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慢性牙周炎患者龈下物种的抗生素耐药性。

Antibiotic resistance of subgingival species in chronic periodontitis patients.

机构信息

Epidemiology Group, University of Antioquia, Medellín, Colombia.

出版信息

J Periodontal Res. 2010 Aug;45(4):557-63. doi: 10.1111/j.1600-0765.2010.01274.x. Epub 2010 Jun 10.

Abstract

BACKGROUND AND OBJECTIVE

The increasing rate of resistance of microorganisms to penicillin and other antibiotics has generated concern among health authorities in Latin America. The present investigation determined the in vitro susceptibility of Porphyromonas gingivalis, Fusobacterium nucleatum, black-pigmented Prevotella spp. and Aggregatibacter actinomycetemcomitans to metronidazole, amoxicillin, amoxicillin/clavulanic acid, clindamycin and moxifloxacin in patients with chronic periodontitis.

MATERIAL AND METHODS

Subgingival plaque samples from patients with periodontitis were collected and cultured on selective and nonselective culture media. The antimicrobial susceptibility of periodontopathogenic isolates was studied in chronic periodontitis patients in Colombia. Metronidazole, amoxicillin, amoxicillin/clavulanic acid, clindamycin and moxifloxacin were tested on all bacterial isolates and the percentage of resistant strains was calculated.

RESULTS

Of the 150 bacteria identified, 51 were P. gingivalis, 45 were black-pigmented Prevotella spp., 36 were F. nucleatum and 18 were A. actinomycetemcomitans. All the isolates were sensitive to amoxicillin/clavulanic acid and to moxifloxacin, but exhibited variable susceptibility patterns to the other antimicrobial agents tested.

CONCLUSION

The results of the present study suggest that periodontal microorganisms in patients with chronic periodontitis can be resistant to the antimicrobial agents commonly used in anti-infective periodontal therapy. We suggest that the indiscriminate use of antimicrobials could result in the appearance of more highly antibiotic-resistant strains of bacteria associated with periodontal diseases in our population compared with the populations of other countries.

摘要

背景与目的

微生物对青霉素和其他抗生素的耐药率不断上升,引起了拉丁美洲卫生当局的关注。本研究旨在测定慢性牙周炎患者中牙龈卟啉单胞菌、核梭杆菌、黑色普雷沃菌和伴放线放线杆菌对甲硝唑、阿莫西林、阿莫西林/克拉维酸、克林霉素和莫西沙星的体外敏感性。

材料与方法

从牙周炎患者的龈下菌斑中采集样本,并在选择性和非选择性培养基上进行培养。在哥伦比亚的慢性牙周炎患者中研究了牙周病病原体分离株的抗菌药敏性。对所有细菌分离株进行了甲硝唑、阿莫西林、阿莫西林/克拉维酸、克林霉素和莫西沙星的药敏试验,并计算了耐药菌株的百分比。

结果

在鉴定出的 150 株细菌中,51 株为牙龈卟啉单胞菌,45 株为黑色普雷沃菌,36 株为核梭杆菌,18 株为伴放线放线杆菌。所有分离株对阿莫西林/克拉维酸和莫西沙星均敏感,但对其他测试的抗菌药物表现出不同的敏感性模式。

结论

本研究结果表明,慢性牙周炎患者的牙周微生物可能对抗感染牙周治疗中常用的抗菌药物产生耐药性。我们建议,与其他国家的人群相比,我们人群中与牙周病相关的细菌可能会出现更多的高度耐药菌株,这与抗菌药物的滥用有关。

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