|Year : 2020 | Volume
| Issue : 2 | Page : 83-84
Microbes from mouth to gut impacting probiotics to antibiotics
Vinod Kumar1, Mohit Bhatia2, Arun H. S Kumar3
1 Editorial Board Member (Managing Editor-Miniseries on Dentistry), Journal of Natural Science, Biology and Medicine; Department of Pedodontics and Preventive Dentistry, Navodaya Dental College, Raichur, Karnataka, India
2 Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
3 Editor in Chief, Journal of Natural Science, Biology and Medicine, University College Dublin, Dublin, Ireland
|Date of Submission||16-Jul-2020|
|Date of Acceptance||17-Jul-2020|
|Date of Web Publication||22-Jul-2020|
Arun H. S Kumar
Editor in Chief, Journal of Natural Science, Biology and Medicine, University College Dublin, Dublin
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kumar V, Bhatia M, Kumar AH. Microbes from mouth to gut impacting probiotics to antibiotics. J Nat Sc Biol Med 2020;11:83-4
|How to cite this URL:|
Kumar V, Bhatia M, Kumar AH. Microbes from mouth to gut impacting probiotics to antibiotics. J Nat Sc Biol Med [serial online] 2020 [cited 2020 Nov 27];11:83-4. Available from: http://www.jnsbm.org/text.asp?2020/11/2/83/290478
Microbial cohabitation plays a significant role in regulating system-specific physiology. Some of the prominent benefits are well documented in gastrointestinal, cardiovascular, and central nervous system. In contrast, pathological outcomes from the microbial cohabitation are also reported in dermatology and dentistry. Hence, understanding the biological mechanisms and optimizing the approaches to assess the risk–benefit of microbial cohabitation to achieve optimal physiological outcomes is necessary. One of the major challenges in controlling infectious diseases globally is the prevalence of antimicrobial resistance (AMR), which makes the existing antimicrobial agents ineffective in the disease management strategy. Hence, AMR is identified as a significant contributor to global health threat with collateral health, political, and economic implications. AMR contributes to an annual mortality of around 700,000 subjects with an annual economic loss of over 2 billion Euros. Highlighting the problems of AMR is an article in this miniseries with a focus on ceftriaxone–sulbactam–ethylenediaminetetraacetic acid (EDTA) susceptibility profile of multidrug-resistant (MDR) Gram-negative bacterial isolates at a tertiary care teaching hospital in India. India has been referred to as “the AMR capital of the world.” This country carries one of the largest burdens of drug-resistant pathogens worldwide, including the alarmingly high resistance among Gram-negative and Gram-positive bacteria even to newer antimicrobials such as carbapenems and faropenem. According to the scoping report on AMR in India (2017), >70% of isolates of Escherichia coli, Klebsiella pneumoniae, and Acinetobacter baumannii and nearly half of all Pseudomonas aeruginosa were resistant to fluoroquinolones and third-generation cephalosporins. Resistance to drug combination of piperacillin–tazobactam was found to be <35% for E. coli and P. aeruginosa and 65% for K. pneumoniae. Increasing rates of carbapenem resistance to the tune of 71% were also observed in A. baumannii. Infections caused by MDR bacteria are usually treated with the last-resort antibiotics such as carbapenems, polymyxins, or tigecycline. However, with the emergence of carbapenem-resistant bacteria and higher toxicity profile of polymyxins and tigecycline, it is imperative that alternate treatment options such as ceftriaxone + sulbactam + disodium edetate (EDTA) highlighted in this miniseries should be looked into.
In recent decades, dentistry has advanced many steps in adopting the better preventive strategies to contain the dental diseases. The preventive strategies have been influenced by the results of the recent research evaluating the knowledge levels of teachers, and health-care professionals. In addition, the research involving the study of diet pattern, sugar exposure, oral hygiene status, oral hygiene practices, and utilization of dental services in the special children (handicapped) has also assumed greater importance in prevention of dental diseases. We have included two articles in the broad areas of dentistry in this joint dental and microbiology miniseries. To bring new changes in the prevention of dental problems, the knowledge and attitude levels of oral health-care workers, schoolteachers, and others are equally important. Hence, we have considered two articles on dentistry in this miniseries, which describes about the knowledge among the schoolteachers of thumb-sucking habit in children, as they are the main media to transmit the positive behavior among schoolchildren. It was very surprising that many participants had expressed that they were unaware about the preventive methods of oral habits, highlighting significant gaps in the knowledge and attitude levels among the schoolteachers. Considering these knowledge gaps, urgent actions to train the teachers for enforcing efficient prevention of poor oral habits among schoolchildren are necessary. These positive oral hygiene enforcements will bring in healthy lifestyle in early childhood and possibly will be helpful in preventing infectious diseases among the schoolchildren. Optimal training of the schoolteachers on current preventive methods and knowledge levels about thumb-sucking habit can be achieved through a coordinated effort from the school management and dental health-care workers. Another article in this miniseries highlights the level of dental caries among the institutionalized differently abled children in comparison to home-cared differently abled children. Diet and oral care play a significant role in the development of dental caries. The current caries concept holds that dental caries is caused by acidogenic bacteria (Streptococcus and Lactobacilli) that produce lactic acid as a result of the anaerobic fermentation of carbohydrates, added with acid-uric properties that allow their survival in a low-pH medium of plaque and saliva. Only a handful of Lactobacillus species out of the over 150 species currently recognized are found in the oral cavity, especially in caries lesions. The caries sequence of events indicated that Streptococcus mutans was involved with the initiation of decay (primary invader), whereas the Lactobacilli were associated with the progression of the lesion (secondary invader). S. mutans and other acidogenic oral bacteria create the necessary niche (a precaries lesion), which mechanically retains Lactobacilli. Noncariogenic diet and good oral hygiene can be helpful in achieving an optimal symbiosis with the oral microbial commensals to prevent caries formation among the institutionalized children, as highlighted in this study. In both the study cohorts, oral hygiene was poor and regular dental checkup and preventive dental treatment was not actively promoted by parents or custodians, despite the dental care services are being widely available and easily accessible. Lack of knowledge and awareness in the society has become barrier in accessing preventive dental care services. The lack of supervision of the toothbrushing technique together with limited motor skills and added with lack of assistance from guardians may have further contributed to the poor oral hygiene status of differently abled children. Hence, parents and caregivers of the differently abled children should be trained by the public health dentistry and pedodontics departments, as they play a vital role in delivering dental care to these children.
Addressing the problems posed by microbial world needs a multisector consensus. Besides judicious use of antimicrobial agents, efforts to harness the beneficial effects of microbial commensals should be actively promoted through extensive public health measures. Coordinated efforts with responsible involvement of both medical and nonmedical professionals to achieve an optimal microbial symbiosis from the mouth to the gut will be necessary for better health outcomes.