Microbiological Speciation of Aerobic Bacteria in Patients undergoing treatment for Oral Malignancy

 

Nirisha Sriram¹, Gheena. S², Gopinath. P³

¹2^ND Year BDS, Saveetha Dental College and Hospitals, Chennai,India

²Professor Department of Oral Pathology, Saveetha Dental College and Hospitals, Chennai, India

³Professor Department of Microbiology, Saveetha Dental College and Hospitals, Chennai,India

 

ABSTRACT:

AIM and OBJECTIVE :The aim of the study is to identify the microbiological speciation of aerobic bacteria in patients undergoing treatment for oral malignancy . BACKGROUND : Cancer patients remain at substantial risk for developing serious infections despite significant advances in cancer therapy and supportive care.Moreover, the oral cavity infections in cancer patients usually result from the combination of neutropenia and mucositis. In any cases of infection involving the oral cavity , the oral micro flora may be subsequently replaced by potentially pathogenic microorganisms.Hence, the aim of this study was to determine infectious pathogens in oral cavity of oral cancer patients undergoing different treatment protocols. REASON : To create awareness about the side effects of the treatment protocols in cancer treatment so as to stipulate a harmless treatment .

 

 

 

INTRODUCTION:

Oral cancers are neoplastic growththat are an  abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissues, and persists in the same excessive manner after cessation of the stimulus which evoked the change. They are mostly caused due to genetic disorders. They can occur anywhere in the oral cavity ranging from buccal muosa , tongue, lips ,hard and soft palate, gums to the salivary glands and floor of the mouth .Some methods to treat cancer includes chemotherapy, radiotherapy and surgery in the advanced cases. However the use of chemotherapy and radiotherapy can produce damaging effects for the patients. The risk of oral complications is due to multiplefactors. High turnover rates for cellsliningthe oral mucosamakethis area susceptible to chemotherapyagents targeted to rapidly dividingcells. There is a diverse and complex natural microflora in the oral cavity,which can lead to opportunisticovergrowth by any of a largegroup of microbes.^[1]

 

The oral cavity may becomethe focus of chemotherapeutic complications, especially if there is concurrent bone marrow suppression. Oral complications from chemotherapy are similar to those induced by radiation, althoughsometimesmoretransient in nature. Xerostomia, dysphagia, and dysgueusia are common problems, and are morelikely in patients with mucositis, soft tissueulceration, or oral infection and mucositis. All this leads to Secondary bacterial colonization of the oral mucosa,and commensals becoming harmful to the body .

 

MATERIALS AND METHOD:

The study was carried out in the department of oral pathology and microbiology,Saveetha Dental college, Chennai, Tamil Nadu and RAI-CBCC Cancer center, chennai, Tamilnadu.  The study consisted of a total group of 10 patients diagnosed with oral cancer out of which 6 were male and 4 were female each having undergone a duration of treatment for a weak.

                             

Inclusion criteria: Patients suffering from carcinoma of oral cavity within  the age group of 45-55 years.

Exclusion criteria: All the other malignancies .

Group A: patients suffering from carcinoma of tongue

Group B : patients suffering from carcinoma of buccal mucosa .

 

SAMPLE COLLECTION:

The sample collected was saliva. 5 patients each suffering from carcinoma of the tongue and buccal mucosa respectively were selected each having undergone a course of chemotherapy  in the RAI-CBCC Cancer center .

 

BACTERIAL CULTURE:

The sample obtained from the patients were cultured in three different culture media namely lactobacillus, Mittissalivarius agar base and MHA medium.

 

Lactobacillus medium: 67.15g of lactobacillus powder was suspended in 1000ml of distilled water .The media is then heated to dissolve the powder completely in water. The media is then autoclavedat 15lbd pressure for 15 minutes. Once the process of autoclave is done ,the suspension is mixed well and poured into sterile petri plates .

 

Mitts salivarius agar base: 3 scoops of agar is heated for 15 minutes .The heated agar is then transferred to the plates after cooling it .The plates are then kept in autoclave for 4 hours .It is then kept in hot air oven for 20 minutes.

 

MULLER HINTON AGAR:

Suspend 38 gm of the medium in one litre of distilled water.Heat with frequent agitation and boil for one minute to completely dissolve the medium. Autoclaving is then done at 121°C for 15 minutes. Cool to room temperature .Pour cooled Mueller Hinton Agar into sterile petri dishes on a level, horizontal surface to give uniform depth. Allow to cool to room temperature and store the plates .

 

RESULT:

 

Fig-1: Graphical representation of difference between bacteria and cancer

 

Table 1: Paired sample statistics amongst the bacteria Paired Samples Statistics

		Mean	N	Std. Deviation	Std. Error Mean
Pair 1	oralcancer	.5000	10	.52705	.16667
	canceroftongue	1.0000	10	1.05409	.33333
Pair 2	bacMb	.4000	10	.51640	.16330
	bacMt	.3000	10	.48305	.15275
Pair 3	bacstaphb	.3000	10	.48305	.15275
	bacstapht	.3000	10	.48305	.15275
Pair 4	bacMitisb	.2000	10	.42164	.13333
	bacMitT	.3000	10	.48305	.15275
Pair 5	bacSanguisb	.0000	10	.00000	.00000
	bacsanguisT	.3000	10	.48305	.15275
Pair 6	bacSalb	.2000	10	.42164	.13333
	bacSalt	.1000	10	.31623	.10000
Pair 7	bacEb	.1000	10	.31623	.10000
	bacEt	.2000	10	.42164	.13333
Pair 8	bacPb	.0000	10	.00000	.00000
	bacPt	.2000	10	.42164	.13333
Pair 9	bacLb	.0000a	10	.00000	.00000
	bacLt	.0000a	10	.00000	.00000
Pair 10	bacSPb	.0000	10	.00000	.00000
	bacbacSPt	.1000	10	.31623	.10000
Pair 11	bacCb	.1000	10	.31623	.10000
	bacCt	.2000	10	.42164	.13333

