Oral Microbial Isolates from Patients Attending the Dental Clinic, University College Hospital, Ibadan, Nigeria

Main Article Content

V. N. Okoje V. I. Akinmoladun T. O. Alonge

Abstract

Aim

To evaluate microbial isolates from the buccal mucosa, carious teeth cavities and root tips of extracted carious teeth from patients attending the dental clinics of the University College Hospital, Ibadan, Nigeria. The isolates may guide the choice of preoperative antibiotics which hitherto has been based on “best guess”.

Materials and Method

Consecutive consenting patients seen over a period of six months were included in the study.

Pre-tested questionnaires were administered for socio-demographic and oral hygiene information. This was followed by an intra-oral examination. Oral swab was performed using a sterile microscopic culturing swab stick which was run along the buccal and labial sulci of the jaws. The swab tips were cut into brain-heart infusion broth and the cultured micro-organisms plated out on blood agar.  Microscopy, culture and sensitivity of the isolates were carried out using standard microbiological techniques.

Data was analyzed using SPSS version 19. Frequency tables were generated and measures of central tendency were calculated.

Results

One hundred and eighty-three patients were seen. The non-commensal micro-organisms isolated from the oral sulcus were predominantly coliforms (Klebsiella species in 15.8%, Escherichia coli in 13.70%) with normal oral flora found in 12 (6.6%) isolates. The carious cavities were also dominated by coliforms; Escherichia coli (20.6%), Klebsiella species (12%) and Proteus species (8.62%) with 10.34% being the normal flora isolates. The isolates from the root tip of extracted carious teeth yielded mainly Escherichia coli (28.6%) with no growth in over half of the samples.   

High sensitivity of the isolates to quinolones and marked resistance to ampicillin and tetracycline were observed. 

Conclusion

The isolation of invasive microorganisms from the oral cavity of our patients suggests the need for precautions that would reduce the oral microflora burden preoperatively. The antimicrobial antibiotic sensitivity pattern may guide the choice of prophylactic antibiotics in maxillofacial surgery.

Article Details

How to Cite
OKOJE, V. N.; AKINMOLADUN, V. I.; ALONGE, T. O.. Oral Microbial Isolates from Patients Attending the Dental Clinic, University College Hospital, Ibadan, Nigeria. Medical Research Archives, [S.l.], v. 5, n. 5, may 2017. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/1171>. Date accessed: 09 dec. 2023.
Keywords
Oral microbial isolates, Antibiotic therapy, Enterobacteria.
Section
Research Articles

References

References

1. Malekipour MR, Messripour M, Shirani F. Buffering Capacity of Saliva in Patients with Active Dental Caries. Asian J Biochem 2008;3:280–3.

2. Fábián T, Hermann P, Beck A, Fejérdy P, Fábián G. Salivary defense proteins: their network and role in innate and acquired oral immunity. Int J Mol Sci. 2012;13:4295–320.

3. Duerden B, Wide W. Medical and Dental Aspects of Anaerobes. Northwood: Science Reviews; 1995.

4. Umar M, Akafy DE, Abdulkarim IM, Yaya AA, Danasabe YJ. Biochemical characterization and antibiogram pattern of Streptococcus Mutans isolated from dental unit, Sick-Bay, Ahmadu Bello University, Zaria, Nigeria. Int J Bio Biomed Sci. 2015;4:63–6.

5. Batabyal B, Chakraborty S, Biswas S. Role of the oral micro flora in human population: A brief review. Int J Pharm Life Sci 2012;3:2220–7.

6. Allaker R, Hardie J. Oral Infections Microbiology and Microbial. 9th ed. Great Britain: The Bath Press; 1998.

7. Jaber WK. Oral Flora [Internet]. 2013 [cited 2016 Jul 12];Available from: http://www.slideshare.net/wali303/oral-flora-25031102 on 10/10/2016

8. Hardie J, Bowden G. The normal micro flora of the mouth. In: Skinner F, Carr J, editors. The Normal Microflora of Man. New York: Academic Press; 1974. page 47–84.

9. Baydas B., Uslu H., Yaruz I.,Ceylan I., Dagsugu J.M. Effect of chronic nail biting habit on the carriage of Enterobacteriaceae. J Oral Microbiol and Immunol. 2007;22: 1-4.

10. Reddy S.., Sanjai K., Kumaraswamy J., Papaiah L., Jeevan M. B. Oral Carriage of Enterobacteriaceae among School Children with Chronic Nail - biting Habit. J Oral Maxillofac Pathol. 2013; 17 (2): 163 -168.

11. Kamada N., Seo S., Chen G.Y., Nunez G. Role of gut microbiota in immunity and inflammatory disease. Nature Reviews Immunol 2013, 13: 321 - 335.

12. Mager D, Ximenez-Fyvie L, Haffajee A, Socransky S. Distribution of selected bacterial species on intraoral surfaces. J Clin Periodontol 2003;30:644–54.

13. Avila M, Ojcius D, Yilmaz O. The oral microbiota: living with a permanent guest. DNA Cell Biol 2009 28:405 -411.

14. Zarco M, Vess T, Ginsburg G. The oral microbiome in health and disease and the potential impact on personalized dental medicine. Oral Dis 2012;18:109–20.

15. Marsh P.D, Martin M. Oral Microbiology. 3rd ed. London: Chapman and Hall; 1992.

16. Williams R, Browers R, Garrod L, Shooter R. Hospital Infection: Causes and Prevention. London: Lloyd-Luke; 1960.

17. Marsh P.D. Sugar, flouride, pH and Microbial homeostasis in Dental Plaque. Proc Finn Dent Soc 1991,87 (4): 515 - 525.

18. Pallares R, Liñares J, Vadillo M, Cabellos C, Manresa F, Viladrich PF, et al. Resistance to penicillin and Cephalosporin and Mortality from Severe Pneumococcal Pneumonia in Barcelona, Spain. N Eng J Med 1995;333:474–80.

19. Carrol K.C. Normal Human Microbiota. Jawetz, Melnick & Adelberg's Medical Microbiology. 26th edition. McGraw - Hill Companies, Inc, 2013. Chapter 10. page 165. ISBN 978-0-07-179031-4

20. Larson E. A casual link between handing washing and risk of infection. Examination of evidence. Infect Control 1988;9:28–36.

21. Lewis J, Feckety F. Proteus bacteria. John Hopkins Med J 1969;124:151–6.

22. Gould F, Magee J, Ingram H. A hospital outbreak of antibiotic-resistant Streptococcus pneumoniae. J Infect 1987;15:77–9.

23. Lidwell O. Aerial dispersal of micro-organisms from the human respiratory tract. In: Skinner FA, Carr JG, editors. The normal microbial flora of man. London: Academic Press; 1974. page 135–54.

24. Tesson S, Skjøth C, Šantl-Temkiv T, Löndahl J. Airborne Microalgae: Insights, Opportunities, and Challenges. Appl Env Microbiol 2016;82:1978–91.

25. Noskin G, Stosor V, Cooper I, Peterson L. Recovery of vancomycin resistant enterooccoci on fingertips and environmental surfaces. Infec Control Hosp Epidemiol 1995;16:577–81.

26. Javis W R, Martone W J. Predominant pathogens in hospital infections. J Antimicrob Chemother 1992;29 Suppl.:19–24.

27. Adams B Marie T. Hand carriage of gram negative rods may not be transient. J Hyg 1982;89:33–46.

28. Poeta P., Igrejas G., Goncalves A, Martin E, Araujo C, Carvalho C. et al. Influence of oral hygiene in petients with fixed appliance in the oral carriage of antimicriobial- resistant Esherichia coli and Enterococcus species. Oral Surg Oral Pathol Oral Radiol Endol. 2009; 108: 557 - 564

29. Hable K.A., Washinton J.A. 11, Herriman E.C. Jr. Bacterial and Viral throat flora comparism of findings in children with acute upper respiratofy tract disease and healthy controls in winter. Clin Pediatric 1971: 10: 199-203.

30. Chang J.C.C., Foltz V.D. Obsevations of Pathogenic Coliform bacteria from adult human mouth. J Dent Res 1960: 39: 1120 - 1127.

31. Leitch J.A., Lang M., Macfarlane T.W., Mackenzie D. The Prevalence and distribution of yeasts and Coliform in dental plaque. J Dent Res 1991; 70: 709 - 712.

32. Mobbs K.J., van Saene H.K., Sunderland D., Davies P.D. Oropharyngeal gram Negative bacillary carriage. A study of 120 healthy individuals. Chest 1999: 115: 1570 - 1575.

33. Back-Brito G.N., El Ackhar V.N., Querido S.M., dos Santos S.S., Jorge A.O., Reis Ade S.et al. Staphylococcus species, Enterobacteriaceae and Pseudomonadeceae Oral isolates from Brazil HIV-positive patients. Correlation with CD4 cell count and Viral load. Arch Oral Biol 2011: 56: 1041 -1046.

34. Schmidth - westhausen A., Schiller R. A., Reichart P.A. Oral Candida and Enterobacteriaceae in HIV-1 infection: Correlation with Clinical Candidiasis and antimycotic therapy. J Oral Pathol Med 1991; 20: 469 - 472.

35. Samaranayake L.P., Lamb A.B., Lamey P-J., Macfarlane T.,W. Oral Carriage of Candida species and Coliforms in Patients with Burning Mouth Sydrome. J Oral Pathol Med 1989; 18: 233 - 235.

36. Samaranayake L.P. 3rd ed. Philadelphia: Churchill Livingston.2006. Essential Microbiology for Dentistry. Poor toilet hygiene pp 253 - 293.

37. Spooner R, Yilmaz O. The role of reactive – Oxygen – Species in microbial persisence and inflammation. Int J Mol Sci 2011;21:334–52.

