Detection of Multidrug resistant cariogenic bacteria among Diabetic Patients attending a Tertiary Hospital in Ado Ekiti, South-Western, Nigeria

Abstract

Microorganisms colonizing the oral cavity have a significant probability of spreading on epithelial surfaces to neighboring sites. Many reports have associated oral bacteria to oral infectious diseases as well as systemic diseases such as cardiovascular disease and diabetes. Oral care is usually neglected in the control of health problems linked with diabetes which may contribute to the increased morbidity and complications from oral health problems. The study aimed to identify the resident microbial flora and assess the possible carriage of cariogenic bacteria among people with diabetes in Ado- Ekiti, Nigeria. Oral swabs were collected from 306 consenting patients. Culture-based isolation was done using standard techniques on Mitis salivarius agar supplemented with 1% Potassium Tellurite, 10% chocolate agar and MacConkey agar at 37 oC for 18-48 hours. The susceptibility patterns of the isolates were detected using standard techniques as recommended by CLSI. Selected bacteria isolates were genomically identified using the bacterial universal primer 16S rRNA and STR-1 and STR 2 primers (partial tuf genes). Amplified genes were sequenced and phylogenetic analysis was carried out using MEGA 7 software. A total of 447 microbial isolates were identified among which were Staphylococcus spp (14.5%), Klebsiella pneumoniae (3.4%), Escherichia coli (2.5%), Candida spp (8%) while the streptococcal organisms such as Streptococcus pyogenes (35.2%), Streptococcus mitis (14%), Streptococcus mutans (7.3%) and Streptococcus salivarius (15.1%). Streptococcus mutans was susceptible to meropenem (71.4%) but highly resistant to Penicillin (100%), cefuroxime (71.4%) cefotaxime (68.6%). Streptococcus mitis was highly resistant to Amoxicillin/Clavulanate (100%), Cloxacillin (100%) and Cefuroxime (70.1%) but was found susceptible to Meropenem (77.3%). 16S ribosomal RNA gene amplification and subsequent sequencing of the isolates revealed twenty-six (26) de-novo bacterial strains. In conclusion, the study showed that diabetic individuals carry multidrug-resistant cariogenic bacteria that may predispose them to other oral diseases. There is a need to incorporate routine oral microbiological screening into routine care for diabetic patients in Nigeria.