Species Composition and Susceptibility to Antibiotics of Microorganisms Isolated from Tooth Sockets of Extracted Teeth in Cases of Alveolar Osteitis

Abstract

Alveolar osteitis (AO) is one of the most common infectious complications after dental extractions. The data on the species composition of AO pathogens and their susceptibility to antimicrobial drugs can be the basis for their empirical use in case of inflammatory process aggravation. Objective. To determine the species composition and susceptibility to the antimicrobial agents of microorganisms, which were detected in patients with AO, who sought medical help in the oral surgery department of the dental medical center of Bogomolets National Medical University. Methods. Throughout 2018–2021, microbiological examination of tooth sockets from 30 patients with AO and 20 patients without AO was performed. The studied biological material was plated on appropriate nutrient media for isolation of aerobic, facultative and obligate-anaerobic microorganisms. Anaerobic conditions were achieved in GENbox 7.0 L and GENbox 2.5 L aerostats using GENbox anaerobic packages (“Biomerieux”, France). The genus and species identity of the bacteria were determined according to Bergey. Antibiotic susceptibility of the isolated strains was determined by disk diffusion method. Results. It was found that most commonly microorganisms from tooth sockets in case of AO are: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus spp., Escherichia coli, Bacteroides spp., Clostridium spp., and Candida species, as well as their mixed cultures of 3–5 species of microorganisms. These aerobic and facultative anaerobic bacteria were susceptible to amoxicillin, ceftriaxone and ciprofloxacin in 92.6–100% of cases. The growth of anaerobic bacteria in 100% of cases was inhibited by colistin and meropenem. Conclusions. AO developing is caused by pathological colonization of socket of the extracted tooth by representatives of endogenous microbiota, namely Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus spp., Escherichia coli, which are present mainly in the mixed cultures with Candida albicans. For empirical antibiotic therapy of complicated forms of AO, amoxicillin or ceftriaxone or ciprofloxacin in complex with colistin or meropenem should be used, since these drugs suppress the growth of 92.6–100% of strains of aerobic, facultative and obligate anaerobic microorganisms, which are potential pathogens of the purulent forms of AO.