Objectives: Refractory periodontitis is the occurrence of additional clinical attachment loss after repeated attempts to control the infection with conventional periodontal therapy. Some microorganisms seem to be involved in the pathogenesis of chronic refractory periodontitis. The prevalence of Enterococcus faecalis in the oral cavity seems to be higher in individuals with periodontitis. Therefore, the present study investigated the presence of E. faecalis in subgingival biofilm of patients with chronic refractory periodontal disease. Study design: Periodontal treatment was instituted for 100 patients suffering from chronic periodontitis. Then samples were obtained from 27 successfully treated and 27 chronic refractory periodontitis subjects and then cultured. Statistical evaluation was performed for descriptive purposes. Results: 27% of the patients had chronic refractory periodontitis. The difference in the presence of E. faecalis in the pockets between the successfully treated (11.1%) and chronic refractory (51.8%) groups by culture methods was statistically significant (P<0.05). Conclusion: Data showed that E. faecalis is probably involved in the pathogenesis of refractory periodontitis. Accurate knowledge about the pathogen and its role in the pathogenesis of refractory infections helps develop effective treating strategies.
The aim of this study was to determine the resistance pattern and the type of resistance genes of vancomycin-resistant Enterococcus faecalis from Gharamalek wastewater treatment plant in Tabriz, Iran. Following filtering of sewage samples, approximately 300 colonies grew on specific media, of which 53 were randomly selected and purified using 0.45 microm membranes. The membranes were placed on culture media containing antibiotics to isolate the vancomycin-resistant Enterococcus. Biochemical tests, antibiogram and determining minimum inhibitory concentration of antibiotics with E-test including vancomycin were performed. Polymerase Chain Reaction (PCR) was carried out to determine the type of resistance genes. All tested samples were found to be E. faecalis. Antimicrobial susceptibility tests indicated multidrug resistance in the samples, with 98% of them highly resistant to vancomycin. The highest frequency was of vanA (96%), followed by vanB (4%); vanC was not seen among the tested samples. The results confirmed that the risk of exposure to antibiotic-resistant pathogens from the evaluated urban wastewater is considerable.
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