Premium
Antibiotic Resistance in Human Chronic Periodontitis Microbiota
Author(s) -
Rams Thomas E.,
Degener John E.,
Winkelhoff Arie J.
Publication year - 2014
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.2013.130142
Subject(s) - amoxicillin , metronidazole , ciprofloxacin , chronic periodontitis , microbiology and biotechnology , aggressive periodontitis , prevotella intermedia , aggregatibacter actinomycetemcomitans , clindamycin , antibiotics , doxycycline , gingival and periodontal pocket , actinobacillus , periodontitis , medicine , biology , porphyromonas gingivalis
Background: Patients with chronic periodontitis (CP) may yield multiple species of putative periodontal bacterial pathogens that vary in their antibiotic drug susceptibility. This study determines the occurrence of in vitro antibiotic resistance among selected subgingival periodontal pathogens in patients with CP. Methods: Subgingival biofilm specimens from inflamed deep periodontal pockets were removed before treatment from 400 adults with CP in the United States. The samples were cultured, and selected periodontal pathogens were tested in vitro for susceptibility to amoxicillin at 8 mg/L, clindamycin at 4 mg/L, doxycycline at 4 mg/L, and metronidazole at 16 mg/L, with a post hoc combination of data for amoxicillin and metronidazole. Gram‐negative enteric rods/pseudomonads were subjected to ciprofloxacin disk‐diffusion testing. Results: Overall, 74.2% of the patients with CP revealed subgingival periodontal pathogens resistant to at least one of the test antibiotics. One or more test species, most often Prevotella intermedia/nigrescens , Streptococcus constellatus , or Aggregatibacter actinomycetemcomitans , were resistant in vitro to doxycycline, amoxicillin, metronidazole, or clindamycin, in 55%, 43.3%, 30.3%, and 26.5% of the patients with CP, respectively. Fifteen percent of patients harbored subgingival periodontal pathogens resistant to both amoxicillin and metronidazole, which were mostly either S. constellatus (45 individuals) or ciprofloxacin‐susceptible strains of Gram‐negative enteric rods/pseudomonads (nine individuals). Conclusions: Patients with CP in the United States frequently yielded subgingival periodontal pathogens resistant in vitro to therapeutic concentrations of antibiotics commonly used in clinical periodontal practice. The wide variability found in periodontal pathogen antibiotic‐resistance patterns should concern clinicians empirically selecting antibiotic treatment regimens for patients with CP.