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Prevalence of penicillin resistant bacteria in acute suppurative oral infection
M A Lewis1, C L Parkhurst, C W Douglas
1Department of Oral Surgery, Medicine and Pathology, Dental School, University of Wales College of Medicine, Cardiff, UK.
Abstract:
Pus aspirated from acute suppurative oral infections in 78 patients (age range 13-76 years) yielded a total of 331 bacterial strains consisting of 143 facultative anaerobes (predominantly Streptococcus spp.) and 188 strict anaerobes (predominantly Prevotella spp.). Seventy-five isolates (23%) were resistant to penicillin (MIC > 1 mg/L), 37 (11%) were resistant to ampicillin (MIC > 2 mg/L) and 16 (5%) isolates were resistant to amoxycillin/clavulanic acid (MIC > 2 mg/L). Samples from 43 (55%) of the patients yielded at least one penicillin resistant isolate and within this group 30 samples (73%) contained at least one strain which produced beta-lactamase. A history of antibiotic therapy during the 6 months before enrollment in the study did not influence the isolation of penicillin resistant bacteria. It is concluded that penicillin resistant bacteria are often present in the microflora of acute dental infection.
Insights
Penicillin-resistant bacteria, including those producing beta-lactamase, are frequently found in acute oral infections. Antibiotic history did not impact the presence of these resistant bacterial strains.
Area of Science:
- Oral microbiology
- Infectious diseases
- Antimicrobial resistance
Background:
- Acute suppurative oral infections are common and can be caused by a mix of bacteria.
- Understanding the prevalence of antibiotic resistance in these infections is crucial for effective treatment.
Purpose of the Study:
- To investigate the prevalence of antibiotic resistance in bacterial isolates from acute suppurative oral infections.
- To identify specific bacterial species and resistance mechanisms involved.
Main Methods:
- Aspiration of pus from oral infections in 78 patients.
- Bacterial culture and identification of 331 strains (143 facultative anaerobes, 188 strict anaerobes).
- Antimicrobial susceptibility testing, including penicillin, ampicillin, and amoxicillin/clavulanic acid, and beta-lactamase production assays.
Main Results:
- Prevalence of resistance: 23% to penicillin, 11% to ampicillin, 5% to amoxicillin/clavulanic acid.
- Penicillin-resistant isolates were found in 55% of patients.
- Beta-lactamase production was detected in 73% of samples with penicillin-resistant strains.
- No significant influence of prior antibiotic therapy on resistance was observed.
Conclusions:
- Penicillin-resistant bacteria are common in the microflora of acute dental infections.
- Beta-lactamase production is a frequent mechanism of resistance in these isolates.
- These findings highlight the need for careful antibiotic selection in treating oral infections.