Fosse T, Madinier I, Hitzig C, Charbit Y
Laboratoire de Bactériologie, Hôpital l'Archet 2, CHU de Nice, France.
Oral Microbiol Immunol. 1999 Dec;14(6):352-7. doi: 10.1034/j.1399-302x.1999.140604.x.
In a prospective study, 47 adults presenting a rapidly progressive periodontitis were selected in order to evaluate the prevalence of beta-lactamase-producing strains among oral anaerobic gram-negative rods. Predominant anaerobes were identified from two of the deepest periodontal pockets. beta-Lactamase-positive strains fulfilled to at least two of three criteria: positive nitrocefin test, penicillin Etest minimal inhibitory concentration > 1 microgram/ml, and disk diffusion synergy between amoxycillin and clavulanic acid > 10 mm. At least one beta-lactamase-producing strain was found in 53.2% of patients and 39.4% of the periodontal pockets investigated. Prominent beta-lactamase-positive species were Prevotella buccae and Prevotella intermedia (respectively 16 of 38: 42% and 18 of 52: 35% positive strains), followed by Prevotella bivia, Prevotella disiens, Prevotella denticola and Fusobacterium nucleatum (respectively 1 of 6: 17%, 1 of 10: 10%, 1 of 10: 10%, and 1 of 13: 8% positive strains). No beta-lactamase producer could be evidenced in Porphyromonas gingivalis (10 strains tested). All the beta-lactamase-positive strains with the nitrocefin test had penicillin minimal inhibitory concentrations > 1 microgram/ml with the Etest, and a strong synergy between amoxicillin and clavulanic acid was always observed.
在一项前瞻性研究中，选取了47例患有快速进展性牙周炎的成年人，以评估口腔厌氧革兰氏阴性杆菌中产β-内酰胺酶菌株的患病率。从两个最深的牙周袋中鉴定出主要厌氧菌。β-内酰胺酶阳性菌株符合以下三项标准中的至少两项：硝基头孢菌素试验阳性、青霉素Etest最低抑菌浓度>1微克/毫升，以及阿莫西林和克拉维酸之间的纸片扩散协同作用>10毫米。在53.2%的患者和39.4%的被调查牙周袋中发现了至少一种产β-内酰胺酶的菌株。突出的β-内酰胺酶阳性菌种是颊普雷沃菌和中间普雷沃菌（分别为38株中的16株：42%和52株中的18株：35%阳性菌株），其次是二路普雷沃菌、双栖普雷沃菌、齿龈普雷沃菌和具核梭杆菌（分别为6株中的1株：17%、10株中的1株：10%、10株中的1株：10%和13株中的1株：8%阳性菌株）。在牙龈卟啉单胞菌（检测了10株）中未发现产β-内酰胺酶的菌株。所有经硝基头孢菌素试验呈β-内酰胺酶阳性的菌株，其青霉素最低抑菌浓度经Etest测定>1微克/毫升，并且始终观察到阿莫西林和克拉维酸之间有很强的协同作用。