38. Gaetti - Jardim ti E.C, Marque A.C., Faverani L.P. and Gaetti - Jardim E. Antimicrobial resistance of aerobes and facultative anaerobes isolated frm the oral cavity. J Appl Oral Sci 2010; 548 (6), 551 - 559.

39. Okoje - Adesomoju V.N., Ifesanya J.U. and Alonge T.O. Antimicrobial Susceptivity Pattern of Oral Microbial Isolates among Pregnant Women in Ibadan South- East Local Government Area, Nigeria. Afr J Biomed Res 2015; 18(3) : 29-35.








References

1. Malekipour MR, Messripour M, Shirani F. Buffering Capacity of Saliva in Patients with
Active Dental Caries. Asian J Biochem 2008;3:280–3.
2. Fábián T, Hermann P, Beck A, Fejérdy P, Fábián G. Salivary defense proteins: their network and role in innate and acquired oral immunity. Int J Mol Sci. 2012;13:4295–320.
3. Duerden B, Wide W. Medical and Dental Aspects of Anaerobes. Northwood: Science Reviews; 1995.
4. Umar M, Akafy DE, Abdulkarim IM, Yaya AA, Danasabe YJ. Biochemical characterization and antibiogram pattern of Streptococcus Mutans isolated from dental unit, Sick-Bay, Ahmadu Bello University, Zaria, Nigeria. Int J Bio Biomed Sci. 2015;4:63–6.
5. Batabyal B, Chakraborty S, Biswas S. Role of the oral micro flora in human population: A brief review. Int J Pharm Life Sci 2012;3:2220–7.
6. Allaker R, Hardie J. Oral Infections Microbiology and Microbial. 9th ed. Great Britain: The Bath Press; 1998.
7. Jaber WK. Oral Flora [Internet]. 2013 [cited 2016 Jul 12];Available from: http://www.slideshare.net/wali303/oral-flora-25031102 on 10/10/2016
8. Hardie J, Bowden G. The normal micro flora of the mouth. In: Skinner F, Carr J, editors. The Normal Microflora of Man. New York: Academic Press; 1974. page 47–84.
9. Baydas B., Uslu H., Yaruz I.,Ceylan I., Dagsugu J.M. Effect of chronic nail biting habit on the carriage of Enterobacteriaceae. J Oral Microbiol and Immunol. 2007;22: 1-4.
10. Reddy S.., Sanjai K., Kumaraswamy J., Papaiah L., Jeevan M. B. Oral Carriage of Enterobacteriaceae among School Children with Chronic Nail - biting Habit. J Oral Maxillofac Pathol. 2013; 17 (2): 163 -168.
11. Kamada N., Seo S., Chen G.Y., Nunez G. Role of gut microbiota in immunity and inflammatory disease. Nature Reviews Immunol 2013, 13: 321 - 335.
12. Mager D, Ximenez-Fyvie L, Haffajee A, Socransky S. Distribution of selected bacterial species on intraoral surfaces. J Clin Periodontol 2003;30:644–54.
13. Avila M, Ojcius D, Yilmaz O. The oral microbiota: living with a permanent guest. DNA Cell Biol 2009 28:405 -411
14. Zarco M, Vess T, Ginsburg G. The oral microbiome in health and disease and the potential impact on personalized dental medicine. Oral Dis 2012;18:109–20.
15. Marsh P.D, Martin M. Oral Microbiology. 3rd ed. London: Chapman and Hall; 1992.
16. Williams R, Browers R, Garrod L, Shooter R. Hospital Infection: Causes and Prevention. London: Lloyd-Luke; 1960.
17. Marsh P.D. Sugar, flouride, pH and Microbial homeostasis in Dental Plaque. Proc Finn Dent Soc 1991,87 (4): 515 - 525.
18. Pallares R, Liñares J, Vadillo M, Cabellos C, Manresa F, Viladrich PF, et al. Resistance to penicillin and Cephalosporin and Mortality from Severe Pneumococcal Pneumonia in Barcelona, Spain. N Eng J Med 1995;333:474–80.
19. Carrol K.C. Normal Human Microbiota. Jawetz, Melnick & Adelberg's Medical Microbiology. 26th edition. McGraw - Hill Companies, Inc, 2013. Chapter 10. page 165. ISBN 978-0-07-179031-4
20. Larson E. A casual link between handing washing and risk of infection. Examination of evidence. Infect Control 1988;9:28–36.
21. Lewis J, Feckety F. Proteus bacteria. John Hopkins Med J 1969;124:151–6.
22. Gould F, Magee J, Ingram H. A hospital outbreak of antibiotic-resistant Streptococcus pneumoniae. J Infect 1987;15:77–9.
23. Lidwell O. Aerial dispersal of micro-organisms from the human respiratory tract. In: Skinner FA, Carr JG, editors. The normal microbial flora of man. London: Academic Press; 1974. page 135–54.
24. Tesson S, Skjøth C, Šantl-Temkiv T, Löndahl J. Airborne Microalgae: Insights, Opportunities, and Challenges. Appl Env Microbiol 2016;82:1978–91.
25. Noskin G, Stosor V, Cooper I, Peterson L. Recovery of vancomycin resistant enterooccoci on fingertips and environmental surfaces. Infec Control Hosp Epidemiol 1995;16:577–81.
26. Javis W R, Martone W J. Predominant pathogens in hospital infections. J Antimicrob Chemother 1992;29 Suppl.:19–24.
27. Adams B Marie T. Hand carriage of gram negative rods may not be transient. J Hyg 1982;89:33–46.
28. Poeta P., Igrejas G., Goncalves A, Martin E, Araujo C, Carvalho C. et al. Influence of oral hygiene in petients with fixed appliance in the oral carriage of antimicriobial- resistant Esherichia coli and Enterococcus species. Oral Surg Oral Pathol Oral Radiol Endol. 2009; 108: 557 - 564
29. Hable K.A., Washinton J.A. 11, Herriman E.C. Jr. Bacterial and Viral throat flora comparism of findings in children with acute upper respiratofy tract disease and healthy controls in winter. Clin Pediatric 1971: 10: 199-203.
30. Chang J.C.C., Foltz V.D. Obsevations of Pathogenic Coliform bacteria from adult human mouth. J Dent Res 1960: 39: 1120 - 1127.
31. Leitch J.A., Lang M., Macfarlane T.W., Mackenzie D. The Prevalence and distribution of yeasts and Coliform in dental plaque. J Dent Res 1991; 70: 709 - 712.
32. Mobbs K.J., van Saene H.K., Sunderland D., Davies P.D. Oropharyngeal gram Negative bacillary carriage. A study of 120 healthy individuals. Chest 1999: 115: 1570 - 1575.
33. Back-Brito G.N., El Ackhar V.N., Querido S.M., dos Santos S.S., Jorge A.O., Reis Ade S.et al. Staphylococcus species, Enterobacteriaceae and Pseudomonadeceae Oral isolates from Brazil HIV-positive patients. Correlation with CD4 cell count and Viral load. Arch Oral Biol 2011: 56: 1041 -1046.
34. Schmidth - westhausen A., Schiller R. A., Reichart P.A. Oral Candida and Enterobacteriaceae in HIV-1 infection: Correlation with Clinical Candidiasis and antimycotic therapy. J Oral Pathol Med 1991; 20: 469 - 472.
35. Samaranayake L.P., Lamb A.B., Lamey P-J., Macfarlane T.,W. Oral Carriage of Candida species and Coliforms in Patients with Burning Mouth Sydrome. J Oral Pathol Med 1989; 18: 233 - 235.
36. Samaranayake L.P. 3rd ed. Philadelphia: Churchill Livingston.2006. Essential Microbiology for Dentistry. Poor toilet hygiene pp 253 - 293.
37. Spooner R, Yilmaz O. The role of reactive – Oxygen – Species in microbial persisence and inflammation. Int J Mol Sci 2011;21:334–52.
38. Gaetti - Jardim ti E.C, Marque A.C., Faverani L.P. and Gaetti - Jardim E. Antimicrobial resistance of aerobes and facultative anaerobes isolated frm the oral cavity. J Appl Oral Sci 2010; 548 (6), 551 - 559.
39. Okoje - Adesomoju V.N., Ifesanya J.U. and Alonge T.O. Antimicrobial Susceptivity Pattern of Oral Microbial Isolates among Pregnant Women in Ibadan South- East Local Government Area, Nigeria. Afr J Biomed Res 2015; 18(3) : 29-35.


















