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Updated: Feb 18, 2026

Oral Biofilm Sampling for Microbiome Analysis in Healthy Children
Published on: December 31, 2017
Prevalence and Sensitivity of Bacilli and Pseudomonas in the Newborn's Oral Cavity
Priscila Vitor Alves Ferreira1, Isabela Amêndola1, Luciane Dias de Oliveira2
1UNITAU - Universidade de Taubaté, Taubaté, SP, Brazil.
Insights
Enterobacteria were found in 8% of hospitalized newborns' oral cavities, with some strains resistant to common antibiotics. This highlights the need for infection control to prevent early colonization and hospital-acquired infections in neonates.
Area of Science:
- Neonatal Medicine
- Microbiology
- Infectious Diseases
Background:
- Hospitalized newborns are susceptible to infections.
- Oral colonization by bacteria can be an early step in hospital-acquired infections.
Purpose of the Study:
- To isolate Enterobacteria and Pseudomonas from hospitalized newborns' oral cavities.
- To determine the prevalence and antibiotic sensitivity profiles of these bacteria.
- To assess the risk of early colonization and potential hospital infections.
Main Methods:
- Oral swabs collected from newborns aged 24-48 hours.
- Bacterial isolation using MacConkey agar, colony counting, and identification.
- Minimum Inhibitory Concentration (MIC) determined by agar dilution.
- Extended spectrum beta-lactamases (ESBL) testing via agar diffusion.
- Antibiotic susceptibility testing of bacteria in biofilms.
Main Results:
- Enterobacteria detected in 8% of samples (mean 6,141 CFU/mL); no Pseudomonas isolated.
- Enterobacter was the most prevalent genus; some strains showed resistance to ampicillin, gentamicin, and cephalothin.
- No ESBL-producing strains were detected. Biofilm microorganisms exhibited high resistance to all tested antibiotics.
Conclusions:
- The presence of antibiotic-resistant Enterobacteria in the neonatal oral cavity warrants attention.
- Preventing early colonization is crucial to avoid hospital-acquired infections in newborns.
- Enhanced hygiene protocols are necessary in neonatal intensive care units.
Abstract:
The aim of this study was to isolate Enterobacteria and Pseudomonas from the oral cavity of hospitalized newborns (NB) and determine their prevalence and the sensitivity profile to most commonly used antibiotics for this age group. Samples from the oral cavity of NB from 24 to 48 h age were collected using swabs. The samples were inoculated on MacConkey agar, incubated and the colonies counted and identified. For each strain, the minimum inhibitory concentration (MIC) was determined using agar dilution test. Tests for enterobacteria producing extended spectrumβ-lactamases (ESBL) were performed using agar diffusion. Descriptive statistics was used for data analysis. Two of the isolated strains were submitted to the susceptibility test in biofilm. Of the collected samples, 8% presented Enterobacteria (mean of 6,141 CFU/mL) and no Pseudomona species was isolated. Positive samples were from NB in accommodation set or in the NB nursery. Enterobacter was the most prevalent genus and some strains were resistant to ampicillin, gentamicin and cephalothin. No ESBL strain was detected. Microorganisms in biofilms were resistant to all antibiotics, with concentrations four times higher than MIC. The presence of enterobacteria in the oral cavity of newborns, especially some strains resistant to normally used antibiotics, warns to the need for care to avoid the early colonization of this niche and the occurrence of a possible hospital infection in this age group.
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