Antibiotic resistance among Aerobic Gram-Negative Bacilli isolated from patients with oral inflammatory dysbiotic conditions—a retrospective study

IntroductionAerobic gram-negative bacilli (AGNB) are not part of the resident oral microflora but are occasionally found in high abundance under inflammatory dysbiotic conditions at various oral niches. The aim of the present study was to investigate the identity and antibiotic susceptibility of AGN...

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Main Authors: A. Basic, S. Blomqvist, G. Charalampakis, G. Dahlén
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-03-01
Series:Frontiers in Dental Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fdmed.2024.1293202/full
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author A. Basic
S. Blomqvist
G. Charalampakis
G. Dahlén
author_facet A. Basic
S. Blomqvist
G. Charalampakis
G. Dahlén
author_sort A. Basic
collection DOAJ
description IntroductionAerobic gram-negative bacilli (AGNB) are not part of the resident oral microflora but are occasionally found in high abundance under inflammatory dysbiotic conditions at various oral niches. The aim of the present study was to investigate the identity and antibiotic susceptibility of AGNB isolated from patients in Sweden with mucosal lesions, periodontitis, and peri-implantitis, with special attention to antibiotic resistance and on the presence of phenotypic Extended Spectrum Beta-Lactamase (ESBL) isolates.Materials and methodsMicrobiolgical samples were harvested from 211 patients in total, experiencing mucosal lesions (N = 113), periodontitis (N = 62), or peri-implantitis (N = 36). The growth of AGNBs was semiquantified by selective and non-selective culture and the strains were isolated, identified, and tested for antibiotic susceptibility. A total of 251 AGNB strains, occurring in moderate to heavy growth (>100 CFU/ml sample), indicating a dysbiotic microbiota, were identified. The disc diffusion method was used for screening of the antibiotic susceptibility of the isolates. Phenotypic identification of ESBL isolates was based on resistance to ceftazidime and/or cefotaxime.ResultsThe most commonly detected AGNB isolates in oral inflammatory dysbiotic conditions were fermentative species belonging to Enterobacteriaceae e.g. Citrobacter spp., Enterobacter spp., Escherichia coli, Klebsiella spp, and the non-fermentative environmental Burkholderia cepacia, Pseudomonas spp., and Stenotrophomonas maltophilia. No clear trends were seen in frequency of the various species in samples from mucosal lesions, severe periodontitis, and peri-implantitis cases. The 138 Enterobacteriaceae isolates and 113 environmental AGNB isolated showed a high antibiotic resistance in general against antibiotics commonly used in dentistry (Amoxicillin, Amoxicillin + