1
|
Duarte Faria F, Cantiga-Silva C, Cardoso CDBM, da Silva Machado NE, de Oliveira PHC, Justo MP, Goto J, de Castilho Jacinto R, Sivieri-Araújo G, Cintra LTA. Influence of systemic antibiotic therapy on the development and progression of induced apical periodontitis in Wistar rats. Odontology 2024:10.1007/s10266-024-00908-2. [PMID: 38457086 DOI: 10.1007/s10266-024-00908-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/29/2024] [Indexed: 03/09/2024]
Abstract
The aim of this study was to investigate the influence of systemic antibiotic therapy on the development and progression of induced apical periodontitis (AP) in Wistar rats. Fifty-six rats were submitted to pulp exposure of the lower left first molar for the induction of AP. On the same day, intraperitoneal antibiotic therapy was administered once a day, for 15 days, until euthanasia. The groups were formed according to the different treatments (n = 8): C-control; GEN-treated with gentamicin (10 mg/Kg); AC-treated with amoxicillin (100 mg/Kg); MZ-treated with metronidazole (40 mg/Kg); AMP-treated with ampicillin (100 mg/Kg); AMC group-treated with amoxicillin + clavulanic acid (100 mg/kg); CLI-treated with clindamycin (60 mg/kg). After euthanasia, the jaws were collected and processed for (1) histological and histometric analysis using hematoxylin and eosin staining, (2) analysis of collagen fibers using Picrosirius Red staining and (3) bacteriological analysis using Brown-Brenn staining. The data were analyzed statistically (p < 0.05). AP induction was confirmed in all groups. The AMC group had the lower intensity of inflammatory infiltrate (p = 0.028) and less periapical bone resorption compared to control (p = 0.006). Regarding collagen maturation, PSR staining revealed a predominance of mature collagen fibers in all groups. The AC and AMC groups had the lower amount of mature fibers and the highest amount of immature fibers, compared to all other groups (p < 0.001). All groups showed bacterial contamination; however, the AC and AMC groups showed a lower extent of bacterial contamination compared to the control (p < 0.001). It can be concluded that systemic antibiotic therapy influences the development and progression of induced AP.
Collapse
Affiliation(s)
- Flávio Duarte Faria
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Cristiane Cantiga-Silva
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Carolina de Barros Morais Cardoso
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Nathália Evelyn da Silva Machado
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Pedro Henrique Chaves de Oliveira
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Mariana Pagliusi Justo
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Juliana Goto
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Rogério de Castilho Jacinto
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Gustavo Sivieri-Araújo
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil.
| |
Collapse
|
2
|
Ardila CM, Bedoya-García JA, González-Arroyave D. Antimicrobial resistance in patients with endodontic infections: A systematic scoping review of observational studies. AUST ENDOD J 2023; 49:386-395. [PMID: 36054305 DOI: 10.1111/aej.12680] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/31/2022] [Accepted: 08/15/2022] [Indexed: 12/29/2022]
Abstract
The aim of this study was to assess the prevalence and proportions of antimicrobial-resistant species in patients with endodontic infections. A systematic scoping review of scientific evidence was accomplished involving different databases. Nine investigations were selected including 651 patients. Enterococcus faecalis was resistant to tetracycline (30%-70%), clindamycin (100%), erythromycin (10%-20%), ampicillin (9%) and azithromycin (60%). On the contrary, Prevotella spp., Fusobacterium spp., Peptostreptococcus spp. and Streptococcus spp. were resistant to penicillin, tetracycline, doxycycline, ciprofloxacin, amoxicillin, erythromycin, metronidazole and clindamycin in different proportions. Fusobacterium nucleatum showed high resistance to amoxicillin, amoxicillin plus clavulanate and erythromycin. Prevotella oralis presented a predisposition to augment its resistance to clindamycin over time. Tanerella forsythia exhibited resistance to ciprofloxacin and rifampicin. Lactococcus lactis presented robust resistance to cephalosporins, metronidazole, penicillin, amoxicillin and amoxicillin-clavulanic acid. It was observed high levels of resistance to antimicrobials that have been utilised in the local and systemic treatment of oral cavity infections.
Collapse
Affiliation(s)
- Carlos-M Ardila
- Universidad de Antioquia U de A, Medellín, Colombia
- Biomedical Stomatology Research Group, Universidad de Antioquia U de A, Medellín, Colombia
| | | | | |
Collapse
|
3
|
Gomes BPFA, Berber VB, Chiarelli-Neto VM, Aveiro E, Chapola RC, Passini MRZ, Lopes EM, Chen T, Paster BJ. Microbiota present in combined endodontic-periodontal diseases and its risks for endocarditis. Clin Oral Investig 2023; 27:4757-4771. [PMID: 37401984 DOI: 10.1007/s00784-023-05104-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 06/05/2023] [Indexed: 07/05/2023]
Abstract
INTRODUCTION Infective endocarditis (IE) is an inflammatory disease usually caused by bacteria that enter the bloodstream and establish infections in the inner linings or valves of the heart, including blood vessels. Despite the availability of modern antimicrobial and surgical treatments, IE continues to cause substantial morbidity and mortality. Oral microbiota is considered one of the most significant risk factors for IE. The objective of this study was to evaluate the microbiota present in root canal (RC) and periodontal pocket (PP) clinical samples in cases with combined endo-periodontal lesions (EPL) to detect species related to IE using NGS. METHODS Microbial samples were collected from 15 RCs and their associated PPs, also from 05 RCs with vital pulp tissues (negative control, NC). Genomic studies associated with bioinformatics, combined with structuring of a database (genetic sequences of bacteria reported for infective endocarditis), allowed for the assessment of the microbial community at both sites. Functional prediction was conducted using PICRUSt2. RESULTS Parvimonas, Streptococcus, and Enterococcus were the major genera detected in the RCs and PPs. A total of 79, 96, and 11 species were identified in the RCs, PPs, and NCs, respectively. From them, a total of 34 species from RCs, 53 from PPs, and 2 from NCs were related to IE. Functional inference demonstrated that CR and PP microbiological profiles may not be the only risk factors for IE but may also be associated with systemic diseases, including myocarditis, human cytomegalovirus infection, bacterial invasion of epithelial cells, Huntington's disease, amyotrophic lateral sclerosis, and hypertrophic cardiomyopathy. Additionally, it was possible to predict antimicrobial resistance variants for broad-spectrum drugs, including ampicillin, tetracycline, and macrolides. CONCLUSION Microorganisms present in the combined EPL may not be the only risk factor for IE but also for systemic diseases. Antimicrobial resistance variants for broad-spectrum drugs were inferred based on PICRUSt-2. State-of-the-art sequencing combined with bioinformatics has proven to be a powerful tool for conducting studies on microbial communities and could considerably assist in the diagnosis of serious infections. CLINICAL RELEVANCE Few studies have investigated the microbiota in teeth compromised by combined endo-periodontal lesions (EPL), but none have correlated the microbiological findings to any systemic condition, particularly IE, using NGS techniques. In such cases, the presence of apical periodontitis and periodontal disease can increase IE risk in susceptible patients.
Collapse
Affiliation(s)
- Brenda P F A Gomes
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas-UNICAMP, Av. Limeira 901, Bairro Areao, Piracicaba, São Paulo, 13414-903, Brazil.
| | - Vanessa B Berber
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas-UNICAMP, Av. Limeira 901, Bairro Areao, Piracicaba, São Paulo, 13414-903, Brazil
| | - Vito M Chiarelli-Neto
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas-UNICAMP, Av. Limeira 901, Bairro Areao, Piracicaba, São Paulo, 13414-903, Brazil
| | - Emelly Aveiro
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas-UNICAMP, Av. Limeira 901, Bairro Areao, Piracicaba, São Paulo, 13414-903, Brazil
| | - Rafaela C Chapola
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas-UNICAMP, Av. Limeira 901, Bairro Areao, Piracicaba, São Paulo, 13414-903, Brazil
| | - Maicon R Z Passini
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas-UNICAMP, Av. Limeira 901, Bairro Areao, Piracicaba, São Paulo, 13414-903, Brazil
| | - Erica M Lopes
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas-UNICAMP, Av. Limeira 901, Bairro Areao, Piracicaba, São Paulo, 13414-903, Brazil
| | - Tsute Chen
- Department of Molecular Genetics, The Forsyth Institute, Cambridge, MA, USA
| | - Bruce J Paster
- Microbiology Department, The Forsyth Institute, Cambridge, MA, USA
| |
Collapse
|
4
|
Ardila CM, Vivares-Builes AM. Antibiotic Resistance in Patients with Peri-Implantitis: A Systematic Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315609. [PMID: 36497685 PMCID: PMC9737312 DOI: 10.3390/ijerph192315609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/17/2022] [Accepted: 11/22/2022] [Indexed: 05/31/2023]
Abstract
The implementation of adjunctive antibiotics has been recommended for the therapy of peri-implantitis (PI). In this review, antibiotic resistance patterns in PI patients were assessed. A systematic scoping review of observational studies and trials was established in conjunction with the PRISMA extension for scoping reviews. The SCOPUS, PubMed/MEDLINE, EMBASE, SCIELO, Web of Science, and LILACS databases were reviewed along with the gray literature. The primary electronic examination produced 139 investigations. Finally, four observational studies met the selection criteria. These studies evaluated 214 implants in 168 patients. Porphyromonas gingivalis and Fusobacterium nucleatum mainly presented high resistance to tetracycline, metronidazole, and erythromycin in PI patients. Similarly, Aggregatibacter actinomycetemcomitans was also highly resistant to clindamycin and doxycycline. Other microorganisms such as Tannerella forsythia, Parvimonas micra, and Prevotella intermedia/nigrescens also presented significant levels of resistance to other antibiotics including amoxicillin, azithromycin, and moxifloxacin. However, most microorganisms did not show resistance to the combination amoxicillin metronidazole. Although the management of adjunctive antimicrobials in the therapy of PI is controversial, in this review, the resistance of relevant microorganisms to antibiotics used to treat PI, and usually prescribed in dentistry, was observed. Clinicians should consider the antibiotic resistance demonstrated in the treatment of PI patients and its public health consequences.
Collapse
Affiliation(s)
- Carlos M. Ardila
- Basic Studies Department, School of Dentistry, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | | |
Collapse
|
5
|
Lima AR, Herrera DR, Francisco PA, Pereira AC, Lemos J, Abranches J, Gomes BPFA. Detection of Streptococcus mutans in symptomatic and asymptomatic infected root canals. Clin Oral Investig 2021; 25:3535-3542. [PMID: 33170373 PMCID: PMC8152374 DOI: 10.1007/s00784-020-03676-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 10/29/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To investigate the presence of Streptococcus mutans in root canals of symptomatic necrotic teeth (SNT) and their associated acute apical abscesses (AAA) and in the root canals of asymptomatic necrotic teeth (ANT). It also aimed to investigate the presence of the cnm and cbm genes in specimens that harbored S. mutans. MATERIALS AND METHODS DNA was extracted from samples collected from 10 patients presenting pulpal necrosis associated with radiographic evidence of apical periodontitis (ANT) and from 10 patients in need of endodontic therapy due to the presence of pulpal necrosis (SNT) and AAA. The control group consisted of 10 patients with teeth with normal vital pulp and requiring endodontic treatment for prosthetic reasons. The presence of S. mutans was detected by quantitative real-time-PCR (qPCR) using species-specific primers. Samples harboring S. mutans were further evaluated for the presence of CBP genes by qPCR as well. RESULTS All studied sites showed a high prevalence of S. mutans, except the control group. Specifically, 60% of ANT and 70% of AAA/SNT paired samples were positive for S. mutans. The cnm gene was detected positive for S. mutans only in ANT samples (66.6%). The cbm gene was not detected in any of the investigated sites. CONCLUSIONS S. mutans was found in high prevalence in both asymptomatic and symptomatic endodontic infections, including in abscesses, but it was not detected in the root canals of teeth with normal vital pulp. Interestingly, cnm+ S. mutans was only detected in asymptomatic/chronic primary endodontic infections associated with apical lesion. Therefore, it appears that cnm, and possibly other CBPs, may play an underestimated role in chronic endodontic infections. CLINICAL RELEVANCE A high prevalence of Streptococcus mutans cnm+ gene was detected only in asymptomatic primary endodontic infections associated with apical lesion. Therefore, it appears that this collagen-binding protein gene plays an underestimated role in asymptomatic/chronic endodontic infections.
Collapse
Affiliation(s)
- Augusto Rodrigues Lima
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, University of Campinas-UNICAMP, Av Limeira, 901, Bairro Areião, Piracicaba, SP, 13414-903, Brazil
- Department of Oral Biology, University of Florida, UF. College of Dentistry, 1395 Center Drive, Box 100424, Gainesville, FL, 32610-0424, USA
| | - Daniel Rodrigo Herrera
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, University of Campinas-UNICAMP, Av Limeira, 901, Bairro Areião, Piracicaba, SP, 13414-903, Brazil
- Department of Endodontics, Fluminense Federal University - UFF, Niteroi, RJ, Brazil
| | - Priscila Amanda Francisco
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, University of Campinas-UNICAMP, Av Limeira, 901, Bairro Areião, Piracicaba, SP, 13414-903, Brazil
| | - Andrea Cardoso Pereira
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, University of Campinas-UNICAMP, Av Limeira, 901, Bairro Areião, Piracicaba, SP, 13414-903, Brazil
- Department of Oral Biology, University of Florida, UF. College of Dentistry, 1395 Center Drive, Box 100424, Gainesville, FL, 32610-0424, USA
| | - Jose Lemos
- Department of Oral Biology, University of Florida, UF. College of Dentistry, 1395 Center Drive, Box 100424, Gainesville, FL, 32610-0424, USA
| | - Jacqueline Abranches
- Department of Oral Biology, University of Florida, UF. College of Dentistry, 1395 Center Drive, Box 100424, Gainesville, FL, 32610-0424, USA.
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, University of Campinas-UNICAMP, Av Limeira, 901, Bairro Areião, Piracicaba, SP, 13414-903, Brazil.
| |
Collapse
|
6
|
Molecular characterization and antibacterial activity of oral antibiotics and copper nanoparticles against endodontic pathogens commonly related to health care-associated infections. Clin Oral Investig 2021; 25:6729-6741. [PMID: 33895915 DOI: 10.1007/s00784-021-03959-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/20/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To carry out molecular characterization and determine the antibacterial activity of oral antibiotics and copper nanoparticles (Cu-NPs) against endodontic strains isolated from persistent infections. MATERIALS AND METHODS Root canal samples from 24 teeth in different patients with persistent endodontic infections were obtained. The isolated strains were identified by biochemical tests and 16S rDNA sequencing. Genotyping was achieved by molecular methods. The antibacterial activity of antibiotics and copper nanostructures was determined by using minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values. Furthermore, a time-kill kinetics assay was evaluated. Nonparametric tests (Kruskal-Wallis ANOVA) were performed (p value <0.05). RESULTS Twenty-one isolated strains were identified. Six isolates of Enterococcus faecalis were grouped into two clusters of three isolates each, two of which were clones. All were clarithromycin-resistant and erythromycin. Eight Pseudomonas putida presented two clusters, two Pseudomonas spp. were not clonal, and all were resistant to the tested antibiotics except tetracycline. Two of five strains of Cutibacterium acnes were clonal, and all were resistant only to metronidazole. The lowest MIC and MBC values were obtained with Cu-NPs. Time-kill kinetics using Cu-NPs showed a significant decrease in all tested species within 4 h and reached 100% in 2 h for C. acnes. CONCLUSION In this study, in relation to health care-associated infections, endodontic strains of each species isolated at least in one patient were polyclonal. In Pseudomonas spp., at least one clone was shared between patients. E. faecalis and C. acnes strains were susceptible to low Cu-NP concentrations, while Pseudomonas spp. strains were resistant. CLINICAL RELEVANCE Assessing and keeping track of the susceptibility of clinical strains to antimicrobial compounds is important for the clinical outcome. Based on our results, Cu-NPs could be an alternative for endodontic treatment, in order to avoid selection of resistant strains.
Collapse
|
7
|
Loyola-Rodriguez JP, Franco-Miranda A, Loyola-Leyva A, Perez-Elizalde B, Contreras-Palma G, Sanchez-Adame O. Prevention of infective endocarditis and bacterial resistance to antibiotics: A brief review. SPECIAL CARE IN DENTISTRY 2019; 39:603-609. [PMID: 31464005 DOI: 10.1111/scd.12415] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 07/31/2019] [Accepted: 08/03/2019] [Indexed: 12/26/2022]
Abstract
The purpose of this statement is to debate the recommendations of the American Heart Association (AHA) for the prevention of infective endocarditis through an antibiotic prophylaxis protocol and its relation with bacterial resistance to antibiotics. Since dental infections involve biofilms that include several bacterial species (Gram-negative and Gram-positive), it is essential, from the dental point of view, to consider the frequency, magnitude, and duration of bacteremia associated with active dental infections before applying antibiotic prophylaxis. The actual guidelines for antibiotic prophylaxis should be revised according to recent evidence of bacterial resistance. Amoxicillin/clavulanic acid and moxifloxacin should be considered due to their effectiveness against bacteria associated with oral, GU, and GI infections and the low rates of antibiotic resistance associated with these antibiotics, instead of the actual protocol, which includes amoxicillin (2 g) or clindamycin (600 mg) administered an hour before the dental procedures. The breaking point to test the antibiotic bacterial resistance (ABR) had a wide range in the different studies that were analyzed, which could explain the widely varied ABR percentages reported for the various antibiotics used for antibiotic prophylaxis.
Collapse
Affiliation(s)
- Juan Pablo Loyola-Rodriguez
- Laboratorio de Biomateriales y Bionanotecnología, Maestría en Ciencias de la Salud, Facultad de Medicina, Universidad Autónoma de Guerrero, Acapulco, México
| | | | - Alejandra Loyola-Leyva
- Doctorado en Ciencias Biomedicas Básicas, Universidad Autónoma de San Luis Potosí, México
| | - Bulfrano Perez-Elizalde
- Medicina Translacional, Maestría en Ciencias de la Salud, Facultad de Medicina, Universidad Autónoma de Guerrero, Acapulco, México
| | - Guillermo Contreras-Palma
- Laboratorio de Biomateriales y Bionanotecnología, Maestría en Ciencias de la Salud, Facultad de Medicina, Universidad Autónoma de Guerrero, Acapulco, México
| | - Oscar Sanchez-Adame
- Medicina Translacional, Maestría en Ciencias de la Salud, Facultad de Medicina, Universidad Autónoma de Guerrero, Acapulco, México
| |
Collapse
|
8
|
Domínguez-Pérez RA, De la Torre-Luna R, Ahumada-Cantillano M, Vázquez-Garcidueñas MS, Pérez-Serrano RM, Martínez-Martínez RE, Guillén-Nepita AL. Detection of the antimicrobial resistance genes blaTEM-1, cfxA, tetQ, tetM, tetW and ermC in endodontic infections of a Mexican population. J Glob Antimicrob Resist 2018; 15:20-24. [DOI: 10.1016/j.jgar.2018.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 05/12/2018] [Accepted: 05/15/2018] [Indexed: 12/28/2022] Open
|
9
|
Abe FC, Bergamaschi CDC, Figueiró MF, Lopes LC. Resistance profile to antimicrobial agents in the main circulating bacteria isolated from acute periodontal and endodontic infections in Latin America (MICROBE- DENT): A systematic review protocol. Medicine (Baltimore) 2018; 97:e13158. [PMID: 30508894 PMCID: PMC6283129 DOI: 10.1097/md.0000000000013158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 10/16/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Antimicrobial resistance is currently considered the main risk to global health. A variety of microbial species have been isolated from endodontic and periodontal infections. However, clinical endodontic and periodontics bacterial isolates have not been sufficiently characterized with regard to their capacity for antibiotic resistance. We aim to assess the existing evidence to estimate the prevalence of the main antimicrobial resistance and multidrug resistant organisms in endodontics and periodontics and to describe their geographic distribution in Latin America. METHODS All types of designs and will be restricted to Latin American studies will be included in this systematic review. MEDLINE, Embase, CINAHL, BVS (LILACS, BBO - bvsalud.org), IBECS (bases.bireme.br), Google Scholar, Cochrane Central Register of Controlled Trials, and Web of Science databases will be searched from 2013 to December 31, 2018 for all types of study designs that report microbial infection in endodontics and periodontics and their resistance and that define the microbiological methods used to identify microorganisms. The selection of articles for inclusion will be performed by 2 reviewers using predefined eligibility criteria. The Cochrane and ROBINS-I risk of bias assessment tools will be used to assess the methodological quality of randomized control trials. The Newcastle-Ottawa scale will be used to assess the quality of methodology in observational studies. The overall quality of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) using the same principles and domains applied in the quality assessment of prognostic studies. The heterogeneity of the findings will be assessed using both the χ test and the I statistic. Sensitivity analysis will be performed by subgroup analyses and meta-regression to investigate the effect of study-level characteristics, such as age, gender, and methodological quality score, whenever possible. Publication bias across studies will be evaluated by visual inspection of the funnel plots and Begg's test for the results covered in 10 or more studies. RESULTS The evidence derived by this study will inform best practices for patients with endodontic and periodontal problems receiving antimicrobial agents. CONCLUSION Successful completion will significantly impact clinical practice and contribute to improved prescribing competency. PROTOCOL REGISTRATION PROSPERO-CRD42018077810.
Collapse
Affiliation(s)
- Flávia Casale Abe
- Department of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, State of São Paulo
| | | | | | - Luciane Cruz Lopes
- Department of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, State of São Paulo
| |
Collapse
|
10
|
Francisco PA, Delboni MG, Lima AR, Xiao Y, Siqueira WL, Gomes BPFA. Proteomic profile of root canal contents in teeth with post-treatment endodontic disease. Int Endod J 2018; 52:451-460. [DOI: 10.1111/iej.13021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 09/30/2018] [Indexed: 02/01/2023]
Affiliation(s)
- P. A. Francisco
- Department of Restorative Dentistry; Endodontic Division; Piracicaba Dental School; State University of Campinas; Piracicaba São Paulo Brazil
- Department of Biochemistry; Schulich School of Medicine & Dentistry; University of Western Ontario; London Ontario Canada
| | - M. G. Delboni
- Department of Restorative Dentistry; Endodontic Division; Piracicaba Dental School; State University of Campinas; Piracicaba São Paulo Brazil
- College of Dentistry; DeVry Facid University; Teresina Piauí Brazil
| | - A. R. Lima
- Department of Restorative Dentistry; Endodontic Division; Piracicaba Dental School; State University of Campinas; Piracicaba São Paulo Brazil
| | - Y. Xiao
- Department of Biochemistry; Schulich School of Medicine & Dentistry; University of Western Ontario; London Ontario Canada
| | - W. L. Siqueira
- Department of Biochemistry; Schulich School of Medicine & Dentistry; University of Western Ontario; London Ontario Canada
| | - B. P. F. A. Gomes
- Department of Restorative Dentistry; Endodontic Division; Piracicaba Dental School; State University of Campinas; Piracicaba São Paulo Brazil
| |
Collapse
|
11
|
Bolfoni MR, Pappen FG, Pereira-Cenci T, Jacinto RC. Antibiotic prescription for endodontic infections: a survey of Brazilian Endodontists. Int Endod J 2017; 51:148-156. [PMID: 28744872 DOI: 10.1111/iej.12823] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 07/20/2017] [Indexed: 11/30/2022]
Abstract
AIM To investigate antibiotic prescribing habits reported by Brazilian endodontists in specific clinical situations. METHODOLOGY Brazilian endodontists (n = 13 853) were invited to answer an online questionnaire. The questionnaire consisted of two parts: the first part contained personal data such as age, gender, years of experience and location of endodontic practice; the second part included questions regarding their behaviour when prescribing antibiotics in dental practice. The subjects provided their registration number in the Regional Council of Dentistry (RCD) to prevent duplication of data. Data were collected and analysed by SPSS 17.0 (SPSS, Inc., Chicago, IL, USA). Chi-square and Fisher's exact tests were used to test the significance of possible associations (P < 0.05). RESULTS From the 13 853 questionnaires, a total of 615 were answered (4.44%). The first-choice antibiotic was amoxicillin (81.5%), followed by amoxicillin + clavulanic acid (30.7%). For acute apical abscesses with intra- and extraoral diffuse swelling, fever and trismus, 90.1% reported they would prescribe antibiotics, whilst 88.1% reported they would prescribe antibiotics even without extraoral swelling, fever and trismus, and 20.5% would prescribe antibiotics in cases of chronic apical periodontitis, and sinus tract. The first-choice antibiotics varied by age of dentist (P < 0.001) and time elapsed since their endodontic graduation (P = 0.001). CONCLUSIONS Many endodontists reported prescribing antibiotics in situations where they would not be indicated. Likewise, the general administration of antibiotics was longer in duration than necessary, reinforcing the need of continuous education regarding the use of antibiotics.
Collapse
Affiliation(s)
- M R Bolfoni
- Graduate Program in Dentistry, Federal University of Pelotas/UFPel, Pelotas, Brazil
| | - F G Pappen
- Graduate Program in Dentistry, Federal University of Pelotas/UFPel, Pelotas, Brazil
| | - T Pereira-Cenci
- Graduate Program in Dentistry, Federal University of Pelotas/UFPel, Pelotas, Brazil
| | - R C Jacinto
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| |
Collapse
|
12
|
Segura-Egea JJ, Gould K, Şen BH, Jonasson P, Cotti E, Mazzoni A, Sunay H, Tjäderhane L, Dummer PMH. Antibiotics in Endodontics: a review. Int Endod J 2017; 50:1169-1184. [DOI: 10.1111/iej.12741] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 12/19/2016] [Indexed: 12/20/2022]
Affiliation(s)
- J. J. Segura-Egea
- Department of Endodontics; School of Dentistry; University of Sevilla; Sevilla Spain
| | - K. Gould
- Newcastle upon Tyne Hospitals NHS Foundation Trust; Newcastle upon Tyne UK
| | | | - P. Jonasson
- Department of Endodontology; Institute of Odontology; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - E. Cotti
- Department of Conservative Dentistry and Endodontics; University of Cagliari; Cagliari, Sardinia Italy
| | - A. Mazzoni
- Department of Biomedical and Neuromotor Sciences; DIBINEM; University of Bologna; Bologna Italy
| | - H. Sunay
- Department of Endodontology; Dental Faculty of Istanbul Kemerburgaz University; Istanbul Turkey
| | - L. Tjäderhane
- Department of Oral and Maxillofacial Diseases; Helsinki University Hospital; University of Helsinki; Helsinki Finland
- Research Unit of Oral Health Sciences; Medical Research Center Oulu (MRC Oulu); Oulu University Hospital and University of Oulu; Oulu Finland
| | - P. M. H. Dummer
- School of Dentistry; College of Biomedical & Life Sciences; Cardiff University; Cardiff UK
| |
Collapse
|
13
|
Lang PM, Jacinto RC, Dal Pizzol TS, Ferreira MBC, Montagner F. Resistance profiles to antimicrobial agents in bacteria isolated from acute endodontic infections: systematic review and meta-analysis. Int J Antimicrob Agents 2016; 48:467-474. [DOI: 10.1016/j.ijantimicag.2016.08.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 08/02/2016] [Accepted: 08/08/2016] [Indexed: 01/01/2023]
|
14
|
Nóbrega LMM, Montagner F, Ribeiro AC, Mayer MAP, Gomes BPFDA. Bacterial diversity of symptomatic primary endodontic infection by clonal analysis. Braz Oral Res 2016; 30:e103. [PMID: 27737357 DOI: 10.1590/1807-3107bor-2016.vol30.0103] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 07/05/2016] [Indexed: 03/29/2023] Open
Abstract
The aim of this study was to explore the bacterial diversity of 10 root canals with acute apical abscess using clonal analysis. Samples were collected from 10 patients and submitted to bacterial DNA isolation, 16S rRNA gene amplification, cloning, and sequencing. A bacterial genomic library was constructed and bacterial diversity was estimated. The mean number of taxa per canal was 15, ranging from 11 to 21. A total of 689 clones were analyzed and 76 phylotypes identified, of which 47 (61.84%) were different species and 29 (38.15%) were taxa reported as yet-uncultivable or as yet-uncharacterized species. Prevotella spp., Fusobacterium nucleatum, Filifactor alocis, and Peptostreptococcus stomatis were the most frequently detected species, followed by Dialister invisus, Phocaeicola abscessus, the uncharacterized Lachnospiraceae oral clone, Porphyromonas spp., and Parvimonas micra. Eight phyla were detected and the most frequently identified taxa belonged to the phylum Firmicutes (43.5%), followed by Bacteroidetes (22.5%) and Proteobacteria (13.2%). No species was detected in all studied samples and some species were identified in only one case. It was concluded that acute primary endodontic infection is characterized by wide bacterial diversity and a high intersubject variability was observed. Anaerobic Gram-negative bacteria belonging to the phylum Firmicutes, followed by Bacteroidetes, were the most frequently detected microorganisms.
Collapse
Affiliation(s)
| | - Francisco Montagner
- Universidade Federal do Rio Grande do Sul (UFRGS), Department of Conservative Dentistry, Porto Alegre, RS, Brazil
| | - Adriana Costa Ribeiro
- Universidade de São Paulo (USP), Institute of Biomedical Science, Department of Oral Microbiology, São Paulo, SP, Brazil
| | - Márcia Alves Pinto Mayer
- Universidade de São Paulo (USP), Institute of Biomedical Science, Department of Oral Microbiology, São Paulo, SP, Brazil
| | | |
Collapse
|
15
|
Barbosa-Ribeiro M, De-Jesus-Soares A, Zaia AA, Ferraz CCR, Almeida JFA, Gomes BPFA. Antimicrobial Susceptibility and Characterization of Virulence Genes of Enterococcus faecalis Isolates from Teeth with Failure of the Endodontic Treatment. J Endod 2016; 42:1022-8. [PMID: 27221594 DOI: 10.1016/j.joen.2016.03.015] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 02/18/2016] [Accepted: 03/14/2016] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The aim of this study was to investigate the prevalence of virulence factors and the antimicrobial resistance of Enterococcus faecalis isolates of teeth with failure of the endodontic treatment. METHODS Twenty root canal samples were collected from teeth with apical periodontitis. E. faecalis was firstly identified based on phenotypic features and then by 16S ribosomal RNA gene sequencing. The antimicrobial susceptibility was determined by the minimum inhibitory concentration (MIC) of amoxicillin, amoxicillin + clavulanate, azithromycin, benzylpenicillin, ciprofloxacin, clindamycin, chloramphenicol, doxycycline, erythromycin, gentamicin, metronidazole, moxifloxacin, rifampicin, tetracycline, and vancomycin using the E test method. Virulence factors (ace, asa, asa373, cylA, efaA, esp, and gelE) were detected by polymerase chain reaction assay. RESULTS Amoxicillin + clavulanate was effective against all strains. Intermediate and total resistance was found against the majority of the tested antimicrobials. The susceptibility of some microorganisms to some antimicrobial agents changed according to the evaluation time. MIC50 and MIC90 also varied according to the evaluation time. In relation to the virulence factors of the E faecalis isolates, ace was detected in 100% of the strains, asa (60%), asa373 (15%), efaA (95%), esp (70%), and gelE (75%), whereas cylA was not detected. CONCLUSIONS It was concluded that E. faecalis isolates from persistent endodontic infections showed varied degrees of intermediate/total resistance to several antimicrobial agents, with amoxicillin + clavulanate being the most effective agent. Moreover, the strains showed different patterns for virulence gene detection.