References

1. Malekipour MR, Messripour M, Shirani F. Buffering Capacity of Saliva in Patients with
Active Dental Caries. Asian J Biochem 2008;3:280–3.
2. Fábián T, Hermann P, Beck A, Fejérdy P, Fábián G. Salivary defense proteins: their network and role in innate and acquired oral immunity. Int J Mol Sci. 2012;13:4295–320.
3. Duerden B, Wide W. Medical and Dental Aspects of Anaerobes. Northwood: Science Reviews; 1995.
4. Umar M, Akafy DE, Abdulkarim IM, Yaya AA, Danasabe YJ. Biochemical characterization and antibiogram pattern of Streptococcus Mutans isolated from dental unit, Sick-Bay, Ahmadu Bello University, Zaria, Nigeria. Int J Bio Biomed Sci. 2015;4:63–6.
5. Batabyal B, Chakraborty S, Biswas S. Role of the oral micro flora in human population: A brief review. Int J Pharm Life Sci 2012;3:2220–7.
6. Allaker R, Hardie J. Oral Infections Microbiology and Microbial. 9th ed. Great Britain: The Bath Press; 1998.
7. Jaber WK. Oral Flora [Internet]. 2013 [cited 2016 Jul 12];Available from: http://www.slideshare.net/wali303/oral-flora-25031102 on 10/10/2016
8. Hardie J, Bowden G. The normal micro flora of the mouth. In: Skinner F, Carr J, editors. The Normal Microflora of Man. New York: Academic Press; 1974. page 47–84.
9. Baydas B., Uslu H., Yaruz I.,Ceylan I., Dagsugu J.M. Effect of chronic nail biting habit on the carriage of Enterobacteriaceae. J Oral Microbiol and Immunol. 2007;22: 1-4.
10. Reddy S.., Sanjai K., Kumaraswamy J., Papaiah L., Jeevan M. B. Oral Carriage of Enterobacteriaceae among School Children with Chronic Nail - biting Habit. J Oral Maxillofac Pathol. 2013; 17 (2): 163 -168.
11. Kamada N., Seo S., Chen G.Y., Nunez G. Role of gut microbiota in immunity and inflammatory disease. Nature Reviews Immunol 2013, 13: 321 - 335.
12. Mager D, Ximenez-Fyvie L, Haffajee A, Socransky S. Distribution of selected bacterial species on intraoral surfaces. J Clin Periodontol 2003;30:644–54.
13. Avila M, Ojcius D, Yilmaz O. The oral microbiota: living with a permanent guest. DNA Cell Biol 2009 28:405 -411
14. Zarco M, Vess T, Ginsburg G. The oral microbiome in health and disease and the potential impact on personalized dental medicine. Oral Dis 2012;18:109–20.
15. Marsh P.D, Martin M. Oral Microbiology. 3rd ed. London: Chapman and Hall; 1992.
16. Williams R, Browers R, Garrod L, Shooter R. Hospital Infection: Causes and Prevention. London: Lloyd-Luke; 1960.
17. Marsh P.D. Sugar, flouride, pH and Microbial homeostasis in Dental Plaque. Proc Finn Dent Soc 1991,87 (4): 515 - 525.
18. Pallares R, Liñares J, Vadillo M, Cabellos C, Manresa F, Viladrich PF, et al. Resistance to penicillin and Cephalosporin and Mortality from Severe Pneumococcal Pneumonia in Barcelona, Spain. N Eng J Med 1995;333:474–80.
19. Carrol K.C. Normal Human Microbiota. Jawetz, Melnick & Adelberg's Medical Microbiology. 26th edition. McGraw - Hill Companies, Inc, 2013. Chapter 10. page 165. ISBN 978-0-07-179031-4
20. Larson E. A casual link between handing washing and risk of infection. Examination of evidence. Infect Control 1988;9:28–36.
21. Lewis J, Feckety F. Proteus bacteria. John Hopkins Med J 1969;124:151–6.
22. Gould F, Magee J, Ingram H. A hospital outbreak of antibiotic-resistant Streptococcus pneumoniae. J Infect 1987;15:77–9.
23. Lidwell O. Aerial dispersal of micro-organisms from the human respiratory tract. In: Skinner FA, Carr JG, editors. The normal microbial flora of man. London: Academic Press; 1974. page 135–54.
24. Tesson S, Skjøth C, Šantl-Temkiv T, Löndahl J. Airborne Microalgae: Insights, Opportunities, and Challenges. Appl Env Microbiol 2016;82:1978–91.
25. Noskin G, Stosor V, Cooper I, Peterson L. Recovery of vancomycin resistant enterooccoci on fingertips and environmental surfaces. Infec Control Hosp Epidemiol 1995;16:577–81.
26. Javis W R, Martone W J. Predominant pathogens in hospital infections. J Antimicrob Chemother 1992;29 Suppl.:19–24.
27. Adams B Marie T. Hand carriage of gram negative rods may not be transient. J Hyg 1982;89:33–46.
28. Poeta P., Igrejas G., Goncalves A, Martin E, Araujo C, Carvalho C. et al. Influence of oral hygiene in petients with fixed appliance in the oral carriage of antimicriobial- resistant Esherichia coli and Enterococcus species. Oral Surg Oral Pathol Oral Radiol Endol. 2009; 108: 557 - 564
29. Hable K.A., Washinton J.A. 11, Herriman E.C. Jr. Bacterial and Viral throat flora comparism of findings in children with acute upper respiratofy tract disease and healthy controls in winter. Clin Pediatric 1971: 10: 199-203.
30. Chang J.C.C., Foltz V.D. Obsevations of Pathogenic Coliform bacteria from adult human mouth. J Dent Res 1960: 39: 1120 - 1127.
31. Leitch J.A., Lang M., Macfarlane T.W., Mackenzie D. The Prevalence and distribution of yeasts and Coliform in dental plaque. J Dent Res 1991; 70: 709 - 712.
32. Mobbs K.J., van Saene H.K., Sunderland D., Davies P.D. Oropharyngeal gram Negative bacillary carriage. A study of 120 healthy individuals. Chest 1999: 115: 1570 - 1575.
33. Back-Brito G.N., El Ackhar V.N., Querido S.M., dos Santos S.S., Jorge A.O., Reis Ade S.et al. Staphylococcus species, Enterobacteriaceae and Pseudomonadeceae Oral isolates from Brazil HIV-positive patients. Correlation with CD4 cell count and Viral load. Arch Oral Biol 2011: 56: 1041 -1046.
34. Schmidth - westhausen A., Schiller R. A., Reichart P.A. Oral Candida and Enterobacteriaceae in HIV-1 infection: Correlation with Clinical Candidiasis and antimycotic therapy. J Oral Pathol Med 1991; 20: 469 - 472.
35. Samaranayake L.P., Lamb A.B., Lamey P-J., Macfarlane T.,W. Oral Carriage of Candida species and Coliforms in Patients with Burning Mouth Sydrome. J Oral Pathol Med 1989; 18: 233 - 235.
36. Samaranayake L.P. 3rd ed. Philadelphia: Churchill Livingston.2006. Essential Microbiology for Dentistry. Poor toilet hygiene pp 253 - 293.
37. Spooner R, Yilmaz O. The role of reactive – Oxygen – Species in microbial persisence and inflammation. Int J Mol Sci 2011;21:334–52.
38. Gaetti - Jardim ti E.C, Marque A.C., Faverani L.P. and Gaetti - Jardim E. Antimicrobial resistance of aerobes and facultative anaerobes isolated frm the oral cavity. J Appl Oral Sci 2010; 548 (6), 551 - 559.
39. Okoje - Adesomoju V.N., Ifesanya J.U. and Alonge T.O. Antimicrobial Susceptivity Pattern of Oral Microbial Isolates among Pregnant Women in Ibadan South- East Local Government Area, Nigeria. Afr J Biomed Res 2015; 18(3) : 29-35.