Table 2: Paired sample correlations amongst the bacteria Paired Samples Correlations

		N	Correlation	Sig.
Pair 1	Oralcancer and canceroftongue	10	-1.000	.000
Pair 2	bacMb and bacMt	10	-.535	.111
Pair 3	Bacstaphb  and  bacstapht	10	-.429	.217
Pair 4	bacMitisb and bacMitT	10	-.327	.356
Pair 5	bacSanguisb and bacsanguisT	10	.	.
Pair 6	bacSalb and bacSalt	10	-.167	.645
Pair 7	bacEb and bacEt	10	-.167	.645
Pair 8	bacPb and bacPt	10	.	.
Pair 10	bacSPb and bacbacSPt	10	.	.
Pair 11	bacCb and bacCt	10	-.167	.645

 

Table 3 : Paired sample test determining the significance  Paired Samples Test

		Paired Differences					t	df	Sig. (2-tailed)
		Mean	Std. Deviation	Std. Error Mean	95% Confidence Interval of the Difference
					Lower	Upper
Pair 1	oralcancer - canceroftongue	-.50000	1.58114	.50000	-1.63108	.63108	-1.000	9	.343
Pair 2	bacMb - bacMt	.10000	.87560	.27689	-.52636	.72636	.361	9	.726
Pair 3	bacstaphb - bacstapht	.00000	.81650	.25820	-.58409	.58409	.000	9	1.000
Pair 4	bacMitisb - bacMitT	-.10000	.73786	.23333	-.62784	.42784	-.429	9	.678
Pair 5	bacSanguisb - bacsanguisT	-.30000	.48305	.15275	-.64555	.04555	-1.964	9	.081
Pair 6	bacSalb - bacSalt	.10000	.56765	.17951	-.30607	.50607	.557	9	.591
Pair 7	bacEb - bacEt	-.10000	.56765	.17951	-.50607	.30607	-.557	9	.591
Pair 8	bacPb - bacPt	-.20000	.42164	.13333	-.50162	.10162	-1.500	9	.168
Pair 10	bacSPb - bacbacSPt	-.10000	.31623	.10000	-.32622	.12622	-1.000	9	.343
Pair 11	bacCb - bacCt	-.10000	.56765	.17951	-.50607	.30607	-.557	9	.591

 

From the present study it can be concluded though there isn’t much statistical significance as P value is greater that 0.05 in all the cases between the bacteria found in buccal mucosa carcinoma and carcinoma of the tongue , some amount of difference is seen in sanguis and pseudomonas . A larger sample size with specific locoregional sample collection method might give results which are statistically significant .

 

DISUSSION:

 More than 700 bacterial species or phylotypes, of which over 50% have not been cultivated, have been detected in the oral cavity. Most of the microorganisms existing in our oral cavity have a symbiotic capacity, maintaining relationships with the host that are based on mutual benefits (Los Alamos National Library, 2009)^(2). Not only do they not causeany  harm, but also the commensal populations may keep pathogenic species in check by not allowing them to adhere to mucosal surfaces. The bacteria do not become successful pathogens, causing infection and disease, until they breach the barrier of commensals (Jenkinson and Lamont, 2005)^(3).There is a high chance for Patients undergoing treatment for Oral carcinoma to suffer from dry mouth , what is called xerostomia in medical terms . This might itself pave a way for the growth of microorganisms there by increasing the chance of a reduction in immunity .The species of microbes  that reside in the oral cavity are yet to be  identified completely, and an estimated 750 different species are anticipated (Jenkinson and Lamont, 2005; Paster et al., 2006^(4). Some of the identified species include Streptococcus, Actinomyces, Veillonella, Fusobacterium, Porphromonas, Prevotella, Treponema, Nisseria, Haemophilis, Eubacteria, Lactobacterium, Capnocytophaga, Eikenella, Leptotrichia, Peptostreptococcus, Staphylococcus, and Propionibacterium, (Jenkinson and Lamont, 2005; Wilson, 2005) ^(5). In the present study,most of the bacteria found in patients undergoing treatment for carcinoma of buccal mucosa and tongue almost have bacteria that are commensals with a very few exceptions being pseudomonas and sanguis. Hence with this pilot study we can come to a conclusion that there is not much of a change in the types of bacteria found in the oral cavity within the first weak of treatment for oral carcinoma.

 

ACKNOWLEDGEMENT:

I would like to thank dr. Rajeskaran from rai-cbcc cancer center  for his support in the research from giving permisson to collect patients sample to extending his support in clearing all the doubts that came during the research process.

 

REFRENCES:

1.       Los Alamos National Library, 2009.

2.       Jenkinson and Lamont, 2005).

3.       Jenkinson and Lamont, 2005; Paster et al., 2006.

4.       Jenkinson and Lamont, 2005; Wilson, 2005.

5.       JornA.Aaset.al.,Defining the Normal Bacterial Flora of the Oral Cavity,Journal of clinical microbiology, 2005 Nov; 43(11): 5721–5732

 

 

 

 

 

 

 

Accepted on 24.08.2016        © RJPT All right reserved

Research J. Pharm. and Tech 2018; 11(7): 2721-2723.