Collapse
Affiliation(s)
- Marlos Barbosa-Ribeiro
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Adriana De-Jesus-Soares
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Alexandre A Zaia
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Caio C R Ferraz
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - José F A Almeida
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
| |
Collapse
|
16
|
Bonifaz A, Tirado-Sánchez A, Calderón L, Montes de Oca G, Torres-Camacho P, Ponce RM. Treatment of cutaneous actinomycosis with amoxicillin/clavulanic acid. J DERMATOL TREAT 2016; 28:59-64. [PMID: 27151779 DOI: 10.1080/09546634.2016.1178373] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Alexandro Bonifaz
- Mycology Department, Hospital General de México, “Dr. Eduardo Liceaga”, Mexico City, Mexico
| | - Andrés Tirado-Sánchez
- Dermatology Service, Hospital General de México, “Dr. Eduardo Liceaga”, Mexico City, Mexico
| | - Luz Calderón
- Dermatology Service, Hospital General de México, “Dr. Eduardo Liceaga”, Mexico City, Mexico
| | - Griselda Montes de Oca
- Dermatology Service, Hospital General de México, “Dr. Eduardo Liceaga”, Mexico City, Mexico
| | - Paula Torres-Camacho
- Dermatology Service, Hospital General de México, “Dr. Eduardo Liceaga”, Mexico City, Mexico
| | - Rosa M. Ponce
- Dermatology Service, Hospital General de México, “Dr. Eduardo Liceaga”, Mexico City, Mexico
| |
Collapse
|
17
|
Di Santi BT, Ribeiro MB, Endo MS, Gomes BPFDA. Avaliação da suscetibilidade antimicrobiana de bactérias anaeróbias facultativas isoladas de canais radiculares de dentes com insucesso endodôntico frente aos antibióticos de uso sistêmico. REVISTA DE ODONTOLOGIA DA UNESP 2015. [DOI: 10.1590/1807-2577.0060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
<title>Resumo</title><sec><title>Introdução</title><p>Bactérias associadas ao insucesso do tratamento endodôntico são capazes de adquirir e expressar resistência aos agentes antimicrobianos comumente empregados para tratar infecções, o que torna necessário, em determinadas situações, a realização de testes laboratoriais para detectar a resistência ou a suscetibilidade antimicrobiana desses micro-organismos.</p></sec><sec><title>Objetivo</title><p>avaliar a suscetibilidade antimicrobiana das cepas de <italic>Enterococcus faecalis</italic>, <italic>Enterococcus faecium</italic>, <italic>Actinomyces viscosus</italic> e <italic>Staphylococcus aureus</italic> isoladas de canais radiculares de dentes com insucesso endodôntico.</p></sec><sec><title>Material e método</title><p>Cepas clínicas de <italic>Enterococcus faecalis</italic> (n=3), <italic>Enterococcus faecium</italic> (n=3), <italic>Actinomyces viscosus</italic> (n=3) e <italic>Staphylococcus aureus</italic> (n=3), coletadas in vivo de canais radiculares com insucesso endodôntico, foram testadas quanto à suscetibilidade antimicrobiana por meio do método E-test em duplicata, utilizando os antibióticos: Amoxicilina (AC), Rifampicina (RI), Moxifloxacina (MX), Vancomicina (VA), Tetraciclina (TC), Ciprofloxacina (CI), Cloranfenicol (CL), Benzilpenicilina (PG), Amoxicilina + ácido clavulânico (XL), Doxiciclina (DC), Eritromicina (EM) e Azitromicina (AZ).</p></sec><sec><title>Resultado</title><p>Todas as cepas clínicas testadas foram suscetíveis aos antibióticos AC, XL, PG, DC, MX, TC e VA. Todos os isolados das espécies de <italic>S. aureus</italic> foram suscetíveis aos 12 antibióticos testados. As cepas de <italic>E. faecalis</italic>, <italic>E. faecium</italic> e <italic>A. viscosus</italic> mostraram padrão de suscetibilidade intermediário contra EM. Algumas cepas de <italic>E. faecalis</italic> e <italic>E. faecium</italic> foram resistentes a AZ e RI.</p></sec><sec><title>Conclusão</title><p>As cepas clínicas isoladas dos canais radiculares de dentes com insucesso endodôntico mostraram perfis diferentes de suscetibilidade antimicrobiana e nenhum isolado de <italic>E. faecalis</italic> e <italic>E. faecium</italic>apresentou-se suscetível a AZ e EM.</p></sec>
Collapse
|
18
|
A. Algarni A, H. Yassen G, L. Gregory R. Inhibitory effect of gels loaded with a low concentration of antibiotics against biofilm formation by Enterococcus faecalis and Porphyromonas gingivalis . J Oral Sci 2015; 57:213-8. [DOI: 10.2334/josnusd.57.213] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Amnah A. Algarni
- Department of Preventive and Community Dentistry, Indiana University School of Dentistry
| | - Ghaeth H. Yassen
- Division of Dental Biomaterials, Department of Restorative Dentistry, Indiana University School of Dentistry
| | | |
Collapse
|
19
|
Bacterial Biofilms and Endodontic Disease: Histobacteriological and Molecular Exploration. SPRINGER SERIES ON BIOFILMS 2015. [DOI: 10.1007/978-3-662-47415-0_5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
20
|
Loyola-Rodriguez JP, Garcia-Cortes JO, Martinez-Martinez RE, Patiño-Marin N, Martinez-Castañon GA, Zavala-Alonso NV, Amano A. Molecular identification and antibiotic resistant bacteria isolated from primary dentition infections. Aust Dent J 2014; 59:497-503. [PMID: 25091293 DOI: 10.1111/adj.12213] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bacterial resistance to antibiotics is a health problem in many parts of the world. The aim of this study was to identify bacteria from dental infections and determine bacterial resistance to antibiotics used in dental care in the primary dentition. METHODS This cross-sectional study comprised 60 children who presented for dental treatment for active dental infections in the primary dentition. Samples from dental infections were collected and bacteria were identified by polymerase chain reaction (PCR) assay. Bacterial resistance to antibiotics was determined by colony forming units on agar plates containing amoxicillin, clindamycin and amoxillicin-clavulanic acid (A-CA) tested at 8 μg/ml or 16 μg/ml. RESULTS Clindamycin in both concentrations tested (8 μg/ml and 16 μg/ml) showed the highest bacterial resistance (85.9%), followed by amoxicillin (43.7%) and A-CA (12.0%). All comparisons among the three antibiotics used in the study exhibited statistical significance (p = <0.05) in both concentrations tested (8 μg/ml and 16 μg/ml), and under aerobic and anaerobic conditions. The most prevalent resistant species identified by PCR in primary dentition infections were: Streptococcus oralis and Prevotella intermedia (75.0%); Treponema denticola and Porphyromonas gingivalis (48.3%); Streptococcus mutans (45.0%); Campylobacter rectus; and Streptococcus salivarius (40%). CONCLUSIONS This study demonstrated that A-CA exhibited the lowest bacterial resistance for clinical isolates in primary dentition infections.
