Prevalence of Predominant Bacterial Flora and Evaluation of Extended-spectrum Beta-lactamase-producing Strains in Pericoronitis: A Cross-sectional Study

Abstract

The objective is to determine predominant flora and extended-spectrum beta-lactamase (ESBL)-producing strains in patients with pericoronitis. The study group comprised 30 patients presenting with the clinical diagnosis of acute pericoronitis. The subgingival plaque sample was collected from the distal cervice of the third molar pericoronal pouch. Gram staining was performed, and aerobic and anaerobic bacterial culture was done following the standard protocol. All the anerobic bacteria isolated were tested for ESBL by double disc synergy, potentiated disc diffusion and nitrocefen disc method. The prevalence of micrococci was 26.6%, whereas, in anaerobes, the major isolates were Porphyromonas gingivalis, Prevotella melaninogenica, which constituted 20%, followed by Bacteroides fragilis (16.6%) and Streptococcus viridans (13.3%). All the strains of B. fragilis, Leptotrichia species, and Fusobacterium nucleatum were 100% ESBL producers, followed by 83.3% of P. melaninogenica and P. gingivalis, 33.3% of Peptostreptococcus anaerobius. Study of microbial flora is crucial in conditions where antibiotics are the first line of treatment. Update of the diverse polymicrobial flora helps the clinician choose appropriate antibiotics. One of the primary causes for prescription failure or worsening of acute infections like pericoronitis might be ESBL-generating bacteria.