1. Malekipour MR, Messripour M, Shirani F. Buffering Capacity of Saliva in Patients with
Active Dental Caries. Asian J Biochem 2008;3:280–3.
2. Fábián T, Hermann P, Beck A, Fejérdy P, Fábián G. Salivary defense proteins: their network and role in innate and acquired oral immunity. Int J Mol Sci. 2012;13:4295–320.
3. Duerden B, Wide W. Medical and Dental Aspects of Anaerobes. Northwood: Science Reviews; 1995.
4. Umar M, Akafy DE, Abdulkarim IM, Yaya AA, Danasabe YJ. Biochemical characterization and antibiogram pattern of Streptococcus Mutans isolated from dental unit, Sick-Bay, Ahmadu Bello University, Zaria, Nigeria. Int J Bio Biomed Sci. 2015;4:63–6.
5. Batabyal B, Chakraborty S, Biswas S. Role of the oral micro flora in human population: A brief review. Int J Pharm Life Sci 2012;3:2220–7.
6. Allaker R, Hardie J. Oral Infections Microbiology and Microbial. 9th ed. Great Britain: The Bath Press; 1998.
7. Jaber WK. Oral Flora [Internet]. 2013 [cited 2016 Jul 12];Available from: http://www.slideshare.net/wali303/oral-flora-25031102 on 10/10/2016
8. Hardie J, Bowden G. The normal micro flora of the mouth. In: Skinner F, Carr J, editors. The Normal Microflora of Man. New York: Academic Press; 1974. page 47–84.
9. Baydas B., Uslu H., Yaruz I.,Ceylan I., Dagsugu J.M. Effect of chronic nail biting habit on the carriage of Enterobacteriaceae. J Oral Microbiol and Immunol. 2007;22: 1-4.
10. Reddy S.., Sanjai K., Kumaraswamy J., Papaiah L., Jeevan M. B. Oral Carriage of Enterobacteriaceae among School Children with Chronic Nail - biting Habit. J Oral Maxillofac Pathol. 2013; 17 (2): 163 -168.
11. Kamada N., Seo S., Chen G.Y., Nunez G. Role of gut microbiota in immunity and inflammatory disease. Nature Reviews Immunol 2013, 13: 321 - 335.
12. Mager D, Ximenez-Fyvie L, Haffajee A, Socransky S. Distribution of selected bacterial species on intraoral surfaces. J Clin Periodontol 2003;30:644–54.
13. Avila M, Ojcius D, Yilmaz O. The oral microbiota: living with a permanent guest. DNA Cell Biol 2009 28:405 -411
14. Zarco M, Vess T, Ginsburg G. The oral microbiome in health and disease and the potential impact on personalized dental medicine. Oral Dis 2012;18:109–20.
15. Marsh P.D, Martin M. Oral Microbiology. 3rd ed. London: Chapman and Hall; 1992.
16. Williams R, Browers R, Garrod L, Shooter R. Hospital Infection: Causes and Prevention. London: Lloyd-Luke; 1960.
17. Marsh P.D. Sugar, flouride, pH and Microbial homeostasis in Dental Plaque. Proc Finn Dent Soc 1991,87 (4): 515 - 525.
18. Pallares R, Liñares J, Vadillo M, Cabellos C, Manresa F, Viladrich PF, et al. Resistance to penicillin and Cephalosporin and Mortality from Severe Pneumococcal Pneumonia in Barcelona, Spain. N Eng J Med 1995;333:474–80.
19. Carrol K.C. Normal Human Microbiota. Jawetz, Melnick & Adelberg's Medical Microbiology. 26th edition. McGraw - Hill Companies, Inc, 2013. Chapter 10. page 165. ISBN 978-0-07-179031-4
20. Larson E. A casual link between handing washing and risk of infection. Examination of evidence. Infect Control 1988;9:28–36.
21. Lewis J, Feckety F. Proteus bacteria. John Hopkins Med J 1969;124:151–6.
22. Gould F, Magee J, Ingram H. A hospital outbreak of antibiotic-resistant Streptococcus pneumoniae. J Infect 1987;15:77–9.
23. Lidwell O. Aerial dispersal of micro-organisms from the human respiratory tract. In: Skinner FA, Carr JG, editors. The normal microbial flora of man. London: Academic Press; 1974. page 135–54.
24. Tesson S, Skjøth C, Šantl-Temkiv T, Löndahl J. Airborne Microalgae: Insights, Opportunities, and Challenges. Appl Env Microbiol 2016;82:1978–91.
25. Noskin G, Stosor V, Cooper I, Peterson L. Recovery of vancomycin resistant enterooccoci on fingertips and environmental surfaces. Infec Control Hosp Epidemiol 1995;16:577–81.
26. Javis W R, Martone W J. Predominant pathogens in hospital infections. J Antimicrob Chemother 1992;29 Suppl.:19–24.
27. Adams B Marie T. Hand carriage of gram negative rods may not be transient. J Hyg 1982;89:33–46.
28. Poeta P., Igrejas G., Goncalves A, Martin E, Araujo C, Carvalho C. et al. Influence of oral hygiene in petients with fixed appliance in the oral carriage of antimicriobial- resistant Esherichia coli and Enterococcus species. Oral Surg Oral Pathol Oral Radiol Endol. 2009; 108: 557 - 564
29. Hable K.A., Washinton J.A. 11, Herriman E.C. Jr. Bacterial and Viral throat flora comparism of findings in children with acute upper respiratofy tract disease and healthy controls in winter. Clin Pediatric 1971: 10: 199-203.
30. Chang J.C.C., Foltz V.D. Obsevations of Pathogenic Coliform bacteria from adult human mouth. J Dent Res 1960: 39: 1120 - 1127.
31. Leitch J.A., Lang M., Macfarlane T.W., Mackenzie D. The Prevalence and distribution of yeasts and Coliform in dental plaque. J Dent Res 1991; 70: 709 - 712.
32. Mobbs K.J., van Saene H.K., Sunderland D., Davies P.D. Oropharyngeal gram Negative bacillary carriage. A study of 120 healthy individuals. Chest 1999: 115: 1570 - 1575.
33. Back-Brito G.N., El Ackhar V.N., Querido S.M., dos Santos S.S., Jorge A.O., Reis Ade S.et al. Staphylococcus species, Enterobacteriaceae and Pseudomonadeceae Oral isolates from Brazil HIV-positive patients. Correlation with CD4 cell count and Viral load. Arch Oral Biol 2011: 56: 1041 -1046.
34. Schmidth - westhausen A., Schiller R. A., Reichart P.A. Oral Candida and Enterobacteriaceae in HIV-1 infection: Correlation with Clinical Candidiasis and antimycotic therapy. J Oral Pathol Med 1991; 20: 469 - 472.
35. Samaranayake L.P., Lamb A.B., Lamey P-J., Macfarlane T.,W. Oral Carriage of Candida species and Coliforms in Patients with Burning Mouth Sydrome. J Oral Pathol Med 1989; 18: 233 - 235.
36. Samaranayake L.P. 3rd ed. Philadelphia: Churchill Livingston.2006. Essential Microbiology for Dentistry. Poor toilet hygiene pp 253 - 293.
37. Spooner R, Yilmaz O. The role of reactive – Oxygen – Species in microbial persisence and inflammation. Int J Mol Sci 2011;21:334–52.
38. Gaetti - Jardim ti E.C, Marque A.C., Faverani L.P. and Gaetti - Jardim E. Antimicrobial resistance of aerobes and facultative anaerobes isolated frm the oral cavity. J Appl Oral Sci 2010; 548 (6), 551 - 559.
39. Okoje - Adesomoju V.N., Ifesanya J.U. and Alonge T.O. Antimicrobial Susceptivity Pattern of Oral Microbial Isolates among Pregnant Women in Ibadan South- East Local Government Area, Nigeria. Afr J Biomed Res 2015; 18(3) : 29-35.



















1. Malekipour MR, Messripour M, Shirani F. Buffering Capacity of Saliva in Patients with
Active Dental Caries. Asian J Biochem 2008;3:280–3.
2. Fábián T, Hermann P, Beck A, Fejérdy P, Fábián G. Salivary defense proteins: their network and role in innate and acquired oral immunity. Int J Mol Sci. 2012;13:4295–320.
3. Duerden B, Wide W. Medical and Dental Aspects of Anaerobes. Northwood: Science Reviews; 1995.
4. Umar M, Akafy DE, Abdulkarim IM, Yaya AA, Danasabe YJ. Biochemical characterization and antibiogram pattern of Streptococcus Mutans isolated from dental unit, Sick-Bay, Ahmadu Bello University, Zaria, Nigeria. Int J Bio Biomed Sci. 2015;4:63–6.
5. Batabyal B, Chakraborty S, Biswas S. Role of the oral micro flora in human population: A brief review. Int J Pharm Life Sci 2012;3:2220–7.
6. Allaker R, Hardie J. Oral Infections Microbiology and Microbial. 9th ed. Great Britain: The Bath Press; 1998.
7. Jaber WK. Oral Flora [Internet]. 2013 [cited 2016 Jul 12];Available from: http://www.slideshare.net/wali303/oral-flora-25031102 on 10/10/2016
8. Hardie J, Bowden G. The normal micro flora of the mouth. In: Skinner F, Carr J, editors. The Normal Microflora of Man. New York: Academic Press; 1974. page 47–84.
9. Baydas B., Uslu H., Yaruz I.,Ceylan I., Dagsugu J.M. Effect of chronic nail biting habit on the carriage of Enterobacteriaceae. J Oral Microbiol and Immunol. 2007;22: 1-4.
10. Reddy S.., Sanjai K., Kumaraswamy J., Papaiah L., Jeevan M. B. Oral Carriage of Enterobacteriaceae among School Children with Chronic Nail - biting Habit. J Oral Maxillofac Pathol. 2013; 17 (2): 163 -168.
11. Kamada N., Seo S., Chen G.Y., Nunez G. Role of gut microbiota in immunity and inflammatory disease. Nature Reviews Immunol 2013, 13: 321 - 335.
12. Mager D, Ximenez-Fyvie L, Haffajee A, Socransky S. Distribution of selected bacterial species on intraoral surfaces. J Clin Periodontol 2003;30:644–54.
13. Avila M, Ojcius D, Yilmaz O. The oral microbiota: living with a permanent guest. DNA Cell Biol 2009 28:405 -411
14. Zarco M, Vess T, Ginsburg G. The oral microbiome in health and disease and the potential impact on personalized dental medicine. Oral Dis 2012;18:109–20.
15. Marsh P.D, Martin M. Oral Microbiology. 3rd ed. London: Chapman and Hall; 1992.
16. Williams R, Browers R, Garrod L, Shooter R. Hospital Infection: Causes and Prevention. London: Lloyd-Luke; 1960.
17. Marsh P.D. Sugar, flouride, pH and Microbial homeostasis in Dental Plaque. Proc Finn Dent Soc 1991,87 (4): 515 - 525.
18. Pallares R, Liñares J, Vadillo M, Cabellos C, Manresa F, Viladrich PF, et al. Resistance to penicillin and Cephalosporin and Mortality from Severe Pneumococcal Pneumonia in Barcelona, Spain. N Eng J Med 1995;333:474–80.
19. Carrol K.C. Normal Human Microbiota. Jawetz, Melnick & Adelberg's Medical Microbiology. 26th edition. McGraw - Hill Companies, Inc, 2013. Chapter 10. page 165. ISBN 978-0-07-179031-4
20. Larson E. A casual link between handing washing and risk of infection. Examination of evidence. Infect Control 1988;9:28–36.
21. Lewis J, Feckety F. Proteus bacteria. John Hopkins Med J 1969;124:151–6.
22. Gould F, Magee J, Ingram H. A hospital outbreak of antibiotic-resistant Streptococcus pneumoniae. J Infect 1987;15:77–9.
23. Lidwell O. Aerial dispersal of micro-organisms from the human respiratory tract. In: Skinner FA, Carr JG, editors. The normal microbial flora of man. London: Academic Press; 1974. page 135–54.
24. Tesson S, Skjøth C, Šantl-Temkiv T, Löndahl J. Airborne Microalgae: Insights, Opportunities, and Challenges. Appl Env Microbiol 2016;82:1978–91.
25. Noskin G, Stosor V, Cooper I, Peterson L. Recovery of vancomycin resistant enterooccoci on fingertips and environmental surfaces. Infec Control Hosp Epidemiol 1995;16:577–81.
26. Javis W R, Martone W J. Predominant pathogens in hospital infections. J Antimicrob Chemother 1992;29 Suppl.:19–24.
27. Adams B Marie T. Hand carriage of gram negative rods may not be transient. J Hyg 1982;89:33–46.
28. Poeta P., Igrejas G., Goncalves A, Martin E, Araujo C, Carvalho C. et al. Influence of oral hygiene in petients with fixed appliance in the oral carriage of antimicriobial- resistant Esherichia coli and Enterococcus species. Oral Surg Oral Pathol Oral Radiol Endol. 2009; 108: 557 - 564
29. Hable K.A., Washinton J.A. 11, Herriman E.C. Jr. Bacterial and Viral throat flora comparism of findings in children with acute upper respiratofy tract disease and healthy controls in winter. Clin Pediatric 1971: 10: 199-203.
30. Chang J.C.C., Foltz V.D. Obsevations of Pathogenic Coliform bacteria from adult human mouth. J Dent Res 1960: 39: 1120 - 1127.
31. Leitch J.A., Lang M., Macfarlane T.W., Mackenzie D. The Prevalence and distribution of yeasts and Coliform in dental plaque. J Dent Res 1991; 70: 709 - 712.
32. Mobbs K.J., van Saene H.K., Sunderland D., Davies P.D. Oropharyngeal gram Negative bacillary carriage. A study of 120 healthy individuals. Chest 1999: 115: 1570 - 1575.
33. Back-Brito G.N., El Ackhar V.N., Querido S.M., dos Santos S.S., Jorge A.O., Reis Ade S.et al. Staphylococcus species, Enterobacteriaceae and Pseudomonadeceae Oral isolates from Brazil HIV-positive patients. Correlation with CD4 cell count and Viral load. Arch Oral Biol 2011: 56: 1041 -1046.
34. Schmidth - westhausen A., Schiller R. A., Reichart P.A. Oral Candida and Enterobacteriaceae in HIV-1 infection: Correlation with Clinical Candidiasis and antimycotic therapy. J Oral Pathol Med 1991; 20: 469 - 472.
35. Samaranayake L.P., Lamb A.B., Lamey P-J., Macfarlane T.,W. Oral Carriage of Candida species and Coliforms in Patients with Burning Mouth Sydrome. J Oral Pathol Med 1989; 18: 233 - 235.
36. Samaranayake L.P. 3rd ed. Philadelphia: Churchill Livingston.2006. Essential Microbiology for Dentistry. Poor toilet hygiene pp 253 - 293.
37. Spooner R, Yilmaz O. The role of reactive – Oxygen – Species in microbial persisence and inflammation. Int J Mol Sci 2011;21:334–52.
38. Gaetti - Jardim ti E.C, Marque A.C., Faverani L.P. and Gaetti - Jardim E. Antimicrobial resistance of aerobes and facultative anaerobes isolated frm the oral cavity. J Appl Oral Sci 2010; 548 (6), 551 - 559.
39. Okoje - Adesomoju V.N., Ifesanya J.U. and Alonge T.O. Antimicrobial Susceptivity Pattern of Oral Microbial Isolates among Pregnant Women in Ibadan South- East Local Government Area, Nigeria. Afr J Biomed Res 2015; 18(3) : 29-35.



















