دراسة تأثير مرض السكري على التنوع و المقاومة للمضادات الحيوية عند بكتريا الفم الهوائية عند الاطفال

Study the effect of diabetes mellitus on diversity and antibiotic-resistance of oral aerobic bacteria in children

Abstract

The continuous persistence of diabetic mellitus (DM) conditions can affect the diversity and density of the oral normal flora. Many oral bacteria can be changed into pathogens under the effect of DM. Resistance to antibiotics can also affect by DM when many oral bacteria can activate its resistance to antibiotics or get a new one in the presence of DM.
A case-control study was designed to include 105 children aging (1.5-15) years divided into two main groups. The first group included 50 patients aging with DM who also subdivided into two subgroups; 25 patients with controlled DM and 25 patients with uncontrolled DM ;The second group was 55 non-diabetic children . Oral swabs were collected from all children groups and cultured for identification of the colony counting and species diagnosis. Susceptibility tests to many antibiotics by disk diffusion method were performed for all isolates with determination of antibiotic-resistant.
Females were represented a great number of patients with DM and control groups, but without significant differences from males. Duration of DM was mostly found within less than one year (52%), especially at age 11-15 years, while duration of 7-8 years (6%) was observed in low number of diabetic patients. Heavy growth of isolated bacteria that exceed 360 cfu was found higher in both DM and non-diabetic children. It counted in 64.76% of subjects. Uncontrolled DM had more heavy growth (20 patients) than in controlled DM (9 patients). This was also observed in non-diabetic children (39children). Counting of 100-200 cfu was represented the second great count of bacteria isolated from all subjects (20%).

Total number of isolated bacteria was 23 species of Gram positive and 2 species of Gram negative bacteria. Number of isolated bacteria was equal (47.61%) in DM patients, while it increased in control (52.38%), but without significant differences. Kocuria kristinae, Kytococcus sedentarius, Streptococcus oralis and Granulicatella adiacens were the most frequent isolated species (23.75%, 13.33%, 12.38% and 9.52%, respectively). In controlled DM, K. kristinae and G. adiacens were common (3.80% for each), while K. kristinae and K. sedentarius were common among patients with uncontrolled DM (6.66% and 4.76%, respectively). Children in non-diabetic group had common isolates of K. kristinae (7.61%), and S. oralis (8.57%)
Susceptibility of isolated bacteria to tested antibiotics was found variable even in the same species. Isolate 2 of S. aureus and isolate 4 of K. kristinae isolated from controlled DM patients and all isolates of K. kristinae of uncontrolled DM were revealed resistant to all of antibiotics. Meanwhile, S. aureus-1 from children of non-diabetic was shown multidrug resistant to at least 9 antibiotics and 8 isolates of K. kristinae were resistant to 8 antibiotics. Resistant to ceftriaxone (CRO), cefixime (CFM) and tetracycline (TE) were the most common in isolates of all participants.