Antibiotic resistance of subgingival species during and after antibiotic therapy
Antibiotic resistance of subgingival species during and after antibiotic therapy
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DOI：
10.1034/j.1600-051x.2002.290809.x
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发表时间：
2002-08-01
影响因子：
6.7
通讯作者：
Socransky, SS
中科院分区：
文献类型：
--
作者：
Feres, M;Haffajee, AD;Socransky, SS
目的：本调查的目的是确定的百分比和身份的抗生素耐药菌群的龈下菌斑和唾液样本从慢性牙周炎患者治疗的刮治和根面平整，然后口服阿莫西林或甲硝唑。方法：在所有，20例慢性牙周炎患者被选中进行研究。在临床和微生物监测后，受试者被随机分配接受口服阿莫西林500 mg，每日3次，连续14天或口服甲硝唑250 mg，每日3次，连续14天。对于抗生素耐药性测定，在基线和90天时从6颗后牙中采集龈下菌斑样本;在抗生素给药期间和之后的第3、7和14天从两颗随机选择的牙齿中采集龈下菌斑样本。将样品铺在含有或不含有2 μ g/mL甲硝唑或2 μ g/mL阿莫西林的富集血琼脂平板上。在第7天计数菌落。通过Quade检验确定耐药微生物百分比随时间的显著差异。从含抗生素的培养基中冲洗微生物生长，并使用棋盘DNA-DNA杂交确定菌种的身份。将数据与先前研究中仅接受SRP或SRP后口服强力霉素14天的受试者的数据进行比较。在该研究中，用于确定抗生素耐药性的多西环素的水平为4 μ g/mL.Results：耐药菌株的平均百分比增加抗生素给药期间，并返回到基线水平治疗后90天。对2 μ g/mL甲硝唑耐药的分离株的平均百分比（+/-SEM）在基线、抗生素给药期间的第3、7和14天分别为53+/-9、65 +/- 9、79 +/- 4和69 +/- 7，在给药期间的第3、7和14天分别为57 +/- 4、64 +/- 5、62 +/- 7和47 +/- 6。抗生素给药后14和90天。在相同时间点，阿莫西林耐药分离株的百分比在给药期间为0.5 +/- 0.2、22 +/- 12、14 +/- 5和37 +/- 11，在给药后为31 +/- 11、8 +/- 3、3 +/- 2和3 +/- 0.6。治疗期间或治疗后检测到的耐药物种的抗生素耐药分离株也在治疗前检测到。甲硝唑处理组中最普遍的耐药菌是：A。naeslundii 1，S. constellatus、A. naeslundii 2、S. mitis，S. oralis、口唇A. dontolyticus、溶齿链霉菌S. sanguis，阿莫西林组为S. constellatus、黑变拟单胞菌P. nigrescens、黑变拟单胞菌E. saburreum、刺萼草A. naeslundii 1，S.结论：全身性抗生素给药短暂增加了龈下耐药菌的百分比，但龈下菌斑的主要成分在给药期间对药物保持敏感。在治疗前和治疗后的样本中均可检测到耐药菌种的抗生素耐药分离株。然而，抗生素耐药分离株%在抗生素给药后90天恢复至基线水平。
Aim: The purpose of the present investigation was to determine the percentage and identity of antibiotic-resistant species in subgingival plaque and saliva samples from chronic periodontitis patients treated by scaling and root planing followed by orally administered amoxicillin or metronidazole.Method: In all, 20 chronic periodontitis patients were selected for study. After clinical and microbiological monitoring, subjects were randomly assigned to receive either orally administered amoxicillin at the dosage of 500 mg, 3 times daily for 14 days or orally administered metronidazole at the dosage of 250 mg, 3 times daily for 14 days. For the antibiotic resistance determinations, subgingival plaque samples were taken from six posterior teeth at baseline, and 90 days; and from two randomly selected teeth at 3, 7 and 14 days during and after antibiotic administration. Samples were plated on enriched blood agar plates with or without either 2 mug/mL metronidazole or 2 mug/mL amoxicillin. Colonies were counted at 7 days. Significant differences in percentage of resistant organisms over time were determined by the Quade test. Microbial growth was washed from antibiotic-containing media and the identity of species determined using checkerboard DNA-DNA hybridization. Data were compared with those obtained in a previous study from subjects receiving SRP only or SRP followed by 14 days of orally administered doxycycline. The level of doxycycline used to determine antibiotic resistance in that study was 4 mug/mL.Results: The mean percentage of resistant isolates increased during antibiotic administration and returned to baseline levels by 90 days post therapy. The mean percentages (+/-SEM) of isolates resistant to 2 mug/mL metronidazole were 53+/-9, 65 +/- 9, 79 +/- 4 and 69 +/- 7 at baseline, 3, 7 and 14 days during antibiotic administration, and 57 +/- 4, 64 +/- 5, 62 +/- 7 and 47 +/- 6 at 3, 7, 14 and 90 days after antibiotic administration. At the same time points, the percentage of resistant isolates to amoxicillin was 0.5 +/- 0.2, 22 +/- 12, 14 +/- 5 and 37 +/- 11 during, and 31 +/- 11, 8 +/- 3, 3 +/- 2 and 3 +/- 0.6 after, administration. Antibiotic-resistant isolates of resistant species detected during or after therapy were also detected prior to therapy. The most prevalent resistant species in the metronidazole-treated group were: A. naeslundii 1, S. constellatus, A. naeslundii 2, S. mitis, S. oralis, A. odontolyticus, S. sanguis, and in the amoxicillin-treated group: S. constellatus, P. nigrescens, E. saburreum, A. naeslundii 1, S. oralis, P. melaninogenica and P. intermedia.Conclusions: Systemic antibiotic administration transiently increased the percentage of resistant subgingival species, but a major component of subgingival plaque remained sensitive to the agents during their administration. Antibiotic-resistant isolates of resistant species could be detected in samples both prior to and after therapy. However, % antibiotic-resistant isolates returned to baseline levels 90 days after antibiotic administration.