Analysis of wound discharge microbiota in patients with drug-associated osteonecrosis of the jaw

Abstract

Introduction. Several key factors in the pathogenesis of drug-associated osteonecrosis have been described in the literature, among which infectious agents play a not insignificant role. The features of the jaw bones and invasive dental manipulations contribute to the adhesion and colonization of pathogenic and opportunistic microorganisms, which contributes to the progression of the disease. The aim of the investigation was to study and analyze the microbiota of the wound discharge in case of medication-associated osteonecrosis of the jaw and to reveal possible etiologically significant microorganisms. Materials and Methods. The study group included 30 men and 26 women with the diagnosis of medication-associated osteonecrosis of the jaw (mean age 66,8 ± 10,03 years), comparison group included 55 men and 27 women with odontogenic inflammatory diseases (mean age 43,6±5,8 years). Microbiota of the wound discharge was studied in the patients of the main group and its composition was compared with the microbiota of the exudate from the control group patients. The results were analyzed on the basis of cultural peculiarities. Results. In the main group association of three or more microorganisms was detected in 62,5 % of cases. In the monoculture in 25 % of cases staphylococci were isolated, in 12,5 % – Escherichia coli family. In the comparison group, staphylococci were detected in 60.9 %, the streptococcus family in 14.6 %, the E. coli family in 8.5 %, and associations of microorganisms in 15.8 %. Discussion. The study found that in the main group microbial associations predominated over monoculture. In the comparison group representatives of Staphylococcus and Streptococcus families were leading. The CFU level in the main group was between 50 and 60 per cup in 100 %, indicating moderate growth. The comparison group was dominated by moderate growth of microorganisms, over high infestation. Conclusion. The analysis of the wound discharge microbiota in the patients of the main group showed that the species composition was represented by the associations of microorganisms in contrast to the control group patients where the leading microorganisms were representatives of the family of staphylococci and streptococci. The predominance of microbial associations over monocultures indicates that colonization of pathogenic and opportunistic bacteria is not a leading factor in the development of drug-associated osteonecrosis of the jaw, but only contributes to the progression of the disease against other factors of pathogenesis.