Collapse
Affiliation(s)
- J P Loyola-Rodriguez
- Master's Degree in Dental Science Program with specialization in Advanced Education in General Dentistry, San Luis Potosi University, Mexico
| | | | | | | | | | | | | |
Collapse
|
21
|
De-Paula KB, Silveira LSD, Fagundes GX, Ferreira MBC, Montagner F. Patient automedication and professional prescription pattern in an urgency service in Brazil. Braz Oral Res 2014; 28:S1806-83242014000100250. [PMID: 25166763 DOI: 10.1590/1807-3107bor-2014.vol28.0041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 05/06/2014] [Indexed: 11/22/2022] Open
Abstract
Several studies have indicated an increased resistance of microorganisms resulting from the widespread use of antimicrobial agents. However, few data are available in the dental literature. The aim of this study was to conduct a survey on the patterns of patient usage of antimicrobial prescriptions agents by dentists. A retrospective cross-sectional study was based on the medical records of 223 patients who sought treatment at the Urgency Service, from a Dental School in the South of Brazil, from March 2009 to March 2011. A specific data sheet was used, with questions regarding: patient age and gender; the main complaint; medications used prior to the service; final diagnosis; proposed dental treatment (including prescription medications); and characteristics of the final prescription. Descriptive and inferential statistics were obtained. There was a high frequency of antibiotic use prior to attendance by young patients (Fisher's exact test, p < 0.05). Toothache of endodontic origin was the most frequent patient complaint (72.6%). Endodontic procedures were the measures most frequently adopted to treat the pain (31.2%). The frequency of patient use of antimicrobials prior to the appointment was 14.3%. According to patient records, 83.9% had no systemic drug prescription after receiving urgency treatment. There were few antimicrobial prescriptions after the urgency treatment. The most frequently prescribed agents were amoxicillin, chlorhexidine, and metronidazole. Local measures were more frequently used than systemic approaches to treat urgencies of dental origin. Antimicrobial agents were not frequently prescribed as adjunctives to local administered at the urgency service.
Collapse
Affiliation(s)
- Karen Barea De-Paula
- Dental School, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | - Maria Beatriz Cardoso Ferreira
- Department of Pharmacology, Institute of Biological Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Francisco Montagner
- Dental School, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| |
Collapse
|
22
|
Al-Ahmad A, Ameen H, Pelz K, Karygianni L, Wittmer A, Anderson AC, Spitzmüller B, Hellwig E. Antibiotic Resistance and Capacity for Biofilm Formation of Different Bacteria Isolated from Endodontic Infections Associated with Root-filled Teeth. J Endod 2014; 40:223-30. [DOI: 10.1016/j.joen.2013.07.023] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 07/30/2013] [Accepted: 07/30/2013] [Indexed: 11/28/2022]
|
23
|
T. Prather B, Ehrlich Y, Spolnik K, A. Platt J, H. Yassen G. Effects of two combinations of triple antibiotic paste used in endodontic regeneration on root microhardness and chemical structure of radicular dentine. J Oral Sci 2014; 56:245-51. [DOI: 10.2334/josnusd.56.245] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
|
24
|
Montagner F, Jacinto RC, Correa Signoretti FG, Scheffer de Mattos V, Grecca FS, Gomes BPFDA. Beta-lactamic resistance profiles in Porphyromonas, Prevotella, and Parvimonas species isolated from acute endodontic infections. J Endod 2013; 40:339-44. [PMID: 24565649 DOI: 10.1016/j.joen.2013.10.037] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Revised: 10/15/2013] [Accepted: 10/24/2013] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Susceptibility to beta-lactamic agents has changed among anaerobic isolates from acute endodontic infections. The aim of the present study was to determine the prevalence of the cfxA/cfxA2 gene in Prevotella spp., Porphyromonas spp., and Parviomonas micra strains and show its phenotypic expression. METHODS Root canal samples from teeth with acute endodontic infections were collected and Porphyromonas, Prevotella, and Parvimonas micra strains were isolated and microbiologically identified with conventional culture techniques. The susceptibility of the isolates was determined by the minimum inhibitory concentration of benzylpenicillin, amoxicillin, and amoxicillin + clavulanate using the E-test method (AB BIODISK, Solna, Sweden). The presence of the cfxA/cfxA2 gene was determined through primer-specific polymerase chain reaction. The nitrocefin test was used to determine the expression of the lactamase enzyme. RESULTS Prevotella disiens, Prevotella oralis, Porphyromonas gingivalis, and P. micra strains were susceptible to benzylpenicillin, amoxicillin, and amoxicillin + clavulanate. The cfxA/cfxA2 gene was detected in 2 of 29 isolates (6.9%). Simultaneous detection of the cfxA/cfxA2 gene and lactamase production was observed for 1 Prevotella buccalis strain. The gene was in 1 P. micra strain but was not expressed. Three strains were positive for lactamase production, but the cfxA/cfxA2 gene was not detected through polymerase chain reaction. CONCLUSIONS There is a low prevalence of the cfxA/cfxA2 gene and its expression in Porphyromonas spp., Prevotella spp., and P. micra strains isolated from acute endodontic infections. Genetic and phenotypic screening must be performed simultaneously to best describe additional mechanisms involved in lactamic resistance for strict anaerobes.
