Examining the Research Gap in Biofilm Formation and Antibiotic Resistance in Oral Pathogens Isolated from Nigerian Patients

Oral pathogens with high biofilm-forming capacity and antibiotic resistance present unique management challenges, and characterising them in Nigerian clinical isolates addresses an important research gap in local oral microbiology. This study examined the research gap in oral pathogen biofilm formation and antibiotic resistance through systematic review and original laboratory research. A systematic scoping review of nine databases identified 21 publications from 2018 to 2024 on antibiotic resistance in oral pathogens from sub-Saharan Africa, of which only 5 specifically examined Nigerian isolates. Original laboratory research collected 120 oral swab samples from confirmed periodontal abscess cases at University of Calabar Teaching Hospital dental clinic. Microbial cultures identified predominant pathogens. Biofilm formation was assessed by microtiter plate method, and antibiotic sensitivity testing conducted by disc diffusion for 10 clinically relevant antibiotics. Prevotella intermedia, Fusobacterium nucleatum, and Streptococcus milleri group were the most frequently isolated organisms. Biofilm formation was high in 62.5 percent of isolates. Metronidazole resistance was identified in 23.3 percent and amoxicillin resistance in 31.7 percent. Co-resistance to both agents was present in 14.2 percent. The study identifies three research gaps: absence of longitudinal resistance tracking, limited data on ESBL-producing organisms in dentoalveolar infections, and absence of Nigerian antibiogram guidance for oral infections. Recommendations include establishing a South South dental microbiology surveillance programme and publishing local antibiogram data for prescribers.

Keywords: oral pathogens, biofilm formation, antibiotic resistance, periodontal abscess, dental microbiology