Fleming P, Feigal R J, Kaplan E L, Liljemark W F, Little J W
School of Dentistry, Royal Victoria Hospital, Belfast, Northern Ireland.
Oral Surg Oral Med Oral Pathol. 1990 Oct;70(4):440-4. doi: 10.1016/0030-4220(90)90206-8.
Oral streptococci may cause infective endocarditis in patients with susceptible cardiac disease after dental treatment. Multiple dental visits, each preceded by penicillin prophylaxis, may result in the unwanted development of resistant oral streptococci. This study was undertaken to determine whether resistant oral streptococci would develop after the repeated use of penicillin prophylaxis in healthy adults. Plaque samples were collected from 20 subjects on each Monday for 5 successive weeks. Each subject was administered 2 gm penicillin V followed by 1 gm 6 hours later (standard prophylaxis regimen of the American Heart Association), on three successive Mondays (weeks 2, 3, and 4). The total cultivable oral streptococci and penicillin-resistant oral streptococci were determined for each plaque sample, and representative colonies of resistant streptococci were speciated. During the study, there was a significant increase in the number of subjects who harbored penicillin-resistant oral streptococci. However, with the exception of one subject who had resistant streptococci throughout the study, the number of resistant strains represented only 0.0003% to 0.41% of the total cultivable oral streptococci.
口腔链球菌可能会在牙科治疗后，使患有易感性心脏病的患者发生感染性心内膜炎。多次看牙，每次看牙前都进行青霉素预防，可能会导致耐药口腔链球菌意外产生。本研究旨在确定在健康成年人中反复使用青霉素预防后是否会产生耐药口腔链球菌。连续5周，每周一从20名受试者中采集菌斑样本。在连续三个周一（第2、3和4周），每位受试者先服用2克青霉素V，6小时后再服用1克（美国心脏协会的标准预防方案）。对每个菌斑样本测定可培养的口腔链球菌总数和耐青霉素口腔链球菌，并对耐药链球菌的代表性菌落进行菌种鉴定。在研究期间，携带耐青霉素口腔链球菌的受试者数量显著增加。然而，除了一名在整个研究过程中都有耐药链球菌的受试者外，耐药菌株数量仅占可培养口腔链球菌总数的0.0003%至0.41%。
