Oral Flora and Routine Antibiotics Sensitivity of HIV Infected and Immune Competent Patients attending Yaoundé Central Hospital

Author(s):

Njoya Youssofa Mbaimoun, Ashu Michael Agbor*, Pierre Rene Fotsing Kwetche, Kouemeni Lysette, Fokunang Charles Ntungwen, Jeanne Ngogang and Sudeshni Naidoo

Introduction: The normal human oral flora can be altered by certain systemic diseases such as Diabetes, HIV, Hypertension, Cancer, Sickle cell anemia. The aim of our study was to determine the oral micro flora and antibiotics sensitivity of HIV infected and non-HIV infected patients attending Yaoundé Central Hospital.

Methods: This was a prospective cross sectional qualitative and comparative laboratory study carried out between the month of March 2016 to July 2016, conducted on thirty subjects divided into two groups of HIV infected patients and, a control group (Non-HIV infected patients). Ninety Specimens from 30 patients were collected from their saliva, gingival crevices and supra-gingival calculus. Microbial culture was done on specific culture media such as manitol, saburau, choccolat PV, choccolat VCN, EMB. This was followed by an enzymatic test (catalyze test, DNAse), while different species were purified and anti-biograms were done for the different isolates.

Results: The age range of the patients recruited in the study was between 19-61 years; with a mean range of 34.30 years and a male: female ratio of 1:2. Tuberculosis was the only opportunistic infection in patients with HIV infection, Candida albicans, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus spp, Streptococcus β hemolytic, Streptoccocus spp., Klebsiella pneumonia were isolated in saliva, gingival crevices and supra gingival calculus of the patients. Candida albicans was found in high proportion in all salivary samples. Amongst the HIV infected patients, the most common commensal microorganism isolated was the Streptococci spp. with mean occurrence of 5 (33.33%); K. pneumonia was isolated in 14.28% of cases; we also have Staphylococcus aureus and S. epidermidis in 20% of cases. In the control groups, the Streptococci spp. were the most common with 33.33%, followed by Streptococcus β hemolytic 26.26%, Klebsiella pneumonia and Staphylococcus epidermidis 6.6% of case. HAART was generally found to reduce the bacteria load in the oral cavity. Candidiasis was the most common pathology found in the HIV group, followed by periodontal diseases as compared to the non-HIV group, where there was no candidiasis but periodontal diseases. Most bacteria isolated were found to develop resistance to Cotrimoxazole and Tetracycline, followed by Ofloxacine, Augmentin (amoxicillin and clavulanic acid) and kanamycin, the bacteria isolated were also sensitive to Minocycline, Levofloxacin, Ofloxacine, Gentamicin, Azetreoname, Cefoxine and Imipeneme.

Conclusion: Though the antimicrobial load was higher in HIV patients, HAART tend to reduce the load of these microorganisms. Among routine antibiotics prescribed, most of the patients were found to develop resistance to Cotrimoxazole and Tetracycline.

Recommendation: The same study should be carried out on routine HIV medications and prescription guidelines should be reviewed.