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Tetracycline resistance in periodontal pathogens
1Nosocomial Pathogens Laboratory Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30333.
Summary
Tetracycline antibiotics may not effectively treat periodontitis due to widespread antimicrobial resistance. Testing bacterial susceptibility before treatment is recommended for refractory periodontitis patients.
Area of Science:
- Periodontology
- Microbiology
- Pharmacology
Background:
- Antimicrobial agents and debridement are standard for treating periodontal disease.
- Tetracyclines are commonly used, but efficacy varies among patients.
- Antimicrobial resistance is a potential cause for treatment failure.
Purpose of the Study:
- To investigate the prevalence and mechanisms of tetracycline resistance in periodontal pathogens.
- To highlight the importance of susceptibility testing for refractory periodontitis.
Main Methods:
- Review of existing literature on antimicrobial resistance in periodontal pathogens.
- Identification of specific resistance determinants like tet(M) and tet(Q).
- Analysis of bacterial isolates from subgingival flora.
Main Results:
- High rates of tetracycline resistance (up to 75%) observed in subgingival bacteria after prolonged treatment.
- Specific resistance mechanisms identified in Veillonella and Fusobacterium species (tet(M)) and Prevotella species (tet(Q)).
- Mechanisms of resistance in many periodontal organisms remain undetermined.
Conclusions:
- Antimicrobial resistance significantly impacts the effectiveness of tetracyclines in periodontitis treatment.
- Susceptibility testing of subgingival flora is crucial before initiating tetracycline therapy for refractory periodontitis.
- Further research is needed to elucidate resistance mechanisms in other periodontal organisms.