1. Malekipour MR, Messripour M, Shirani F. Buffering Capacity of Saliva in Patients with
Active Dental Caries. Asian J Biochem 2008;3:280–3.
2. Fábián T, Hermann P, Beck A, Fejérdy P, Fábián G. Salivary defense proteins: their network and role in innate and acquired oral immunity. Int J Mol Sci. 2012;13:4295–320.
3. Duerden B, Wide W. Medical and Dental Aspects of Anaerobes. Northwood: Science Reviews; 1995.
4. Umar M, Akafy DE, Abdulkarim IM, Yaya AA, Danasabe YJ. Biochemical characterization and antibiogram pattern of Streptococcus Mutans isolated from dental unit, Sick-Bay, Ahmadu Bello University, Zaria, Nigeria. Int J Bio Biomed Sci. 2015;4:63–6.
5. Batabyal B, Chakraborty S, Biswas S. Role of the oral micro flora in human population: A brief review. Int J Pharm Life Sci 2012;3:2220–7.
6. Allaker R, Hardie J. Oral Infections Microbiology and Microbial. 9th ed. Great Britain: The Bath Press; 1998.
7. Jaber WK. Oral Flora [Internet]. 2013 [cited 2016 Jul 12];Available from: http://www.slideshare.net/wali303/oral-flora-25031102 on 10/10/2016
8. Hardie J, Bowden G. The normal micro flora of the mouth. In: Skinner F, Carr J, editors. The Normal Microflora of Man. New York: Academic Press; 1974. page 47–84.
9. Baydas B., Uslu H., Yaruz I.,Ceylan I., Dagsugu J.M. Effect of chronic nail biting habit on the carriage of Enterobacteriaceae. J Oral Microbiol and Immunol. 2007;22: 1-4.
10. Reddy S.., Sanjai K., Kumaraswamy J., Papaiah L., Jeevan M. B. Oral Carriage of Enterobacteriaceae among School Children with Chronic Nail - biting Habit. J Oral Maxillofac Pathol. 2013; 17 (2): 163 -168.
11. Kamada N., Seo S., Chen G.Y., Nunez G. Role of gut microbiota in immunity and inflammatory disease. Nature Reviews Immunol 2013, 13: 321 - 335.
12. Mager D, Ximenez-Fyvie L, Haffajee A, Socransky S. Distribution of selected bacterial species on intraoral surfaces. J Clin Periodontol 2003;30:644–54.
13. Avila M, Ojcius D, Yilmaz O. The oral microbiota: living with a permanent guest. DNA Cell Biol 2009 28:405 -411
14. Zarco M, Vess T, Ginsburg G. The oral microbiome in health and disease and the potential impact on personalized dental medicine. Oral Dis 2012;18:109–20.
15. Marsh P.D, Martin M. Oral Microbiology. 3rd ed. London: Chapman and Hall; 1992.
16. Williams R, Browers R, Garrod L, Shooter R. Hospital Infection: Causes and Prevention. London: Lloyd-Luke; 1960.
17. Marsh P.D. Sugar, flouride, pH and Microbial homeostasis in Dental Plaque. Proc Finn Dent Soc 1991,87 (4): 515 - 525.
18. Pallares R, Liñares J, Vadillo M, Cabellos C, Manresa F, Viladrich PF, et al. Resistance to penicillin and Cephalosporin and Mortality from Severe Pneumococcal Pneumonia in Barcelona, Spain. N Eng J Med 1995;333:474–80.
19. Carrol K.C. Normal Human Microbiota. Jawetz, Melnick & Adelberg's Medical Microbiology. 26th edition. McGraw - Hill Companies, Inc, 2013. Chapter 10. page 165. ISBN 978-0-07-179031-4
20. Larson E. A casual link between handing washing and risk of infection. Examination of evidence. Infect Control 1988;9:28–36.
21. Lewis J, Feckety F. Proteus bacteria. John Hopkins Med J 1969;124:151–6.
22. Gould F, Magee J, Ingram H. A hospital outbreak of antibiotic-resistant Streptococcus pneumoniae. J Infect 1987;15:77–9.
23. Lidwell O. Aerial dispersal of micro-organisms from the human respiratory tract. In: Skinner FA, Carr JG, editors. The normal microbial flora of man. London: Academic Press; 1974. page 135–54.
24. Tesson S, Skjøth C, Šantl-Temkiv T, Löndahl J. Airborne Microalgae: Insights, Opportunities, and Challenges. Appl Env Microbiol 2016;82:1978–91.
25. Noskin G, Stosor V, Cooper I, Peterson L. Recovery of vancomycin resistant enterooccoci on fingertips and environmental surfaces. Infec Control Hosp Epidemiol 1995;16:577–81.
26. Javis W R, Martone W J. Predominant pathogens in hospital infections. J Antimicrob Chemother 1992;29 Suppl.:19–24.
27. Adams B Marie T. Hand carriage of gram negative rods may not be transient. J Hyg 1982;89:33–46.
28. Poeta P., Igrejas G., Goncalves A, Martin E, Araujo C, Carvalho C. et al. Influence of oral hygiene in petients with fixed appliance in the oral carriage of antimicriobial- resistant Esherichia coli and Enterococcus species. Oral Surg Oral Pathol Oral Radiol Endol. 2009; 108: 557 - 564
29. Hable K.A., Washinton J.A. 11, Herriman E.C. Jr. Bacterial and Viral throat flora comparism of findings in children with acute upper respiratofy tract disease and healthy controls in winter. Clin Pediatric 1971: 10: 199-203.
30. Chang J.C.C., Foltz V.D. Obsevations of Pathogenic Coliform bacteria from adult human mouth. J Dent Res 1960: 39: 1120 - 1127.
31. Leitch J.A., Lang M., Macfarlane T.W., Mackenzie D. The Prevalence and distribution of yeasts and Coliform in dental plaque. J Dent Res 1991; 70: 709 - 712.
32. Mobbs K.J., van Saene H.K., Sunderland D., Davies P.D. Oropharyngeal gram Negative bacillary carriage. A study of 120 healthy individuals. Chest 1999: 115: 1570 - 1575.
33. Back-Brito G.N., El Ackhar V.N., Querido S.M., dos Santos S.S., Jorge A.O., Reis Ade S.et al. Staphylococcus species, Enterobacteriaceae and Pseudomonadeceae Oral isolates from Brazil HIV-positive patients. Correlation with CD4 cell count and Viral load. Arch Oral Biol 2011: 56: 1041 -1046.
34. Schmidth - westhausen A., Schiller R. A., Reichart P.A. Oral Candida and Enterobacteriaceae in HIV-1 infection: Correlation with Clinical Candidiasis and antimycotic therapy. J Oral Pathol Med 1991; 20: 469 - 472.
35. Samaranayake L.P., Lamb A.B., Lamey P-J., Macfarlane T.,W. Oral Carriage of Candida species and Coliforms in Patients with Burning Mouth Sydrome. J Oral Pathol Med 1989; 18: 233 - 235.
36. Samaranayake L.P. 3rd ed. Philadelphia: Churchill Livingston.2006. Essential Microbiology for Dentistry. Poor toilet hygiene pp 253 - 293.
37. Spooner R, Yilmaz O. The role of reactive – Oxygen – Species in microbial persisence and inflammation. Int J Mol Sci 2011;21:334–52.
38. Gaetti - Jardim ti E.C, Marque A.C., Faverani L.P. and Gaetti - Jardim E. Antimicrobial resistance of aerobes and facultative anaerobes isolated frm the oral cavity. J Appl Oral Sci 2010; 548 (6), 551 - 559.
39. Okoje - Adesomoju V.N., Ifesanya J.U. and Alonge T.O. Antimicrobial Susceptivity Pattern of Oral Microbial Isolates among Pregnant Women in Ibadan South- East Local Government Area, Nigeria. Afr J Biomed Res 2015; 18(3) : 29-35.



















