Caesarian Vs Vaginal Delivery: From A Human Microbiota Perspective

The route of the birth delivery influences new born's health. Children born via Cesarean section are at increased risk of developing asthma, systemic connective tissue disorders, juvenile arthritis, inflammatory bowel disease, immune deficiencies and leukemia. Part of these diseases is believed to be related to maturation of neonatal immune system. During vaginal delivery, the contact with the maternal vaginal and intestinal flora is an important source for the start of the infant's colonisation. During Caesarean delivery, this direct contact is absent, and non-maternally derived environmental bacteria plays an important role for infant's gastro-intestinal colonisation. The primary function of microbial colonisation during the foetal period, intrapartum and after the birth is crucial in maturation and development of new-bornimmune system. This review supports the choice of the route of birth delivery and consequently favours a decrease in unnecessary Cesarean sections. It is crucial to provide this information to pregnant women and/or couples and health workers to make informed and educated decisions

“Comparative evaluation of surface modified elastomeric ligatures for microbial colonization”: An in vivo study.

Introduction: Elastomeric ligatures are observed to reduce chair side time; however, they are also seen to have greater bacterial adhesion. Polymeric coating utilizing the Metafasix Technology and the OrthoShield Technology have been introduced in the Super Slick™* and Safe‑T‑Ties™** by TP Orthodontics, Ortho Organizers, respectively, to reduce bacterial adhesion. While each of the elastomers has been individually evaluated, no study compares the two elastomers manufactured by differing technologies together; hence the need for this study was felt. This in vivo study compared the Super Slick and Safe‑T‑Ties with their unmodified counterparts for bacterial adhesion. Materials and Methods: Thirty patients undergoing orthodontic treatment, between 12 and 25 years age group were selected and the modified, and the unmodified elastomers were randomly placed quadrant wise, on all the premolar brackets. After a period of 4 weeks, the elastomeric rings were removed and transported for culture on Mitis–Salivarius, Rogosa SL agar for Streptococcus mutans and Lactobacilli, respectively. The colonies were digitally counted (HiMedia) after 48 h of incubation at 37°C. Results: There was a significant difference in the S. mutans and Lactobacilli counts in both surface modified and unmodified elastomeric modules (P < 0.01). Unmodified elastomeric modules Mini Stix™*, Hand‑EE‑Lasts™** was associated with higher mean values of colony‑forming units/millimeter than the surface modified Super Slick™* and Safe‑T‑Ties™** ligatures. When compared pair‑wise, the surface modified elastomers showed less bacterial accumulations than the unmodified counterparts for both S. mutans and Lactobacillus, and the differences were statistically significant. Conclusion: Technological modifications of the elastomers using the Metafasix or OrthoShield Technology, is a definite improvement over the regular elastomers with regard to adhesion of S. mutans and Lactobacilli.

Microbial colonization of Provox voice prosthesis in the Indian scenario.

INTRODUCTION: Tracheoesophageal speech using the voice prosthesis is considered to be the “gold standard” with success rates as high as 90%. Despite significant developments, majority eventually develop dysfunction due to microbial deterioration. We did a pilot study of 58 laryngectomy patients who developed prosthesis dysfunction. MATERIALS AND METHODS: A total of 58 laryngectomy patients who had their dysfunctional prosthesis removed were included in this study. Dysfunctional prostheses were removed and examined. Esophageal and tracheal flanges were examined separately. After obtaining pure fungal and bacterial cultures, the yeast strains were identified. Bacteria were identified with the light microscope and gram staining. We analyzed prosthesis lifespan and probable factors affecting it. RESULTS: Central leak was found in 43% cases while in 57% peri‑prosthetic leakage was the most common reason for prosthesis replacement. Microbial analysis revealed a combination of yeast and bacteria in approximately 55% culture samples. Out of these, almost 90% had the presence of single yeast species with bacteria. Pure fungal culture was identified in rest of the 45% cultures while none detected pure bacterial forms. Candida tropicalis was the solitary yeast in 81% while Candida albicans was seen in 10% as the solitary yeast. Bacterial isolates revealed Klebsiella pneumonia in 19%, Escherichia coli in 8% while Staphylococcus aureus was grown in 1% cultures. The consumption of curd (P = 0.036, 95% confidence intervals [CI]: 2.292‑64.285) to have a significant correlation of the mean prosthesis lifespan. Consumption of curd (P = 0.001, 95% CI: 0.564‑2.008) and history of prior radiotherapy (P = 0.015, 95% CI: 0.104‑0.909) had a significant bearing on the Provox prosthesis lifespan. CONCLUSIONS: Candida is the most common organism grown on voice prosthesis in Indian scenario. Consumption of curd and history of prior radiotherapy significantly affect Provox prosthesis lifespan.

Dynamics of Microbial Colonization of the Oral Cavity in Newborns

The host defense mechanisms are not well developed in neonates. The aim of this study was to evaluate the dynamics of microbial colonization of the oral cavity in newborns. Eighty-one samples of the oral microbiota were obtained from 51 healthy newborns 10 min to 53 h after birth by gently rubbing sterile swabs onto the surface of the tongue, cheek mucosa, alveolar process and palate. After microbiological processing, counting of the colony forming units of streptococci, staphylococci and Gram-negative aerobic bacilli was performed. Between 10 min and 8 h, Staphylococcus epidermidis was detected in 30.7% of the samples; between 8 and 16 h, S. epidermidis was detected in 69.5% of the samples and streptococci in 56.5% of the samples; between 16 and 24 h, S. epidermidis, streptococci and S. aureus were detected in 77.78%, 85.18% and 37.03% of the samples, respectively. Between 24 and 53 h, S. epidermidis was detected in 88.89%, streptococci in 94.4% and S. aureus in 33.3% of the samples. Mutans streptococci were not detected in any of the samples. The adoption of strict hygienic measures by the mother and the nursing staff should be emphasized to avoid or at least delay the occurrence of infections caused by microorganisms in newborns. In addition, hospital procedures must be aseptic and invasive interventions must be minimized.

Os mecanismos de defesa do hospedeiro não estão bem desenvolvidos em neonatos. O objetivo deste estudo foi avaliar a dinâmica da colonização microbiana da cavidade oral em recém-nascidos. Oitenta e uma amostras da microbiota oral foram obtidas a partir de 51 recém-nascidos saudáveis, entre 10 min e 53 h após o nascimento, esfregando-se, suavemente, cotonetes esterilizados sobre a superfície da língua, mucosa bucal, processo alveolar e palato. Após o processamento microbiológico foi realizada a contagem de unidades formadoras de colônias de estreptococos, estafilococos e bacilos aeróbios Gram-negativos. Entre 10 min e 8 h, Staphylococcus epidermidis foram detectados em 30,7% das amostras; entre 8 e 16 h, S. epidermidis foram detectados em 69,5% das amostras e streptococci foram detectados em 56,5% das amostras. Entre 16 e 24 h, S. epidermidis, streptococci e S. aureus foram detectados em 77,78%, 85,18% e 37,03% das amostras, respectivamente. Entre 24 e 53 h, S. epidermidis foram detectados em 88,89% das amostras, streptococci em 94,4% e S. aureus em 33,3% das amostras. S. mutans não foram encontrados em nenhuma amostra. A adoção de medidas de higiene rigorosas por parte da mãe e da equipe de enfermagem deve ser enfatizada para evitar ou pelo menos retardar a ocorrência de infecções causadas por microorganismos em recém-nascidos. Adicionalmente, procedimentos hospitalares devem ser assépticos e intervenções invasivas devem ser minimizadas.