Identification and Antifungal Sensitivity Pattern of Candida Species Isolated from Various Oro-dental Conditions.

Background: Oral candidiasis is the most common oral opportunistic infection seen in immunocompromised patients. Apart from C. albicans the non albicans Candida species, which are less susceptible to the commonly used antifungal drugs are major etiological agent for candidiasis. Thus, in recent years there has been an increased interest in spectrum of infections caused by Candida species. However with the recognition, that Candida spp. differ in the production of virulence factor and sensitivity to antifungal agents, greater emphasis has been placed on identification of isolates up to species level. In the past identification of various species of Candida other than C. albicans has not been attempted in oral lesions. Methods: A total of 158 swabs were collected from oral cavity of patients having lesions suggestive of oral candidiasis. One swab was subjected for direct microscopy using Gram staining. The second swab was inoculated on two tubes of Sabouraud Dextrose agar (SDA) with antibiotics (Hi-Media). Results: Candida albicans though was the commonest species isolated. , NAC is also emerging as important opportunistic pathogens in oro-dental infections. Conclusion: In view of the changing pattern, it is strongly recommended that species identification and sensitivity test can help in much better treatment strategies, and thus, gain a good control over the disease.

Association of Enterococcus faecalis with Different Forms of Dental Diseases among Patients Visiting a Tertiary Hospital in Ekiti State, Nigeria.

Aims: The implication of Enterococcus faecalis in dental infections is rising and resistance to common antibiotics continues to rise globally as well. In this study, the association of E. faecalis with different forms of dental infections was investigated and the antibiotic resistance profile of the isolates was determined. Place and Duration of Study: The samples were collected from a tertiary health institution in Ekiti State, transferred to the Department of Microbiology, Ekiti State University, Ado-Ekiti, Nigeria and processed immediately. This study was carried out between June, 2009 and March, 2010. Methodology: Oral interview was conducted among the patients in order to collect relevant data while sterile culturette was used to collect the samples after proper diagnoses, plated and incubated appropriately using standard microbiological techniques. The susceptibility of the isolates to commonly and frequently used antibiotics was determined by the disc diffusion method on Müller-Hinton agar. Results: Overall, 46.0% of the subjects had dental infections The subjects with dental infections were 46.60% males and 53.40% females. Students accounted for 58.25% of the total subjects followed by traders with 16.50%. Enterococcus faecalis was isolated from 52.08% of the students, 22.92% traders and 4.17% of the farmers. The highest occurrence (37.86%) of dental infection was recorded among patients within the age bracket 21 and 30 years while dento-aveola abscess (DAA) followed by dental caries (DC) were the predominant dental infections recorded in that order. A total of 46.60% of the dental infections were colonized by E. faecalis that were mostly resistant to amoxicillin (93.90%) and cloxacillin (92.68%). Resistance to the fluoroquinolones tested was relatively low, ranging from 8.54 to 25.61% in spafloxacin and perfloxacin, respectively whilst it was 1.22% to vancomycin among the isolates. Conclusion: The isolates were resistant to common antibiotics tested, however, vancomycin proved to be the most effective in the inhibition of the isolates.

Rinosinusitis maxilar crónica de origen dental / Chronic maxillary rhinosinusitis of dental origin

Introducción: La rinosinusitis maxilar de origen dental (RSMD) es una entidad reconocida con una incidencia cercana al 30%. Su diagnóstico puede pasar inadvertido, tanto en la clínica como en las imágenes, llevando a persistencia de sintomatología y fracaso de tratamiento. Objetivo: Describir la presentación clínica, diagnóstico y tratamiento de pacientes con rinosinusitis maxilar de origen dental. Material y método: Reporte de casos. Se revisaron historias clínicas, imágenes radiológicas, protocolos operatorios y cultivos microbiológicos de pacientes con diagnóstico de rinosinusitis de origen dental atendidos en Clínica Las Condes. Resultados: Diez pacientes, siete mujeres y tres hombres con edad promedio de 63 años. Descarga posterior y rinorrea fueron los síntomas más frecuentes. El estudio incluyó radiografía dental y tomografía computarizada de cavidades paranasales. Las complicaciones secundarias a extracciones dentales y de implantes dentales fueron las etiologías más frecuentes, siendo el primer molar la pieza dental más comprometida. Todos los casos fueron manejados en conjunto por equipo médico y odontológico. Ocho pacientes requirieron tratamiento quirúrgico y 5 de ellos además procedimientos dentales asociados. La flora responsable fue mixta aerobia y anaerobia. Conclusión: En pacientes rebeldes a tratamiento y con síntomas unilaterales, se debe tener un alto índice de sospecha y buscar dirigidamente patologías dentales que expliquen cuadros rinosinusales máxilo-etmoidales.

Introduction: Odontogenic maxillary sinusitis is a well-recognized condition and accounts for approximately 30% of maxillary sinusitis cases. The diagnosis can be missed leading to failure in medical and surgical treatments. Aim: To describe clinical features, diagnosis procedures and treatment of odontogenic maxillary sinusitis. Material and method: Case Report. We retrospectively reviewed medical records, radiologic characteristic, surgical findings and intraoperative microbial cultures of patients with diagnosis of odontogenic sinusitis at Clínica Las Condes. Results: 10 patients were identified, 7 females and 3 males with a mean age of 63 years. Posterior discharge and rhinorrhea were the most common symptoms. Dental x-rays and paranasal sinus CT-scans were performed in all patients. Iatrogenic causes, which include dental implants and dental extractions, were the most common etiology and the 1st molar was the dental piece most frequently involved. Both otolaryngologists and dentistsworked together in all cases. 8 patients had endoscopic sinus surgery and five of them received concomitant management of the dental origin. Polymicrobial cultures were obtained. Conclusions: Otolaryngologists must have a high index of suspicion and look for an odontogenic cause in individuals with unilateral maxillary and ethmoidal symptoms, resistant to conventional sinusitis therapy.