1. Malekipour MR, Messripour M, Shirani F. Buffering Capacity of Saliva in Patients with
Active Dental Caries. Asian J Biochem 2008;3:280–3.
2. Fábián T, Hermann P, Beck A, Fejérdy P, Fábián G. Salivary defense proteins: their network and role in innate and acquired oral immunity. Int J Mol Sci. 2012;13:4295–320.
3. Duerden B, Wide W. Medical and Dental Aspects of Anaerobes. Northwood: Science Reviews; 1995.
4. Umar M, Akafy DE, Abdulkarim IM, Yaya AA, Danasabe YJ. Biochemical characterization and antibiogram pattern of Streptococcus Mutans isolated from dental unit, Sick-Bay, Ahmadu Bello University, Zaria, Nigeria. Int J Bio Biomed Sci. 2015;4:63–6.
5. Batabyal B, Chakraborty S, Biswas S. Role of the oral micro flora in human population: A brief review. Int J Pharm Life Sci 2012;3:2220–7.
6. Allaker R, Hardie J. Oral Infections Microbiology and Microbial. 9th ed. Great Britain: The Bath Press; 1998.
7. Jaber WK. Oral Flora [Internet]. 2013 [cited 2016 Jul 12];Available from: http://www.slideshare.net/wali303/oral-flora-25031102 on 10/10/2016
8. Hardie J, Bowden G. The normal micro flora of the mouth. In: Skinner F, Carr J, editors. The Normal Microflora of Man. New York: Academic Press; 1974. page 47–84.
9. Baydas B., Uslu H., Yaruz I.,Ceylan I., Dagsugu J.M. Effect of chronic nail biting habit on the carriage of Enterobacteriaceae. J Oral Microbiol and Immunol. 2007;22: 1-4.
10. Reddy S.., Sanjai K., Kumaraswamy J., Papaiah L., Jeevan M. B. Oral Carriage of Enterobacteriaceae among School Children with Chronic Nail - biting Habit. J Oral Maxillofac Pathol. 2013; 17 (2): 163 -168.
11. Kamada N., Seo S., Chen G.Y., Nunez G. Role of gut microbiota in immunity and inflammatory disease. Nature Reviews Immunol 2013, 13: 321 - 335.
12. Mager D, Ximenez-Fyvie L, Haffajee A, Socransky S. Distribution of selected bacterial species on intraoral surfaces. J Clin Periodontol 2003;30:644–54.
13. Avila M, Ojcius D, Yilmaz O. The oral microbiota: living with a permanent guest. DNA Cell Biol 2009 28:405 -411
14. Zarco M, Vess T, Ginsburg G. The oral microbiome in health and disease and the potential impact on personalized dental medicine. Oral Dis 2012;18:109–20.
15. Marsh P.D, Martin M. Oral Microbiology. 3rd ed. London: Chapman and Hall; 1992.
16. Williams R, Browers R, Garrod L, Shooter R. Hospital Infection: Causes and Prevention. London: Lloyd-Luke; 1960.
17. Marsh P.D. Sugar, flouride, pH and Microbial homeostasis in Dental Plaque. Proc Finn Dent Soc 1991,87 (4): 515 - 525.
18. Pallares R, Liñares J, Vadillo M, Cabellos C, Manresa F, Viladrich PF, et al. Resistance to penicillin and Cephalosporin and Mortality from Severe Pneumococcal Pneumonia in Barcelona, Spain. N Eng J Med 1995;333:474–80.
19. Carrol K.C. Normal Human Microbiota. Jawetz, Melnick & Adelberg's Medical Microbiology. 26th edition. McGraw - Hill Companies, Inc, 2013. Chapter 10. page 165. ISBN 978-0-07-179031-4
20. Larson E. A casual link between handing washing and risk of infection. Examination of evidence. Infect Control 1988;9:28–36.
21. Lewis J, Feckety F. Proteus bacteria. John Hopkins Med J 1969;124:151–6.
22. Gould F, Magee J, Ingram H. A hospital outbreak of antibiotic-resistant Streptococcus pneumoniae. J Infect 1987;15:77–9.
23. Lidwell O. Aerial dispersal of micro-organisms from the human respiratory tract. In: Skinner FA, Carr JG, editors. The normal microbial flora of man. London: Academic Press; 1974. page 135–54.
24. Tesson S, Skjøth C, Šantl-Temkiv T, Löndahl J. Airborne Microalgae: Insights, Opportunities, and Challenges. Appl Env Microbiol 2016;82:1978–91.
25. Noskin G, Stosor V, Cooper I, Peterson L. Recovery of vancomycin resistant enterooccoci on fingertips and environmental surfaces. Infec Control Hosp Epidemiol 1995;16:577–81.
26. Javis W R, Martone W J. Predominant pathogens in hospital infections. J Antimicrob Chemother 1992;29 Suppl.:19–24.
27. Adams B Marie T. Hand carriage of gram negative rods may not be transient. J Hyg 1982;89:33–46.
28. Poeta P., Igrejas G., Goncalves A, Martin E, Araujo C, Carvalho C. et al. Influence of oral hygiene in petients with fixed appliance in the oral carriage of antimicriobial- resistant Esherichia coli and Enterococcus species. Oral Surg Oral Pathol Oral Radiol Endol. 2009; 108: 557 - 564
29. Hable K.A., Washinton J.A. 11, Herriman E.C. Jr. Bacterial and Viral throat flora comparism of findings in children with acute upper respiratofy tract disease and healthy controls in winter. Clin Pediatric 1971: 10: 199-203.
30. Chang J.C.C., Foltz V.D. Obsevations of Pathogenic Coliform bacteria from adult human mouth. J Dent Res 1960: 39: 1120 - 1127.
31. Leitch J.A., Lang M., Macfarlane T.W., Mackenzie D. The Prevalence and distribution of yeasts and Coliform in dental plaque. J Dent Res 1991; 70: 709 - 712.
32. Mobbs K.J., van Saene H.K., Sunderland D., Davies P.D. Oropharyngeal gram Negative bacillary carriage. A study of 120 healthy individuals. Chest 1999: 115: 1570 - 1575.
33. Back-Brito G.N., El Ackhar V.N., Querido S.M., dos Santos S.S., Jorge A.O., Reis Ade S.et al. Staphylococcus species, Enterobacteriaceae and Pseudomonadeceae Oral isolates from Brazil HIV-positive patients. Correlation with CD4 cell count and Viral load. Arch Oral Biol 2011: 56: 1041 -1046.
34. Schmidth - westhausen A., Schiller R. A., Reichart P.A. Oral Candida and Enterobacteriaceae in HIV-1 infection: Correlation with Clinical Candidiasis and antimycotic therapy. J Oral Pathol Med 1991; 20: 469 - 472.
35. Samaranayake L.P., Lamb A.B., Lamey P-J., Macfarlane T.,W. Oral Carriage of Candida species and Coliforms in Patients with Burning Mouth Sydrome. J Oral Pathol Med 1989; 18: 233 - 235.
36. Samaranayake L.P. 3rd ed. Philadelphia: Churchill Livingston.2006. Essential Microbiology for Dentistry. Poor toilet hygiene pp 253 - 293.
37. Spooner R, Yilmaz O. The role of reactive – Oxygen – Species in microbial persisence and inflammation. Int J Mol Sci 2011;21:334–52.
38. Gaetti - Jardim ti E.C, Marque A.C., Faverani L.P. and Gaetti - Jardim E. Antimicrobial resistance of aerobes and facultative anaerobes isolated frm the oral cavity. J Appl Oral Sci 2010; 548 (6), 551 - 559.
39. Okoje - Adesomoju V.N., Ifesanya J.U. and Alonge T.O. Antimicrobial Susceptivity Pattern of Oral Microbial Isolates among Pregnant Women in Ibadan South- East Local Government Area, Nigeria. Afr J Biomed Res 2015; 18(3) : 29-35.



















