification of risk factors associated with oral infection and dental problems will be found very helpful in developing control and prevention programs aimed at reducing oral infection and dental problems.

1.2 Rationale

Despite advancements in dental care, bacterial and fungal infections continue to pose challenges in dental practice, leading to complications such as periodontitis, endodontic infections, and oral candidiasis. The emergence of antimicrobial resistance further complicates treatment outcomes, emphasizing the need for comprehensive surveillance of microbial isolates and antimicrobial susceptibility testing. Investigating the prevalence, distribution, and resistance profiles of bacterial and fungal pathogens in dental patients can inform evidence-based interventions to improve patient care and reduce the burden of oral infections.

1.3 Objectives

The primary objectives of this study are to:

Isolate and identify bacterial and fungal agents from patients attending the dental clinic at General Hospital Akwanga.

Determine the antimicrobial susceptibility patterns of the isolated bacterial and fungal strains.

Assess the prevalence of antimicrobial resistance among bacterial and fungal isolates in dental patients.

1.4 Scope of the Study

This study focuses on isolating and characterizing bacterial and fungal agents from patients presenting at the dental clinic of General Hospital Akwanga, Nigeria. The study will include patients of all ages and genders with symptoms suggestive of oral infections. Bacterial and fungal isolates will be subjected to antimicrobial susceptibility testing against a panel of commonly used antibiotics and antifungal agents.

1.5 Significance of the Study

The findings of this study will provide valuable insights into the microbial etiology of oral infections among dental patients in the study area. The antimicrobial susceptibility data generated will guide clinicians in selecting appropriate antibiotic and antifungal therapies, thereby improving treatment outcomes and reducing the risk of treatment failure and antimicrobial resistance development. Additionally, the study results will contribute to the body of knowledge on antimicrobial resistance patterns in dental practice, informing future research and public health interventions aimed at combating antimicrobial resistance.

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