AiM  Vol.11 No.8 , August 2021
Isolation and Antibiotic-Resistant Pattern of Opportunistic Infectious Microbes from the Infected Sites of Oral Cancer Patients Compared to That of Healthy People Oral Microbiota
Abstract: Introduction: Oral cancer is the third most prominent type of cancer in Bangladesh. During or after oral cancer treatment, immune-compromised cancer patients may be susceptible to an infection by multi-drug-resistant opportunistic microbes. This study aims to identify the prevalent microorganisms from the infected site of oral cancer patients and observe their antibiotic susceptibility pattern. Materials and Methods: Clinical samples were collected from the infected sites of oral cancer patients and healthy people. The swabs collected were placed on nutrient agar slant, then incubated for 24 hours at 37ºC. Bacteria from the slant were inoculated in several selective media (Mannitol Salt Agar Media, KF Streptococcus Agar media, Cetrimide Agar, Eosin Methylene Blue Agar). Several biochemical tests identified opportunistic microorganisms. Finally, the antibiotic susceptibility test was performed by the Kirby Bauer disc diffusion method. Results: The study found that 65.4% of microbes isolated from the patients’ oral cavities were Gram-negative bacteria, and 34.6% were Gram-positive bacteria. Among the patient group isolates (n = 55), the most prevalent organism was Pseudomonas spp. (30; 54.54%). Others were Klebsiella spp. (27; 49.09%), Staphylococcus spp. (24; 43.63%), E. coli (14; 25.45%), Streptococcus spp. (14; 25.45%), Proteus spp. (12; 21.8%) and Enterococcus spp. (6; 10.90%). Both Gram-positive and Gram-negative microbes from the patient group have shown high resistance to the commonly used antibiotics. In the control group (n = 50), the most prevalent organism was Staphylococcus spp. (15; 30%). Other organisms were Streptococcus spp. (6; 12%), Klebsiella spp. (11; 22%), E. coli (3; 6%), Streptococcus spp. (14; 25.45%), Pseudomonas spp. (8; 16%). The microbes of the control group showed less resistance to the antibiotics and rather showed sensitivity to them. Conclusion: The study revealed a high prevalence of multi-drug-resistant opportunistic microbes on immune-compromised oral cancer patients compared to microbes isolated from healthy people’s oral cavity.
Cite this paper: Nawar, Z. , Ashreen, S. , Hossain, M. and Ahmed, A. (2021) Isolation and Antibiotic-Resistant Pattern of Opportunistic Infectious Microbes from the Infected Sites of Oral Cancer Patients Compared to That of Healthy People Oral Microbiota. Advances in Microbiology, 11, 343-359. doi: 10.4236/aim.2021.118027.

[1]   Rodrigues, V.C., Moss, S.M. and Tuomainen, H. (1998) Oral Cancer in the UK: To Screen or Not to Screen. Oral oncology, 34, 454-465.

[2]   Ahmed, F. and Islam, K.M. (1990) Site Predilection of Oral Cancer and Its Correlation with Chewing and Smoking Habit—A Study of 103 Cases. Bangladesh Medical Research Council Bulletin, 16, 17-25.

[3]   Cawson, R.A. (1969) Leukoplakia and Oral Cancer. Journal of the Royal Society of Medicine, 62, 610-615.

[4]   Shaheed, S.M.I. and Molla, M.R. (1996) Oral Cancer in Bangladesh: Its Aetiology and Histological Grading. Journal of Oral Health, 2, 8-11.

[5]   Hussain, S.M.A. (2013) Comprehensive Update on Cancer Scenario of Bangladesh. South Asian Journal of Cancer, 2, 279-284.

[6]   Cloke, D.J., Green, J.E., Khan, A.L., Hodgkinson, P.D. and McLean, N.R (2004) Factors Influencing the Development of Wound Infection Following Free-Flap Reconstruction for Intra-Oral Cancer. British Journal of Plastic Surgery, 57, 556-560.

[7]   Gabrilove, J.L., Jakubowski, A., Scher, H., Sternberg, C., Wong, G., Grous, J., et al. (1988) Effect of Granulocyte Colony-Stimulating Factor on Neutropenia and Associated Morbidity Due to Chemotherapy for Transitional-Cell Carcinoma of the Urothelium. New England Journal of Medicine, 318, 1414-1422.

[8]   Ubeda, C. and Pamer, E.G. (2012) Antibiotics, Microbiota, and Immune Defense. Trends in Immunology, 33, 459-466.

[9]   Davison, J. (1999) Genetic Exchange between Bacteria in the Environment. Plasmid, 42, 73-91.

[10]   Clinical & Laboratory Standards Institute (2009) Performance Standards for Antimicrobial Susceptibility Testing; 19th Informational Supplement, CLSI M100-S19, Clinical and Laboratory Standards Institute, Wayne.

[11]   Ferraro, M.J., Craig, W.A. and Dudley, M.N. (2001) Performance Standards for Antimicrobial Susceptibility Testing. Clinical & Laboratory Standards Institute, Wayne.

