牙周脓肿专性厌氧菌的分离及其对抗生素耐药性的研究  

Distribution of anaerobes in periodontal abscess and its resistance to antibiotics

作　　者：何俊霖[1] 俞立英[1] 陈嘉臻[1] 

机构地区：[1]复旦大学附属华山医院口腔科,上海200040

出　　处：《中华口腔医学杂志》2012年第12期719-724,共6页Chinese Journal of Stomatology

摘　　要：目的对牙周脓肿专性厌氧菌进行分离、培养、鉴定、药敏分析及耐药基因检测，为临床治疗牙周厌氧菌感染合理选用抗菌药物提供依据。方法联合API20A生化鉴定法和聚合酶链反应（pdymerase chain reaction，PCR）对分离培养出的牙周脓肿专性厌氧菌进行鉴定，采用琼脂稀释法测定牙周厌氧菌对8种临床常用抗菌药物的敏感性；依据药敏结果，用PCR法筛查耐药菌株各型耐药基因。结果牙周脓肿专性厌氧菌检出率为48％（28／58），其中以产黑色素普雷沃菌分离率最高43％（12／28）；AP120A生化鉴定技术和16SrRNA序列测定技术鉴定牙周专性厌氧菌的一致率为82％（23／28）。厌氧菌对甲硝唑、克林霉素和头孢美唑存在耐药，耐克林霉素株中有3株检测出抗红霉素甲基化酶F基因，PCR法进一步证实其位点不在质粒上；耐甲硝唑株中均未检测出耐药基因与质粒。结论产黑色素普雷沃菌是牙周脓肿患者厌氧菌群中的优势菌；牙周厌氧菌对抗菌药物的耐药性存在差异，治疗时应结合患者全身状况慎重选择用药，牙周脓肿应以局部治疗为主。Objective To isolate and culture the predominant anaerobes from the periodontal abscesses, and to test the antibiotic susceptibility and drug resistant genes of the strains. Methods The isolated strains were identified by both API20A biochemical method and polymerase chain reaction （PCR） method. The antibiotic susceptibility test was performed by agar dilution method. The resistant genes of the drug-resistant strains obtained were screened by PCR. Results The anaerobes were detected in 48% （28/58） of the samples and Prevotella melaninogenica （Pm） was mostly identified in 43% （12/28）. API20A biochemical method had 82% （23/28） agreement with the 16SrRNA method in identification rate. Anaerobes were resistant to metronidazole, clindamycin and cefmetazole. The erythromycin-resistant methylase genes F（ermF） gene was detected in three of eight clindamycin resistant strains. None of them was found coded on bacterial plasmids. However, no metronidazole resistant gene was detected on drug resistant strains. Conclusions Pm was the predominant species dectected in the periodontal abscess of the patients. The antibiotic agents should be used based on the genotypes and general condition of the patients.

关 键 词：牙周脓肿 细菌 厌氧 微生物敏感性试验 耐药基因 

分 类 号：R446.5[医药卫生—诊断学]