德国牙周炎患者龈下微生物群中牙周病原体的流行情况和抗生素敏感性趋势：一项回顾性监测研究。
Prevalence and antibiotic susceptibility trends of periodontal pathogens in the subgingival microbiota of German periodontitis patients: A retrospective surveillance study.
机构信息
Department of Periodontology, Operative and Preventive Dentistry, Center for Dental and Oral Medicine, University Hospital Bonn, Bonn, Germany.
Center for Oral & Dental Microbiology, Service Laboratory, Kiel, Germany.
出版信息
J Clin Periodontol. 2021 Sep;48(9):1216-1227. doi: 10.1111/jcpe.13468. Epub 2021 Jun 27.
OBJECTIVE
This retrospective surveillance study aimed to follow periodontitis-associated bacterial profiles and to identify time-dependent changes in antibiotic susceptibility patterns.
MATERIALS AND METHODS
From 2008 to 2015, bacterial specimen from deep periodontal pockets were collected from a total of 7804 German adults diagnosed with periodontitis. Presence of selected bacteria was confirmed by anaerobic culture and nucleic acid amplification. Antimicrobial susceptibility of clinical isolates was tested by disc diffusion with antibiotics used for the treatment of periodontitis and oral infections. The prevalences of periodontal pathogens were calculated and temporal evolution of antimicrobial susceptibility towards amoxicillin, amoxicillin/clavulanic acid, metronidazole, doxycycline, clindamycin, azithromycin, ciprofloxacin and ampicillin was analysed with logistic regression.
RESULTS
The prevalence of patients harbouring bacteria was 95.9% Fusobacterium nucleatum, 88.0% Tannerella forsythia, 76.4% Treponema denticola, 76.5%, Campylobacter rectus, 76.0% Eikenella corrodens, 75.0% Capnocytophaga spp., 68.2% Porphyromonas gingivalis, 57.7% Peptostreptococcus micros, 43.1% Prevotella intermedia, 30.4% Eubacterium nodatum and 21.5% Aggregatibacter actinomycetemcomitans. In 63.5% of patients, one or more isolates were not susceptible to at least one of the antibiotics tested. The data further revealed a trend towards decreasing susceptibility profiles (p < 0.05) with antibiotic non-susceptibilities in 37% of patients in 2008 and in 70% in 2015.
CONCLUSIONS
The present study confirmed a high prevalence of periodontal pathogens in the subgingival microbiota of German periodontitis patients. The data revealed an incremental increase in isolates displaying resistance to some antibiotics but no relevant change in susceptibility to amoxicillin and metronidazole.
目的
本回顾性监测研究旨在跟踪牙周炎相关细菌谱，并确定抗生素敏感性模式的时间依赖性变化。
材料和方法
2008 年至 2015 年，从 7804 名被诊断患有牙周炎的德国成年人的深牙周袋中采集细菌标本。通过厌氧培养和核酸扩增确认选定细菌的存在。用治疗牙周炎和口腔感染的抗生素通过圆盘扩散法测试临床分离株的抗菌药敏性。计算牙周病原体的患病率，并使用逻辑回归分析阿莫西林、阿莫西林/克拉维酸、甲硝唑、强力霉素、克林霉素、阿奇霉素、环丙沙星和氨苄西林的抗菌敏感性随时间的演变。
结果
携带细菌的患者患病率为：产黑色素普雷沃菌 95.9%、福赛斯坦纳菌 88.0%、齿垢密螺旋体 76.4%、直肠弯曲杆菌 76.5%、腐蚀艾肯菌 76.0%、噬二氧化碳噬纤维菌 75.0%、牙龈卟啉单胞菌 68.2%、微小消化链球菌 57.7%、中间普雷沃菌 43.1%、真杆菌 30.4%和伴放线放线杆菌 21.5%。在 63.5%的患者中，一种或多种分离物对至少一种测试抗生素不敏感。数据进一步显示，随着抗生素不敏感性的增加（p<0.05），2008 年有 37%的患者和 2015 年有 70%的患者的敏感性谱呈下降趋势。
结论
本研究证实了德国牙周炎患者龈下微生物群中牙周病原体的高患病率。数据显示，一些抗生素的分离物耐药性呈递增趋势，但对阿莫西林和甲硝唑的敏感性无明显变化。
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