Unusually isolated Staphylococcus arlettae in intra-oral sutures - Case series

Abstract

Introduction: The human oral cavity comprises various niches such as teeth, gingiva, tongue, soft and hard palate, and various dental prostheses, all inhabited by different bacterial species. Although more than 600 taxa belong to the oral cavity, identifying Staphylococcus arlettae , an incompletely understood bacterium, has been rare.

Methods: Three patients who underwent periodontal flap surgeries were reported with the incidental finding of S. arlettae associated with the intra-oral sutures placed. Environmental sampling was performed, to establish the exact source of this bacterium.

Results: Staphylococcus arlettae was isolated in three patients' intra-oral sutures. All environmental samples were negative for the presence of the bacterium.

Conclusion: . To this date, no studies have identified such an occurrence of Staphylococcus arlettae with intra-oral sutures. Its identification in association with foreign materials, such as sutures, can be considered a potential for surgical site infections and requires further investigation.

Keywords: Staphylococcus arlettae; intra-oral sutures; periodontal; scanning electron microscopy; surgical site infection.

Fig. 1.

Materials and methods: (a) Clinical presentation of three cases at Day 0 (day of surgery), Day 8 (suture removal) and Day 30 (follow-up) assessing the wound healing. (b) Staphylococcus arlettae solation in pure form on blood agar and BHIA (brain heart infusion agar) media, and bacterial morphology by SEM. (c) Environmental sampling on NAM (nutrient agar medium) and blood agar from dental chair – showing β hemolytic organism growth and dental water unit lines – showing no microbial growth, microbiology laboratory workstation (BLST) (biosafety cabinet type-IIA) – showing growth other than S. arlettae and sterile suture on incubation – showing no microbial growth).

Fig. 2.

Scanning Electron Microscopy (SEM) images of suture samples with S. arlettae biofilm formation: (a) Resorbable chlorhexidine coated polyglycolic-lactic acid (PGLA) suture under 150× and 10000× magnification showing biofilm formation. (b) Resorbable non coated PGLA suture under 150× and 10000× magnification showing biofilm formation. (c) Control (sterile suture) under 150× and 10000× magnification. (d) SEM image of S. arlettae colonies at 10000× magnification.