1. Malekipour MR, Messripour M, Shirani F. Buffering Capacity of Saliva in Patients with
Active Dental Caries. Asian J Biochem 2008;3:280–3.
2. Fábián T, Hermann P, Beck A, Fejérdy P, Fábián G. Salivary defense proteins: their network and role in innate and acquired oral immunity. Int J Mol Sci. 2012;13:4295–320.
3. Duerden B, Wide W. Medical and Dental Aspects of Anaerobes. Northwood: Science Reviews; 1995.
4. Umar M, Akafy DE, Abdulkarim IM, Yaya AA, Danasabe YJ. Biochemical characterization and antibiogram pattern of Streptococcus Mutans isolated from dental unit, Sick-Bay, Ahmadu Bello University, Zaria, Nigeria. Int J Bio Biomed Sci. 2015;4:63–6.
5. Batabyal B, Chakraborty S, Biswas S. Role of the oral micro flora in human population: A brief review. Int J Pharm Life Sci 2012;3:2220–7.
6. Allaker R, Hardie J. Oral Infections Microbiology and Microbial. 9th ed. Great Britain: The Bath Press; 1998.
7. Jaber WK. Oral Flora [Internet]. 2013 [cited 2016 Jul 12];Available from: http://www.slideshare.net/wali303/oral-flora-25031102 on 10/10/2016
8. Hardie J, Bowden G. The normal micro flora of the mouth. In: Skinner F, Carr J, editors. The Normal Microflora of Man. New York: Academic Press; 1974. page 47–84.
9. Baydas B., Uslu H., Yaruz I.,Ceylan I., Dagsugu J.M. Effect of chronic nail biting habit on the carriage of Enterobacteriaceae. J Oral Microbiol and Immunol. 2007;22: 1-4.
10. Reddy S.., Sanjai K., Kumaraswamy J., Papaiah L., Jeevan M. B. Oral Carriage of Enterobacteriaceae among School Children with Chronic Nail - biting Habit. J Oral Maxillofac Pathol. 2013; 17 (2): 163 -168.
11. Kamada N., Seo S., Chen G.Y., Nunez G. Role of gut microbiota in immunity and inflammatory disease. Nature Reviews Immunol 2013, 13: 321 - 335.
12. Mager D, Ximenez-Fyvie L, Haffajee A, Socransky S. Distribution of selected bacterial species on intraoral surfaces. J Clin Periodontol 2003;30:644–54.
13. Avila M, Ojcius D, Yilmaz O. The oral microbiota: living with a permanent guest. DNA Cell Biol 2009 28:405 -411
14. Zarco M, Vess T, Ginsburg G. The oral microbiome in health and disease and the potential impact on personalized dental medicine. Oral Dis 2012;18:109–20.
15. Marsh P.D, Martin M. Oral Microbiology. 3rd ed. London: Chapman and Hall; 1992.
16. Williams R, Browers R, Garrod L, Shooter R. Hospital Infection: Causes and Prevention. London: Lloyd-Luke; 1960.
17. Marsh P.D. Sugar, flouride, pH and Microbial homeostasis in Dental Plaque. Proc Finn Dent Soc 1991,87 (4): 515 - 525.
18. Pallares R, Liñares J, Vadillo M, Cabellos C, Manresa F, Viladrich PF, et al. Resistance to penicillin and Cephalosporin and Mortality from Severe Pneumococcal Pneumonia in Barcelona, Spain. N Eng J Med 1995;333:474–80.
19. Carrol K.C. Normal Human Microbiota. Jawetz, Melnick & Adelberg's Medical Microbiology. 26th edition. McGraw - Hill Companies, Inc, 2013. Chapter 10. page 165. ISBN 978-0-07-179031-4
20. Larson E. A casual link between handing washing and risk of infection. Examination of evidence. Infect Control 1988;9:28–36.
21. Lewis J, Feckety F. Proteus bacteria. John Hopkins Med J 1969;124:151–6.
22. Gould F, Magee J, Ingram H. A hospital outbreak of antibiotic-resistant Streptococcus pneumoniae. J Infect 1987;15:77–9.
23. Lidwell O. Aerial dispersal of micro-organisms from the human respiratory tract. In: Skinner FA, Carr JG, editors. The normal microbial flora of man. London: Academic Press; 1974. page 135–54.
24. Tesson S, Skjøth C, Šantl-Temkiv T, Löndahl J. Airborne Microalgae: Insights, Opportunities, and Challenges. Appl Env Microbiol 2016;82:1978–91.
25. Noskin G, Stosor V, Cooper I, Peterson L. Recovery of vancomycin resistant enterooccoci on fingertips and environmental surfaces. Infec Control Hosp Epidemiol 1995;16:577–81.
26. Javis W R, Martone W J. Predominant pathogens in hospital infections. J Antimicrob Chemother 1992;29 Suppl.:19–24.
27. Adams B Marie T. Hand carriage of gram negative rods may not be transient. J Hyg 1982;89:33–46.
28. Poeta P., Igrejas G., Goncalves A, Martin E, Araujo C, Carvalho C. et al. Influence of oral hygiene in petients with fixed appliance in the oral carriage of antimicriobial- resistant Esherichia coli and Enterococcus species. Oral Surg Oral Pathol Oral Radiol Endol. 2009; 108: 557 - 564
29. Hable K.A., Washinton J.A. 11, Herriman E.C. Jr. Bacterial and Viral throat flora comparism of findings in children with acute upper respiratofy tract disease and healthy controls in winter. Clin Pediatric 1971: 10: 199-203.
30. Chang J.C.C., Foltz V.D. Obsevations of Pathogenic Coliform bacteria from adult human mouth. J Dent Res 1960: 39: 1120 - 1127.
31. Leitch J.A., Lang M., Macfarlane T.W., Mackenzie D. The Prevalence and distribution of yeasts and Coliform in dental plaque. J Dent Res 1991; 70: 709 - 712.
32. Mobbs K.J., van Saene H.K., Sunderland D., Davies P.D. Oropharyngeal gram Negative bacillary carriage. A study of 120 healthy individuals. Chest 1999: 115: 1570 - 1575.
33. Back-Brito G.N., El Ackhar V.N., Querido S.M., dos Santos S.S., Jorge A.O., Reis Ade S.et al. Staphylococcus species, Enterobacteriaceae and Pseudomonadeceae Oral isolates from Brazil HIV-positive patients. Correlation with CD4 cell count and Viral load. Arch Oral Biol 2011: 56: 1041 -1046.
34. Schmidth - westhausen A., Schiller R. A., Reichart P.A. Oral Candida and Enterobacteriaceae in HIV-1 infection: Correlation with Clinical Candidiasis and antimycotic therapy. J Oral Pathol Med 1991; 20: 469 - 472.
35. Samaranayake L.P., Lamb A.B., Lamey P-J., Macfarlane T.,W. Oral Carriage of Candida species and Coliforms in Patients with Burning Mouth Sydrome. J Oral Pathol Med 1989; 18: 233 - 235.
36. Samaranayake L.P. 3rd ed. Philadelphia: Churchill Livingston.2006. Essential Microbiology for Dentistry. Poor toilet hygiene pp 253 - 293.
37. Spooner R, Yilmaz O. The role of reactive – Oxygen – Species in microbial persisence and inflammation. Int J Mol Sci 2011;21:334–52.
38. Gaetti - Jardim ti E.C, Marque A.C., Faverani L.P. and Gaetti - Jardim E. Antimicrobial resistance of aerobes and facultative anaerobes isolated frm the oral cavity. J Appl Oral Sci 2010; 548 (6), 551 - 559.
39. Okoje - Adesomoju V.N., Ifesanya J.U. and Alonge T.O. Antimicrobial Susceptivity Pattern of Oral Microbial Isolates among Pregnant Women in Ibadan South- East Local Government Area, Nigeria. Afr J Biomed Res 2015; 18(3) : 29-35.



