Inr In Pediatric Patients With Acute Dental Infections : A Plot Study.

Patients with congenital or acquired coagulopathies are common in the general population. Dentists should have access to the patients’ appropriate and current laboratory values to prevent bleeding complications during and after invasive dental procedures. A laboratory test called an INR(International Normalized Ratio) measures the time it takes for blood to clot and compares it to an average. Many drugs can change the INR such as aspirin, ibuprofen and Antibiotics the most common drugs used for treating acute dental infections. Aims: To determine whether there is any change in bleeding tendencies of pediatric patients with acute dental infections also to evaluate the utility of testing INR in patients who have to receive invasive dental treatments especially those with acute dental infections. Method: 10 patients, 7 boys and 3 girls, with acute dental infections were randomly selected from the patients arriving at Department of Pedodontics. Blood sample was collected through venepuncture and was immediately sent for prothrombin time tests. Using these values INR was calculated. Results: The mean INR value for the study was 1.194. The Mean INR among boys was 1.164 and Mean INR among girls was 1.29. The Mean Prothrombin Time was 14.39 sec. The Mean Prothrombin time among the boys was found to be 13.98 secs. The Mean Prothrombin time among the girls was found to be 15.33 sec. Conclusion: There was no significant change in INR in patients with acute dental infections.

Etiología y tratamiento de procesos infecciosos odontogénicos en niños indigentes / Etiology and treatment of dental infections in indigent children

Objetivo: determinar los agentes infecciosos y la eficacia de la Amoxicilina +Sulbactam en procesos infecciosos odontogénicos en niños y adolescentes de y en la calle. Material y métodos: durante febrero a julio del año 2004 se valoraron 47 pacientes; 25 varones y 22 mujeres, entre niños y adolescentes “de y en la calle” hasta los 19 años, todos presentaron signos y síntomas de procesos infecciosos de origen dental. Se realizó la toma de muestras para cultivos, para luego procesar las mismas en el laboratorio de microbiología del hospital Arco Iris. Seguida la lectura de los cultivos se realizaron pruebas bioquímicas de acuerdo a cada germen aislado para determinar la identificación definitiva. La antibióticoterapia administrada consistió en Amoxicilina + Sulbactam oral en diferentes dosis de acuerdo a la edad, al peso de cada paciente. Resultados: el número de aislamientos positivos fueron 47; 25 en varones y 22 en mujeres. De acuerdo al grupo etáreo se hallaron 27 aislamientos positivos en niños menores de 12 años y 20 en mayores de 12 años. Los agentes etiológicos identificados según su frecuencia fueron: Streptococcus mutans en 24,5%, Porphyromonas gingivalis en 23,6%, Porphyromonas endodontalis en 18,2%, Streptococcus salivarius en 10,1%, Streptococcus sanguis en 8,2%, Peptostreptoco-ccus sp. en 7,3%, Prevotella oralis en 3,6% Streptococcus pyogenes en 2,7%, y Actinomycetos en 1,8%. El total de pacientes que concluyeron el tratamiento fueron de 38 niños y adolescentes; registrándose 9 pacientes de sexo femenino que abandonaron dicho tratamiento. Los cultivos de los 38 pacientes posteriores al tratamiento fueron negativos. Conclusiones: los agentes frecuentemente implicados en este tipo de procesos infecciosos odontogénicos son el: Streptococcus mutans, Porphyromonas gingivalis y Porphyromonas endodontalis. El tratamiento con Amoxicilina + Sulbactam, resultó efectivo en todos los casos.

Objective: to identify infectious agents and determine the efficacy of Amoxiciline-Sulbactam in dental infections in children and teenagers who live and work in the streets. Materials and methods: from February to July 2004 we followed 47 patients, 25 of which were males. All patients were children and teenagers who live and work in the streets. All of them showed signs and symptoms of dental infections. Cultures of all of them were taken and processed at the microbiology laboratory of Arco Iris Hospital. All of them received treatment with a combination of Amoxiciline and Sulbactam, dosages was established according to the age of each patient. Results: all cultures were positive in 25 males and 22 females, 27 positive cultures belonged to children under 12 years of age and 20 positive cultures belonged to patients over this age. The bacteria identified according to order of frequency were: Streptococcus mutans 24,5%, Porphyromonas gingivalis in 23,6%, Porphyromonas endodontalis in 18,2%, Streptococcus salivarius 10,1%, Streptococcus sanguis 8,2%, Peptostreptococcus sp. 7,3%, Prevotella oralis 3,6% Streptococcus pyogenes 2,7% and Actinomycetos 1,8%. 38 patients finished treatment and 9 female patients abandoned the study. All post-treatment cultures were negative. Conclusions: bacterial agents more frequently found in these dental infections were: Streptococcus mutans, Porphyromonas gingivalis and Porphyromonas endodontalis. The Amoxiciline-Sulbactam combination treatment was effective in all cases.