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成功与失败牙种植体患者中抗生素耐药基因的流行情况:一项初步研究。

Prevalence of antibiotic resistance genes in subjects with successful and failing dental implants. A pilot study.

作者信息

Koukos Georgios, Papadopoulos Christos, Tsalikis Lazaros, Sakellari Dimitra, Arsenakis Minas, Konstantinidis Antonios

机构信息

251 General Air Force Hospital, Department of Periodontology, Athens, Greece.

Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thes-saloniki, Thessaloniki, Greece.

出版信息

Open Dent J. 2015 Jan 6;8:257-63. doi: 10.2174/1874210601408010257. eCollection 2014.

Abstract

OBJECTIVES

To investigate the prevalence of the bacterial genes encoding resistance to beta-lactams, tetracyclines and metronidazole respectively, in subjects with successful and failing dental implants and to assess the presence of Staphylococcus aureus and the mecA gene encoding for Methicillin Resistant Staphylococcus aureus (MRSA) in the same samples.

MATERIALS AND METHODOLOGY

The subject sample included 20 participants with clinically healthy osseointegrated implants and 20 participants with implants exhibiting peri-implantitis. Clinical parameters were assessed with an automated probe, samples were collected from the peri-implant sulcus or pocket and analyzed with Polymerase Chain Reaction for bla TEM , tetM, tetQ and nim genes, S. aureus and MRSA using primers and conditions previously described in the literature.

RESULTS

Findings have shown high frequencies of detection for both groups for the tetracycline resistance genes tetM (>30%), tetQ (>65%) with no statistical differences between them (z-test with Bonferroni corrections, p<0.05). The bla TEM gene, which encodes resistance to beta-lactams, was detected in <15% of the samples. The nim gene, which encodes resistance to metronidazole, S.aureus and the mecA gene encoding for MRSA were not detected in any of the analyzed samples.

CONCLUSIONS

Healthy peri-implant sulci and peri-implantitis cases often harbor bacterial genes encoding for resistance to the tetracyclines and less often for beta-lactams. Thus, the antimicrobial activity of the tetracyclines and to a lower extent to beta-lactams, might be compromised for treatment of peri-implantitis. Since no metronidazole resistance genes were detected in the present study, its clinical use is supported by the current findings. S.aureus may not participate in peri-implant pathology.

摘要

目的

分别调查成功和失败的牙种植体患者中编码对β-内酰胺类、四环素类和甲硝唑耐药的细菌基因的流行情况,并评估同一样本中金黄色葡萄球菌和编码耐甲氧西林金黄色葡萄球菌(MRSA)的mecA基因的存在情况。

材料与方法

受试者样本包括20名临床健康的骨结合种植体参与者和20名患有种植体周围炎的种植体参与者。使用自动探针评估临床参数,从种植体周围龈沟或袋中采集样本,并使用文献中先前描述的引物和条件,通过聚合酶链反应分析bla TEM、tetM、tetQ和nim基因、金黄色葡萄球菌和MRSA。

结果

研究结果显示,两组中四环素耐药基因tetM(>30%)和tetQ(>65%)的检测频率均较高,两者之间无统计学差异(采用Bonferroni校正的z检验,p<0.05)。编码对β-内酰胺类耐药的bla TEM基因在<15%的样本中被检测到。在任何分析样本中均未检测到编码对甲硝唑耐药的nim基因、金黄色葡萄球菌和编码MRSA的mecA基因。

结论

健康的种植体周围龈沟和种植体周围炎病例中常存在编码对四环素耐药的细菌基因,而编码对β-内酰胺类耐药的细菌基因则较少见。因此,四环素类药物的抗菌活性以及较低程度上β-内酰胺类药物的抗菌活性,可能会在治疗种植体周围炎时受到影响。由于在本研究中未检测到甲硝唑耐药基因,目前的研究结果支持其临床应用。金黄色葡萄球菌可能不参与种植体周围病变。

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本文引用的文献

1
The therapy of peri-implantitis: a systematic review.种植体周围炎的治疗:系统评价。
Int J Oral Maxillofac Implants. 2014;29 Suppl:325-45. doi: 10.11607/jomi.2014suppl.g5.3.
7
The characteristics of biofilms in peri-implant disease.种植体周围病中生物膜的特征。
J Clin Periodontol. 2011 Mar;38 Suppl 11:203-13. doi: 10.1111/j.1600-051X.2010.01666.x.

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