Epidemiology Group, University of Antioquia, Medellín, Colombia.
J Periodontol. 2010 Feb;81(2):292-9. doi: 10.1902/jop.2009.090464.
Gram-negative enteric rods were associated with periodontal diseases in several populations. The association between enteric and putative periodontal pathogens has received little attention in the literature. The present investigation determined the occurrence and in vitro antimicrobial susceptibility of isolates of Gram-negative enteric rods from Colombian patients with chronic periodontitis.
Clinical parameters and the in vitro antimicrobial sensitivity of isolates of Gram-negative enteric rods were examined in 76 patients with chronic periodontitis in Medellin, Colombia. Subgingival samples were processed using culture and biochemical tests for the detection of periodontal and superinfecting pathogens. Selected colonies of Gram-negative enteric rods from pure cultures were used to test the susceptibility to amoxicillin/clavulanic acid, ciprofloxacin, and moxifloxacin. Chi-square and Mann-Whitney tests were used to determine differences in clinical variables versus the presence or absence of Gram-negative enteric rods.
Klebsiella pneumoniae was found in 12 patients, Pseudomonas aeruginosa was found in four patients, and three other species were recovered with a lower prevalence. Men (38.75%) tended to harbor more of the studied organisms than women (17.7%) (P = 0.04). Gram-negative enteric rods in periodontal pockets correlated positively with the presence of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, and Prevotella intermedia/nigrescens (respectively, r = 0.66, 0.31, and 0.32; P <0.001). All superinfecting organisms demonstrated a high susceptibility to moxifloxacin and ciprofloxacin but exhibited a variable susceptibility to amoxicillin/clavulanic acid.
This study found high levels of Gram-negative enteric rods in patients with chronic periodontitis. Moxifloxacin and ciprofloxacin appeared capable of eradicating these organisms from periodontal pockets. Its good activity against Gram-negative enteric rods and periodontopathogens suggests the potential use of moxifloxacin as an adjunctive antibiotic in the treatment of mixed periodontal infections.
革兰氏阴性肠道杆菌与几个人群的牙周病有关。肠道和疑似牙周病原体之间的关联在文献中很少受到关注。本研究旨在确定哥伦比亚慢性牙周炎患者肠道革兰氏阴性杆菌分离株的发生和体外抗菌药物敏感性。
在哥伦比亚麦德林的 76 名慢性牙周炎患者中，检查了临床参数和革兰氏阴性肠道杆菌分离株的体外抗菌药物敏感性。使用培养和生化试验处理龈下样本，以检测牙周和超感染病原体。从纯培养物中选择革兰氏阴性肠道杆菌的选定菌落，用于测试阿莫西林/克拉维酸、环丙沙星和莫西沙星的敏感性。使用卡方检验和曼-惠特尼检验确定临床变量与革兰氏阴性肠道杆菌的存在与否之间的差异。
在 12 名患者中发现了肺炎克雷伯菌，在 4 名患者中发现了铜绿假单胞菌，其他三种细菌的检出率较低。男性（38.75%）比女性（17.7%）更容易携带研究的微生物（P=0.04）。牙周袋中的革兰氏阴性肠道杆菌与伴放线放线杆菌（以前称为嗜二氧化碳噬纤维菌）、牙龈卟啉单胞菌和中间普雷沃菌/黑普雷沃菌的存在呈正相关（分别为 r=0.66、0.31 和 0.32；P<0.001）。所有超感染菌对莫西沙星和环丙沙星高度敏感，但对阿莫西林/克拉维酸的敏感性不同。
本研究发现慢性牙周炎患者中存在高水平的革兰氏阴性肠道杆菌。莫西沙星和环丙沙星似乎能够从牙周袋中消除这些细菌。其对革兰氏阴性肠道杆菌和牙周病原体的良好活性表明，莫西沙星有可能作为混合牙周感染的辅助抗生素使用。
