68例慢性牙周炎患者龈下菌斑致病菌的分布及耐药性分析

Distribution and antimicrobial susceptibility of subgingival pathogenic bacteria in 68 patients with chronic periodontitis

目的了解慢性牙周炎患者龈下菌斑可疑致病菌的分布及抗生素耐药情况,为临床治疗提供参考。方法对口腔门诊诊断为慢性牙周炎患者龈下菌斑中的致病菌进行分离培养,采用琼脂稀释法测定分离菌对甲硝唑、阿莫西林等10种常用抗生素的敏感性。结果从68例慢性牙周炎患者龈下菌斑中共分离到262株可疑致病菌,所有病例均检出有致病菌感染,其中以牙龈卟啉单胞菌和产黑色素普雷沃菌分离率较高,分别检出66.2%和60.3%,其次为伴放线嗜血杆菌(55.9%)、具核梭杆菌(51.5%)和消化链球菌(45.6%)等。药敏结果显示:所测菌株对硝基咪唑类药物敏感性较高,对甲硝唑、替硝唑、奥硝唑的敏感率均在90%以上,对阿莫西林/克拉维酸全部敏感,对阿奇霉素、米诺环素、克林霉素的敏感率在51%～78%之间,但对青霉素、红霉素耐药性高,敏感率仅分别为2.3%和17.9%。结论牙龈卟啉单胞菌、产黑色素普雷沃菌等菌为宁夏青铜峡市小坝地区慢性牙周炎患者龈下菌斑中主要的可疑致病菌,对阿莫西林/克拉维酸和硝基咪唑类药物普遍敏感。

Objective The present study aims to investigate the distribution and antimicrobial susceptibilities of subgingival pathogenic bacteria from patients with chronic periodontitis. Methods The putative periodontal pathogens were isolated from subgingival plaque in patients with chronic periodontitis. Antimicrobial susceptibility of the bacteria to ten antimicrobial agents was measured by the agar dilution technique. Results A total of 262 bacterial strains were isolated from the subgingival plaques of 68 patients with chronic periodontitis. Among the 262 isolates, Porphyromon gingivalis（66.2%） and Prevotella melaninogenica（60.3%） were the most predominant, followed by Actinobacillus actin omycetemcomitan（55.9%）, Fusobacterius nucleatum（51.5%）, Peptostreptococcus（45.6%）, and so on. The tested strains were highly susceptible to nitro imidazole drugs, and their susceptibility rates to metronidazole, tinidazole, and ornidazole were over 90%. All isolates were susceptible to amoxicillin/clavulanate. Approximately 51% to 78% of the isolates were susceptible to azithromycin, minocycline, and clindamycin. Susceptibility to penicillin and erythromycin were only 2.3% and 17.9%, respectively. Conclusion Porphyromon gingivalis and Prevotella melaninogenica were the most frequently isolated putative periodontal pathogens in patients with chronic periodontitis in the Xiaoba district of Qingtongxia City, Ningxia. Amoxicillin/clavulanate and nitro imidazole drugs are useful alternatives against anaerobic bacteria involved in periodontitis.