Periodontal disease as reservoir for multi-resistant and hydrolytic enterobacterial species

Abstract

Aims: This investigation aimed to isolate enteric rods from subgingival sites of patients presenting chronic periodontitis lesions, and to assess antimicrobial resistance and expression of hydrolytic enzymes. Methods and Results: Enterobacteriaceae were isolated from 20% patients, and assayed for antimicrobial susceptibility and hydrolytic enzymes with specificity to different substrates. Isolates comprised seven Enterobacter cloacae (43·75%), five Serratia marcescens (31·25%), one Klebsiella pneumoniae (6·25%), one Enterobacter aerogenes (6·25%), one Pantoea agglomerans (6·25%), and one Citrobacter freundii (6·25%). Gelatinase activity was observed for 75% strains; caseinase and elastase was produced by six and two strains, respectively. DNase, lecithinase and lipase were expressed by S. marcescens. Most of strains were resistant to ampicillin (93·75%) and amoxicillin/clavulanic acid (81·25%). The majority of strains were susceptible to cephalosporins and aztreonam. Enterobacteria remained susceptible to imipenem, streptomycin and fluoroquinolones. Resistance to gentamicin, amikacin, sulfamethoxazole/thrimethoprim, tetracycline, and chloramphenicol were also observed. Eight strains presented multiple drug resistance. Conclusions: Subgingival sites from periodontal diseases contain multi‐resistant and hydrolytic enzyme‐producing enterobacteria that may contribute to overall tissue destruction and spreading. Significance and Impact of the Study: Enterobacteria isolated from patients generally considered as healthy individuals poses periodontal diseases as reservoir for systemic infections particularly in immunocompromised and hospitalized hosts.

Osteomielite crônica mandibular: relato de caso

“…É sabido que nos países em desenvolvimento, a determinação dos padrões de resistência aos antimicrobianos não constitui um procedimento rotineiro 19,20 , o que obriga o clínico a se basear, na prescrição desses medicamentos, na literatura europeia, japonesa e norte-americana, onde hábitos de automedicação não são amplamente disseminados na população e os índices de resistência em infecções de cabeça e pescoço são proporcionalmente menores. Além disso, o mau uso de antibióticos e outras drogas geralmente levam à seleção de microrganismos resistentes e o resultado do tratamento clínico pode ser bastante ruim 21 .…”

Efecto de las enterobacterias en pacientes con periodontitis crónica

“…La selección de antibióticos en la práctica clínica puede estar basada en análisis microbiológicos de muestras obtenidas de sitios afectados, pero este enfoque está limitado a casos de difícil tratamiento porque tales análisis pueden ser costosos, técnicamente complicados y requieren de laboratorios altamente estandarizados que reporten resultados con-fiables (8,47). Otra dificultad de la selección de antibióticos, mediante pruebas de laboratorio, es que se ha demostrado mayor resistencia contra las bacterias presentes en la placa subgingival in vivo comparado con estudios in vitro (48,49). Es así, como con regularidad, la selección de los antibióticos se realiza de manera empírica y se basa en los signos clínicos (44).…”

Effect of andiroba oil on periodontitis in Wistar rats

“…The oral cavity is a natural reservoir of thousands of micro-organisms with a high potential for infection 1 . When associated with a poor oral hygiene and / or indiscriminate use of antibiotics can easily cause a differentiated of the microbiota on this area of the body 1,2 .…”