Chronic nail biting, orthodontic treatment and Enterobacteriaceae in the oral cavity.
Chronic nail biting, orthodontic treatment and Enterobacteriaceae in the oral cavity.
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DOI：
10.4317/jced.56059
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发表时间：
2019-12-01
影响因子：
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通讯作者：
Chawla, Gurveen
中科院分区：
文献类型：
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作者：
Chinnasamy, Alagesan;Ramalingam, Karthikeyan;Chawla, Gurveen
背景：慢性咬指甲在儿童和年轻人中很常见。环境病原体的自动接种可能表现为远处器官的感染。多重耐药的革兰氏阴性细菌在全球范围内呈上升趋势。几种食源性细菌属于肠杆菌科，但很少有研究探索这些细菌在有慢性咬指甲习惯或正畸治疗的儿童的口腔中。材料与方法：对150例儿童(不咬指甲，60例咬指甲，30例固定正畸，30例使用固定正畸矫治器，30例同时使用固定矫治器和咬指甲习惯)进行细菌培养。采用浓缩式口腔冲洗技术。将漂洗液接种在麦康基和血液琼脂中。革兰氏染色培养用Bimer ieux VITEK 2紧凑型全自动微生物分析仪进行亚种鉴定生化试验。Fisher‘s Exact和Kruskal Wallis采用Dunn方法进行后继分析，以检验组间相关性和差异。结果：72%的儿童肠杆菌科细菌阳性。其中，咬指甲或正畸治疗组占89%。咬指甲并接受正畸治疗的患者CFU/ml最高，不咬指甲或不接受正畸治疗的患者CFU/ml最低。在正畸治疗组，分离出的四种细菌中有三种检测呈阳性。结论：慢性咬指甲或使用固定正畸矫治器与口腔中肠杆菌科细菌的发生率较高。口腔卫生专业人员在预防多重耐药传染病方面发挥着重要作用。关键词：肠杆菌科、咬指甲、食甲症、正畸治疗。
BACKGROUND: Chronic nail biting is common in children and young adults. Auto inoculation of environmental pathogens can manifest as infection in distant organs. Multi-drug resistance gram negative bacteria are on the rise globally. Several of the foodborne bacteria fall within the Enterobacteriaceae family but very few studies have explored these microbes in the oral cavity of children with chronic nail-biting habit or orthodontic treatment. The study aims to investigate oral load of Enterobacteriaceae in children with chronic nail-biting habit and or those undergoing orthodontic treatment.MATERIAL AND METHODS: 150 children (no nail-biting n=30, nail biting n=60, fixed orthodontic treatment n =30 and a combination of fixed orthodontic appliance use and nail-biting habit n =30) were assessed for culture based microbiological investigation. The concentrated oral rinse technique was used. The rinse was inoculated in MacConkey's and Blood Agar. The gram stained culture was subjected to biochemical tests for sub-species identification using Biomerieux Vitek 2 Compact Automated Microbiological Analyzer. Fisher's exact and Kruskal Wallis with post hoc analysis using Dunn method was performed to test association and difference between groups.RESULTS: Enterobacteriaceae was positive for 72% of the children. Of them, nail biting or orthodontic treatment group comprised 89%. Those with a combination of nail biting and undergoing orthodontic treatment exhibited highest CFU/ml and those without nail biting or orthodontic treatment exhibited the lowest. Three of the four organisms isolated tested positive in the orthodontic treatment group. E. coli was positive in 38% of the children while Klebsiella and E. cloacae were isolated exclusively in the orthodontic treatment group.CONCLUSIONS: Chronic nail biting or the use of fixed orthodontic appliances is associated with higher incidence of Enterobacteriaceae in the oral cavity. Oral health professionals play an important role in preventing multi drug resistance infectious diseases. Key words:Enterobacteriaceae, nail-biting, Onychophagia, orthodontic treatment.