ASSOCIATION BETWEEN THE STREPTOCOCCUS MUTANS BIOFILM FORMATION AND DENTAL CARIES EXPERIENCE AND ANTIBIOTICS RESISTANCE IN ADULT FEMALES
Authors: Alhasani Abdalhaq Hussin , Ishag Ramy Abdulrhman , Al-Akwa Ameen Abdullah Yahya , Al-Shamahy Hassan A. , Al-labani Mohammed A A. 
Published: January 2021

Objectives: The aim of this study was to consider the potential association between the formation of salivary streptococcus biofilms and the incidence of caries, as well as with the occurrence of antibiotic resistance among adult mothers in Sana'a, Yemen. 
Study design: A total of 261; 25-35 year old females were chosen. Clinical examination of females were performed to estimate dental caries experience with the Silness-Loe index, as well as stimulated saliva were collected to assess biofilm production by the phenotypic method i.e. Tissue culture palate methods (TCPM). Finally, antibiogram susceptibility pattern of isolated S. mutans was done by Kirby-Bauer disc diffusion method for 6  β-Lactam antibiotics (ampicillin, penicillin, amoxicillin, cefotaxime, methicillin and cefazolin) and 4 non β-Lactam antibiotics (clindamycin, erythromycin, lincomycin and vancomycin).
Results: When isolated S. mutans were exposed to biofilm detection by TCP method, 31 (12.2%) showed high biofilm formation capacity, 46 (18%) showed moderate biofilm formation capacity, while 184 (72.2%) showed non / weak formation capacity of biofilm. The overall rate of biofilm formation was 30.2%. There was an escalation in the rate of formation of S. mutans biofilms with an increased degree of caries index. The S. mutans biofilms positve showed a higher rate of resistance than non/weak biofilm formation e.g ampicillin (28.6% versus 12.9%,  p = 0.002), amoxicillin (77.9% versus 18%, p <0.0001), and penicillin (79.2 % versus 23%, <0.0001) etc. 
Conclusion: The present study proved that S. mutans is still the major bacteria isolate from the oral cavity, but few persons might not have significant number of S. mutans in oral cavity. The S. mutans biofilm - producers were more able to cause dental caries compared to the S. mutans biofilm-non-producers. Drug resistant factor in the S. mutans isolates was found to be associated with S. mutans biofilm formation.
                         
Peer Review History:
Received 12 November  2020; Revised 20 Decembe; Accepted 5 January, Available online 15 January 2021
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Received file:                           Comments of reviewer(s):        
Average Peer review marks at initial stage: 6.5/10
Average Peer review marks at publication stage: 8.0/10
Reviewer(s) detail:
Dr. Alfonso Alexander Aguileral, University of Veracruz,  Mexico, aalexander_2000@yahoo.com
Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, sansan4240732@163.com
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