Collapse
Affiliation(s)
- Francisco Montagner
- Endodontic Division, Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Rogério Castilho Jacinto
- Endodontic Division, Department of Semiology and Clinics, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Vanessa Scheffer de Mattos
- Endodontic Division, Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fabiana Soares Grecca
- Endodontic Division, Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | |
Collapse
|
25
|
Detection of antibiotic resistance genes in samples from acute and chronic endodontic infections and after treatment. Arch Oral Biol 2013; 58:1123-8. [PMID: 23591127 DOI: 10.1016/j.archoralbio.2013.03.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 03/04/2013] [Accepted: 03/20/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was twofold: survey samples from acute and chronic endodontic infections for the presence of genes encoding resistance to beta-lactams, tetracycline and erythromycin, and evaluate the ability of treatment to eliminate these genes from root canals. DESIGN DNA extracts from samples of abscess aspirates (n=25) and root canals of teeth with asymptomatic apical periodontitis (n=24) were used as template for direct detection of the genes blaTEM, cfxA, tetM, tetQ, tetW, and ermC using real-time polymerase chain reaction (PCR). Bacterial presence was determined using PCR with universal bacterial primers. Root canals of the asymptomatic cases were also sampled and evaluated after chemomechanical procedures using NiTi instruments with 2.5% NaOCl irrigation. RESULTS All abscess and initial root canal samples were positive for bacteria. At least one of the target resistance genes was found in 36% of the abscess samples and 67% of the asymptomatic cases. The most prevalent genes in abscesses were blaTEM (24%) and ermC (24%), while tetM (42%) and tetW (29%) prevailed in asymptomatic cases. The blaTEM gene was significantly associated with acute cases (p=0.02). Conversely, tetM was significantly more prevalent in asymptomatic cases (p=0.008). Treatment eliminated resistance genes from most cases. CONCLUSIONS Acute and chronic endodontic infections harboured resistance genes for 3 classes of widely used antibiotics. In most cases, treatment was effective in eliminating these genes, but there were a few cases in which they persisted. The implications of persistence are unknown. Direct detection of resistance genes in abscesses may be a potential method for rapid diagnosis and establishment of proactive antimicrobial therapy.
Collapse
|
26
|
Microbiological profile and antimicrobial susceptibility pattern of infected root canals associated with periapical abscesses. Eur J Clin Microbiol Infect Dis 2012; 32:573-80. [PMID: 23224675 DOI: 10.1007/s10096-012-1777-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2012] [Accepted: 11/04/2012] [Indexed: 10/27/2022]
Abstract
The aim of this investigation was to identify microorganisms from root canals with periapical abscesses and assess the susceptibility of specific anaerobic bacteria to selected antimicrobials and their β-lactamase production. Sixty root canals were microbiologically investigated. The susceptibility of Anaerococcus prevotii, Fusobacterium necrophorum, F. nucleatum, Parvimonas micra, and Prevotella intermedia/nigrescens to antimicrobials was evaluated with the Etest, whereas β-lactamase production was assessed with nitrocefin. A total of 287 different bacterial strains were recovered, including 201 strict anaerobes. The most frequently strict isolated anaerobes were A. prevotii, P. micra, and F. necrophorum. The selected bacteria were susceptible to all the tested antibiotics, except A. prevotii and Fusobacterium species to azithromycin and erythromycin, as well as A. prevotii and F. necrophorum to metronidazole. None of the microorganisms produced β-lactamase. Gram-positive anaerobic bacteria predominated in the root canals with periapical abscesses. All microorganisms tested were susceptible to benzylpenicillin, amoxicillin, amoxicillin + clavulanate, cefaclor, and clindamycin, producing no β-lactamase.
Collapse
|
27
|
|
28
|
Lee MJ, Ha YE, Park HY, Lee JH, Lee YJ, Sung KS, Kang CI, Chung DR, Song JH, Peck KR. Osteomyelitis of a long bone due to Fusobacterium nucleatum and Actinomyces meyeri in an immunocompetent adult: a case report and literature review. BMC Infect Dis 2012; 12:161. [PMID: 22817336 PMCID: PMC3481430 DOI: 10.1186/1471-2334-12-161] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 07/06/2012] [Indexed: 11/26/2022] Open
Abstract
Background Fusobacterium species are uncommon causes of osteomyelitis. These organisms are normal flora of the oral cavity. Therefore, they mostly cause osteomyelitis of the head and neck. Hematogenous osteomyelitis at distant sites other than the head and neck has rarely been reported in pediatric or immunocompromised patients. Here, we report the first case of osteomyelitis of a long bone combined with a muscle abscess due to Fusobacterium nucleatum in an otherwise healthy adult. Case presentation A 59-year-old Korean man was admitted for pain and swelling of the right lower leg, which had been persistent for two weeks. Magnetic resonance imaging showed osteomyelitis of the right fibula with a surrounding muscle abscess of the right lower leg. Incision and drainage was performed, and repetitive tissue cultures grew F. nucleatum. In this patient, it was presumed that recurrent periodontitis caused hematogenous seeding of F. nucleatum to a distant site leading to osteomyelitis with a muscle abscess. The patient was successfully treated with intravenous ampicillin-sulbactam for three weeks and oral amoxicillin-clavulanate for eight weeks. He also underwent repeated surgical drainage. He has no evidence of recurrence after seven months of follow-up. Conclusions Clinicians should be aware that F. nucleatum could be the etiologic agent of hematogenous osteomyelitis of a long bone in an immunocompetent patient.
Collapse
Affiliation(s)
- Min Ji Lee
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Scarano A, Artese L, Piattelli A, Carinci F, Mancino C, Iezzi G. Hemostasis Control in Endodontic Surgery: A Comparative Study of Calcium Sulfate versus Gauzes and versus Ferric Sulfate. J Endod 2012; 38:20-3. [DOI: 10.1016/j.joen.2011.09.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 09/21/2011] [Accepted: 09/22/2011] [Indexed: 11/25/2022]
|