Antibiotic resistance in human peri-implantitis microbiota
Antibiotic resistance in human peri-implantitis microbiota
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DOI：
10.1111/clr.12160
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发表时间：
2014-01-01
影响因子：
4.3
通讯作者：
van Winkelhoff, Arie J.
中科院分区：
文献类型：
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作者：
Rams, Thomas E.;Degener, John E.;van Winkelhoff, Arie J.
由于抗菌药物治疗经常用于治疗感染性种植体并发症，本研究确定了推定种植体周围细菌病原体的体外抗生素耐药情况。方法对120例成人种植体周围炎患者的160例种植体粘膜下生物膜标本进行培养，分离推定病原菌进行种级鉴定，并对多西环素（4mg/l）、阿莫西林（8mg/l）、甲硝唑（16mg/l）和克林霉素（4mg/l）进行体外敏感性试验。事后将阿莫西林和甲硝唑的结果结合起来，以确定对这两种抗生素耐药的种植体周围物种。革兰氏阴性肠棒/假单胞菌行环丙沙星盘片扩散试验。结果一种或多种可培养的粘膜下病原菌对克林霉素、阿莫西林、多西环素和甲硝唑的体外耐药率分别为46.7%、39.2%、25%和21.7%，其中以中/黑变普雷沃氏菌或星状链球菌居多。只有6.7%的受试者发现粘膜下试验菌种对阿莫西林和甲硝唑均有体外耐药，其中包括1例constellatus或7例革兰氏阴性肠杆状菌/假单胞菌对环丙沙星敏感。总体而言，120名种植体周围炎患者中有71.7%表现出对一种或多种测试抗生素的体外黏膜下细菌病原体耐药。结论speri -种植体炎患者粘膜下细菌病原菌对克林霉素、阿莫西林、多西环素或甲硝唑等单独治疗浓度的体外耐药较多，对阿莫西林和甲硝唑均耐药较少。由于观察到的耐药模式差异很大，对可培养的粘膜下细菌病原体进行抗生素敏感性试验可能有助于对种植体周围炎患者进行抗菌治疗的选择。
ObjectivesBecause antimicrobial therapy is often employed in the treatment of infectious dental implant complications, this study determined the occurrence of in vitro antibiotic resistance among putative peri-implantitis bacterial pathogens.MethodsSubmucosal biofilm specimens were cultured from 160 dental implants with peri-implantitis in 120 adults, with isolated putative pathogens identified to species level, and tested in vitro for susceptibility to 4mg/l of doxycycline, 8mg/l of amoxicillin, 16mg/l of metronidazole, and 4mg/l of clindamycin. Findings for amoxicillin and metronidazole were combined post-hoc to identify peri-implantitis species resistant to both antibiotics. Gram-negative enteric rods/pseudomonads were subjected to ciprofloxacin disk diffusion testing.ResultsOne or more cultivable submucosal bacterial pathogens, most often Prevotella intermedia/nigrescens or Streptococcus constellatus, were resistant in vitro to clindamycin, amoxicillin, doxycycline, or metronidazole in 46.7%, 39.2%, 25%, and 21.7% of the peri-implantitis subjects, respectively. Only 6.7% subjects revealed submucosal test species resistant in vitro to both amoxicillin and metronidazole, which were either S.constellatus (one subject) or ciprofloxacin-susceptible strains of gram-negative enteric rods/pseudomonads (seven subjects). Overall, 71.7% of the 120 peri-implantitis subjects exhibited submucosal bacterial pathogens resistant in vitro to one or more of the tested antibiotics.ConclusionsPeri-implantitis patients frequently yielded submucosal bacterial pathogens resistant in vitro to individual therapeutic concentrations of clindamycin, amoxicillin, doxycycline, or metronidazole, but only rarely to both amoxicillin and metronidazole. Due to the wide variation in observed drug resistance patterns, antibiotic susceptibility testing of cultivable submucosal bacterial pathogens may aid in the selection of antimicrobial therapy for peri-implantitis patients.