[12]   Wade, W.G. (2013) Characterisation of the Human oral Microbiome. Journal of Oral Biosciences, 55, 143-148.

[13]   Whitmore, S.E. and Lamont, R.J. (2014) Oral Bacteria and Cancer. PLoS Pathogens, 10, e1003933.

[14]   Philip, K., Teoh, W.Y., Muniandy, S. and Yaakob, H. (2009) Pathogenic Bacteria Predominate in the Oral Cavity of Malaysian Subjects. Journal of Biological Sciences, 9, 438-444.

[15]   Yamashita, K., Ohara, M., Kojima, T., Nishimura, R., Ogawa, T., Hino, T., et al. (2013) Prevalence of Drug-Resistant Opportunistic Microorganisms in Oral Cavity after Treatment for Oral Cancer. Journal of Oral Science, 55, 145-155.

[16]   Anjali, K., ArunAnatapadma, B., BastitianThattil, S., Parthiban, R. and Selvamani, M. (2020) Study on Oral Microbial Flora and Antibiotic Sensitivity Pattern among Oral Cancer Patients in a Tertiary Cancer Care Center. Journal of Orofacial Sciences, 11, 93-99.

[17]   Oji, C. and Chukwuneke, F. (2012) Poor Oral Hygiene May Be the Sole Cause of Oral Cancer. Journal of Maxillofacial and Oral Surgery, 11, 379-383.

[18]   Gaonkar, P.P., Patankar, S.R., Tripathi, N. and Sridharan, G. (2018) Oral Bacterial Flora and Oral Cancer: The Possible Link? Journal of Oral and Maxillofacial Pathology, 22, 234-238.

[19]   Ashreen, S., Ahmed, A., Hasan, N., Akhtar, W. and Hossain, M. (2020) Isolation and Identification of Gram-Negative Bacteria from Oral Cancer Site Infections and Study of Their Antibiotic Resistance Pattern. Bangladesh Journal of Microbiology, 36, 85-90.

[20]   Gaynes, R., Weinstein, R.A., Edwards, J.R. and National Nosocomial Infections Surveillance System (2005) Overview of Nosocomial Infections Caused by Gram-Negative Bacilli. Clinical Infectious Diseases, 41, 848-854.

[21]   Horan, T.C., Garner, J.S., Jarvis, W.R., Emori, T.G. and Hughes, J.M. (1988) CDC Definitions for Nosocomial Infections, 1988. American Journal of Infection Control, 16, 128-140.

[22]   Carpenter, C.B. (1990) Immunosuppression in Organ Transplantation. New England Journal of Medicine, 322, 1224-1226.

[23]   Cairncross, S., Hunt, C., Boisson, S., Bostoen, K., Curtis, V., Fung, I.C.H. and Schmidt, W.-P. (2010) Water, Sanitation and Hygiene for the Prevention of Diarrhoea. International Journal of Epidemiology, 39, i193-i205.

[24]   Gupta, A. (2002) Hospital-Acquired Infections in the Neonatal Intensive Care Unit—Klebsiella pneumoniae. Seminars in Perinatology, 26, 340-345.

[25]   Ali, A., Pineda, L.A. and Saliba, R.G. (2006) Effect of Oral Decontamination with Chlorhexidine on the Incidence of Nosocomial Pneumonia: A Meta-Analysis. Critical Care, 10, Article No. R35.

[26]   Rocio, R.C., Florence, L.G., Krista, R., Gilles, R., Michèle, V., Stephanie, G., Geneviève, H., Georges, B. and Sylvie, B. (2015) Pseudomonas Aeruginosa and Periodontal Pathogens in the Oral Cavity and Lungs of Cystic Fibrosis Patients: A Case-Control Study. Journal of Clinical Microbiology, 53, 1898-1907.

[27]   Minah, G.E., Solomon, E.S. and Chu, K. (1985) The Association between Dietary Sucrose Consumption and Microbial Population Shifts at Six Oral Sites in Man. Archives of Oral Biology, 30, 397-401.

[28]   Dhand, A. and Snydman, D.R. (2009) Mechanism of Resistance in Metronidazole. In: Mayers, D.L., Ed., Antimicrobial Drug Resistance. Infectious Disease, Humana Press, New York, 223-227.

[29]   Leiros, H.K., Kozielski-Stuhrmann, S., Kapp, U., Terradot, L., Leonard, G.A. and McSweeney, S.M. (2004) Structural Basis of 5-Nitroimidazole Antibiotic Resistance: The Crystal Structure of NimA from Deinococcus radiodurans. Journal of Biological Chemistry, 279, 55840-55849.

[30]   Patel, G. and Bonomo, R.A. (2013) “Stormy Waters Ahead”: Global Emergence of Carbapenemases. Frontiers in Microbiology, 4, Article No. 48.

[31]   Bud, R. (2007) Penicillin: Triumph and Tragedy. Oxford University Press, Oxford.