Isolation, identification, and antibiotic sensitivity pattern of oral microflora from children with neurodevelopmental disorders in comparison to typically developing children

Abstract

Neurodevelopmental disorders impact brain function and development, leading to difficulties in social, cognitive, and emotional areas. A study by the Neuro-Developmental Disability Protection Trust, 2020 reported that 3 million people in Bangladesh are diagnosed with autism spectrum disorder and other Neurodevelopmental disorders. Additionally, a 2013 pilot study found that 7.1% of Bangladesh's population has some form of neurodevelopmental disorder. Recent research suggests a potential link between the oral microbiome and autism, with individuals with NDs at higher risk of oral health issues that can affect their oral microbiome. In this study, the oral microbiota of children with neurodevelopmental disorders was compared to that of neurotypical children, along with an analysis of antibiotic susceptibility patterns in the identified microorganisms. This study revealed notable differences between the isolates from the control and sample groups. Oral swabs were taken from 20 children with NDs, including those diagnosed with Autism, ADHD, Asperger’s syndrome, Cerebral Palsy, and both mild and high-functioning autism. For comparison, 40 samples were taken from neurotypical children. Although the control group had twice as many samples, the number of isolates was not proportional, with 78 isolates found in the control group and 54 in the sample group, suggesting a higher number of bacterial isolates in the sample group. In the control group, 27% of the isolates were gram-positive and 73% were gram-negative, while in the sample group, 61% were gram-positive and 39% were gram-negative. Notably, the sample group had more than twice as many staphylococcus species compared to the control group, with 52%, compared to 19% in the control group. This indicates a greater vulnerability to bacterial colonization in children with NDs. The antibiotic susceptibility analysis further highlighted significant challenges, as children with NDs showed higher resistance to several key antibiotics compared to the control group. Although some similarities were found in resistance patterns for Gram-positive isolates, there were significant differences for Vancomycin, Doxycycline, and Levofloxacin, with the sample group showing much higher resistance rates with 87.5% for Vancomycin, 62.5% for Doxycycline, and 68.8% for Levofloxacin, compared to 45.5%, 31.8%, and 45.5%, in the control group. The situation was even more concerning for Gramnegative isolates, where the sample group demonstrated much higher resistance across multiple antibiotics. For example, resistance to Levofloxacin and Doxycycline was 90.5% in the sample group, while the control group showed much lower resistance rates of 18.6% for both. This pattern was consistent across other antibiotics, with the ND group showing resistance rates of 95.3% for Azithromycin, 95.2% for Ampicillin, and 57.2% for Gentamicin, compared to 56%, 61%, and 15.2% in the control group. The data gained from this study depicts the distinct difference in bacterial presence between neurotypical individuals and children with neurodevelopmental disorders as well as their antibiotic susceptibility pattern. PCR was performed to confirm the isolates of staphylococcus aureus and staphylococcus species. The PCR test confirmed the presence of Staphylococcus aureus in 15% of the controls and in 22.5% of the samples. Moreover, other Staphylococcus species were confirmed to be present in 45% of the controls and in 95% of the Samples.