1. Malekipour MR, Messripour M, Shirani F. Buffering Capacity of Saliva in Patients with
Active Dental Caries. Asian J Biochem 2008;3:280–3.
2. Fábián T, Hermann P, Beck A, Fejérdy P, Fábián G. Salivary defense proteins: their network and role in innate and acquired oral immunity. Int J Mol Sci. 2012;13:4295–320.
3. Duerden B, Wide W. Medical and Dental Aspects of Anaerobes. Northwood: Science Reviews; 1995.
4. Umar M, Akafy DE, Abdulkarim IM, Yaya AA, Danasabe YJ. Biochemical characterization and antibiogram pattern of Streptococcus Mutans isolated from dental unit, Sick-Bay, Ahmadu Bello University, Zaria, Nigeria. Int J Bio Biomed Sci. 2015;4:63–6.
5. Batabyal B, Chakraborty S, Biswas S. Role of the oral micro flora in human population: A brief review. Int J Pharm Life Sci 2012;3:2220–7.
6. Allaker R, Hardie J. Oral Infections Microbiology and Microbial. 9th ed. Great Britain: The Bath Press; 1998.
7. Jaber WK. Oral Flora [Internet]. 2013 [cited 2016 Jul 12];Available from: http://www.slideshare.net/wali303/oral-flora-25031102 on 10/10/2016
8. Hardie J, Bowden G. The normal micro flora of the mouth. In: Skinner F, Carr J, editors. The Normal Microflora of Man. New York: Academic Press; 1974. page 47–84.
9. Baydas B., Uslu H., Yaruz I.,Ceylan I., Dagsugu J.M. Effect of chronic nail biting habit on the carriage of Enterobacteriaceae. J Oral Microbiol and Immunol. 2007;22: 1-4.
10. Reddy S.., Sanjai K., Kumaraswamy J., Papaiah L., Jeevan M. B. Oral Carriage of Enterobacteriaceae among School Children with Chronic Nail - biting Habit. J Oral Maxillofac Pathol. 2013; 17 (2): 163 -168.
11. Kamada N., Seo S., Chen G.Y., Nunez G. Role of gut microbiota in immunity and inflammatory disease. Nature Reviews Immunol 2013, 13: 321 - 335.
12. Mager D, Ximenez-Fyvie L, Haffajee A, Socransky S. Distribution of selected bacterial species on intraoral surfaces. J Clin Periodontol 2003;30:644–54.
13. Avila M, Ojcius D, Yilmaz O. The oral microbiota: living with a permanent guest. DNA Cell Biol 2009 28:405 -411
14. Zarco M, Vess T, Ginsburg G. The oral microbiome in health and disease and the potential impact on personalized dental medicine. Oral Dis 2012;18:109–20.
15. Marsh P.D, Martin M. Oral Microbiology. 3rd ed. London: Chapman and Hall; 1992.
16. Williams R, Browers R, Garrod L, Shooter R. Hospital Infection: Causes and Prevention. London: Lloyd-Luke; 1960.
17. Marsh P.D. Sugar, flouride, pH and Microbial homeostasis in Dental Plaque. Proc Finn Dent Soc 1991,87 (4): 515 - 525.
18. Pallares R, Liñares J, Vadillo M, Cabellos C, Manresa F, Viladrich PF, et al. Resistance to penicillin and Cephalosporin and Mortality from Severe Pneumococcal Pneumonia in Barcelona, Spain. N Eng J Med 1995;333:474–80.
19. Carrol K.C. Normal Human Microbiota. Jawetz, Melnick & Adelberg's Medical Microbiology. 26th edition. McGraw - Hill Companies, Inc, 2013. Chapter 10. page 165. ISBN 978-0-07-179031-4
20. Larson E. A casual link between handing washing and risk of infection. Examination of evidence. Infect Control 1988;9:28–36.
21. Lewis J, Feckety F. Proteus bacteria. John Hopkins Med J 1969;124:151–6.
22. Gould F, Magee J, Ingram H. A hospital outbreak of antibiotic-resistant Streptococcus pneumoniae. J Infect 1987;15:77–9.
23. Lidwell O. Aerial dispersal of micro-organisms from the human respiratory tract. In: Skinner FA, Carr JG, editors. The normal microbial flora of man. London: Academic Press; 1974. page 135–54.
24. Tesson S, Skjøth C, Šantl-Temkiv T, Löndahl J. Airborne Microalgae: Insights, Opportunities, and Challenges. Appl Env Microbiol 2016;82:1978–91.
25. Noskin G, Stosor V, Cooper I, Peterson L. Recovery of vancomycin resistant enterooccoci on fingertips and environmental surfaces. Infec Control Hosp Epidemiol 1995;16:577–81.
26. Javis W R, Martone W J. Predominant pathogens in hospital infections. J Antimicrob Chemother 1992;29 Suppl.:19–24.
27. Adams B Marie T. Hand carriage of gram negative rods may not be transient. J Hyg 1982;89:33–46.
28. Poeta P., Igrejas G., Goncalves A, Martin E, Araujo C, Carvalho C. et al. Influence of oral hygiene in petients with fixed appliance in the oral carriage of antimicriobial- resistant Esherichia coli and Enterococcus species. Oral Surg Oral Pathol Oral Radiol Endol. 2009; 108: 557 - 564
29. Hable K.A., Washinton J.A. 11, Herriman E.C. Jr. Bacterial and Viral throat flora comparism of findings in children with acute upper respiratofy tract disease and healthy controls in winter. Clin Pediatric 1971: 10: 199-203.
30. Chang J.C.C., Foltz V.D. Obsevations of Pathogenic Coliform bacteria from adult human mouth. J Dent Res 1960: 39: 1120 - 1127.
31. Leitch J.A., Lang M., Macfarlane T.W., Mackenzie D. The Prevalence and distribution of yeasts and Coliform in dental plaque. J Dent Res 1991; 70: 709 - 712.
32. Mobbs K.J., van Saene H.K., Sunderland D., Davies P.D. Oropharyngeal gram Negative bacillary carriage. A study of 120 healthy individuals. Chest 1999: 115: 1570 - 1575.
33. Back-Brito G.N., El Ackhar V.N., Querido S.M., dos Santos S.S., Jorge A.O., Reis Ade S.et al. Staphylococcus species, Enterobacteriaceae and Pseudomonadeceae Oral isolates from Brazil HIV-positive patients. Correlation with CD4 cell count and Viral load. Arch Oral Biol 2011: 56: 1041 -1046.
34. Schmidth - westhausen A., Schiller R. A., Reichart P.A. Oral Candida and Enterobacteriaceae in HIV-1 infection: Correlation with Clinical Candidiasis and antimycotic therapy. J Oral Pathol Med 1991; 20: 469 - 472.
35. Samaranayake L.P., Lamb A.B., Lamey P-J., Macfarlane T.,W. Oral Carriage of Candida species and Coliforms in Patients with Burning Mouth Sydrome. J Oral Pathol Med 1989; 18: 233 - 235.
36. Samaranayake L.P. 3rd ed. Philadelphia: Churchill Livingston.2006. Essential Microbiology for Dentistry. Poor toilet hygiene pp 253 - 293.
37. Spooner R, Yilmaz O. The role of reactive – Oxygen – Species in microbial persisence and inflammation. Int J Mol Sci 2011;21:334–52.
38. Gaetti - Jardim ti E.C, Marque A.C., Faverani L.P. and Gaetti - Jardim E. Antimicrobial resistance of aerobes and facultative anaerobes isolated frm the oral cavity. J Appl Oral Sci 2010; 548 (6), 551 - 559.
39. Okoje - Adesomoju V.N., Ifesanya J.U. and Alonge T.O. Antimicrobial Susceptivity Pattern of Oral Microbial Isolates among Pregnant Women in Ibadan South- East Local Government Area, Nigeria. Afr J Biomed Res 2015; 18(3) : 29-35.



















1. Malekipour MR, Messripour M, Shirani F. Buffering Capacity of Saliva in Patients with
Active Dental Caries. Asian J Biochem 2008;3:280–3.
2. Fábián T, Hermann P, Beck A, Fejérdy P, Fábián G. Salivary defense proteins: their network and role in innate and acquired oral immunity. Int J Mol Sci. 2012;13:4295–320.
3. Duerden B, Wide W. Medical and Dental Aspects of Anaerobes. Northwood: Science Reviews; 1995.
4. Umar M, Akafy DE, Abdulkarim IM, Yaya AA, Danasabe YJ. Biochemical characterization and antibiogram pattern of Streptococcus Mutans isolated from dental unit, Sick-Bay, Ahmadu Bello University, Zaria, Nigeria. Int J Bio Biomed Sci. 2015;4:63–6.
5. Batabyal B, Chakraborty S, Biswas S. Role of the oral micro flora in human population: A brief review. Int J Pharm Life Sci 2012;3:2220–7.
6. Allaker R, Hardie J. Oral Infections Microbiology and Microbial. 9th ed. Great Britain: The Bath Press; 1998.
7. Jaber WK. Oral Flora [Internet]. 2013 [cited 2016 Jul 12];Available from: http://www.slideshare.net/wali303/oral-flora-25031102 on 10/10/2016
8. Hardie J, Bowden G. The normal micro flora of the mouth. In: Skinner F, Carr J, editors. The Normal Microflora of Man. New York: Academic Press; 1974. page 47–84.
9. Baydas B., Uslu H., Yaruz I.,Ceylan I., Dagsugu J.M. Effect of chronic nail biting habit on the carriage of Enterobacteriaceae. J Oral Microbiol and Immunol. 2007;22: 1-4.
10. Reddy S.., Sanjai K., Kumaraswamy J., Papaiah L., Jeevan M. B. Oral Carriage of Enterobacteriaceae among School Children with Chronic Nail - biting Habit. J Oral Maxillofac Pathol. 2013; 17 (2): 163 -168.
11. Kamada N., Seo S., Chen G.Y., Nunez G. Role of gut microbiota in immunity and inflammatory disease. Nature Reviews Immunol 2013, 13: 321 - 335.
12. Mager D, Ximenez-Fyvie L, Haffajee A, Socransky S. Distribution of selected bacterial species on intraoral surfaces. J Clin Periodontol 2003;30:644–54.
13. Avila M, Ojcius D, Yilmaz O. The oral microbiota: living with a permanent guest. DNA Cell Biol 2009 28:405 -411
14. Zarco M, Vess T, Ginsburg G. The oral microbiome in health and disease and the potential impact on personalized dental medicine. Oral Dis 2012;18:109–20.
15. Marsh P.D, Martin M. Oral Microbiology. 3rd ed. London: Chapman and Hall; 1992.
16. Williams R, Browers R, Garrod L, Shooter R. Hospital Infection: Causes and Prevention. London: Lloyd-Luke; 1960.
17. Marsh P.D. Sugar, flouride, pH and Microbial homeostasis in Dental Plaque. Proc Finn Dent Soc 1991,87 (4): 515 - 525.
18. Pallares R, Liñares J, Vadillo M, Cabellos C, Manresa F, Viladrich PF, et al. Resistance to penicillin and Cephalosporin and Mortality from Severe Pneumococcal Pneumonia in Barcelona, Spain. N Eng J Med 1995;333:474–80.
19. Carrol K.C. Normal Human Microbiota. Jawetz, Melnick & Adelberg's Medical Microbiology. 26th edition. McGraw - Hill Companies, Inc, 2013. Chapter 10. page 165. ISBN 978-0-07-179031-4
20. Larson E. A casual link between handing washing and risk of infection. Examination of evidence. Infect Control 1988;9:28–36.
21. Lewis J, Feckety F. Proteus bacteria. John Hopkins Med J 1969;124:151–6.
22. Gould F, Magee J, Ingram H. A hospital outbreak of antibiotic-resistant Streptococcus pneumoniae. J Infect 1987;15:77–9.
23. Lidwell O. Aerial dispersal of micro-organisms from the human respiratory tract. In: Skinner FA, Carr JG, editors. The normal microbial flora of man. London: Academic Press; 1974. page 135–54.
24. Tesson S, Skjøth C, Šantl-Temkiv T, Löndahl J. Airborne Microalgae: Insights, Opportunities, and Challenges. Appl Env Microbiol 2016;82:1978–91.
25. Noskin G, Stosor V, Cooper I, Peterson L. Recovery of vancomycin resistant enterooccoci on fingertips and environmental surfaces. Infec Control Hosp Epidemiol 1995;16:577–81.
26. Javis W R, Martone W J. Predominant pathogens in hospital infections. J Antimicrob Chemother 1992;29 Suppl.:19–24.
27. Adams B Marie T. Hand carriage of gram negative rods may not be transient. J Hyg 1982;89:33–46.
28. Poeta P., Igrejas G., Goncalves A, Martin E, Araujo C, Carvalho C. et al. Influence of oral hygiene in petients with fixed appliance in the oral carriage of antimicriobial- resistant Esherichia coli and Enterococcus species. Oral Surg Oral Pathol Oral Radiol Endol. 2009; 108: 557 - 564
29. Hable K.A., Washinton J.A. 11, Herriman E.C. Jr. Bacterial and Viral throat flora comparism of findings in children with acute upper respiratofy tract disease and healthy controls in winter. Clin Pediatric 1971: 10: 199-203.
30. Chang J