Antimicrobial profiles of periodontal pathogens isolated from periodontitis patients in The Netherlands and Spain.
OBJECTIVE
Antimicrobial resistance of periodontal pathogens towards currently used antibiotics in periodontics has been investigated in a previous study. Microbial resistance in the periodontal microflora was more frequently observed in Spanish patients in comparison with Dutch patients. The aim of the present study was to compare antimicrobial susceptibility profiles of five periodontal bacteria isolated from periodontitis patients in Spain and in The Netherlands.


METHODS
Subgingival plaque samples from adult patients with periodontitis were collected and cultured on selective and non-selective plates. Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum and Micromonas micros were isolated and used for minimal inhibitory concentration tests using the Epsilometer (E-test) technique. Eight different antibiotics were tested on all bacterial isolates. MIC50 and MIC90 values for each antibiotic and each species were determined and the percentage of resistant strains was calculated.


RESULTS
Significantly higher MIC values were noted in Spanish strains of F. nucleatum for penicillin, ciprofloxacin, of P. intermedia for penicillin, amoxicillin and tetracycline, of M. micros for tetracycline, amoxicillin and azithromycin, and of P. gingivalis for tetracycline and ciprofloxacin. Based on breakpoint concentrations, a higher number of resistant strains in Spain were found in F. nucleatum for penicillin, amoxicillin and metronidazole, in Prevotella intermedia for tetracycline and amoxicillin, and in A. actinomycetemcomitans for amoxicillin and azithromycin. Resistance of P. gingivalis strains was not observed for any of the antibiotics tested both in Spain and The Netherlands.


CONCLUSIONS
Differences exist in the susceptibility profiles of periodontal pathogens isolated from periodontitis patients in Spain and in The Netherlands. This implicates that antibiotic susceptibility testing is necessary to determine efficacy of antimicrobial agents. Also, clinical studies with antibiotics should take these differences into account. The information from the present study indicates that it may not be possible to develop uniform protocols for usage of antibiotics in the treatment of severe periodontitis in the European Union.
Department of Oral Microbiology, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands. aj.vanwinkelhoff@vumc.nl
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van Winkelhoff
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Herrera
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Oteo
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Sanz
D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000187:drug effects; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001421:Bacteria, Anaerobic / Q000187:drug effects*; D003773:Dental Plaque / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D016967:Fusobacterium nucleatum / Q000187:drug effects; D006801:Humans; D008826:Microbial Sensitivity Tests; D009426:Netherlands; D010462:Peptostreptococcus / Q000187:drug effects; D010518:Periodontitis / Q000382:microbiology*; D016966:Porphyromonas gingivalis / Q000187:drug effects; D018713:Prevotella intermedia / Q000187:drug effects; D013030:Spain; D013045:Species Specificity; D018709:Statistics, Nonparametric
D000900:Anti-Bacterial Agents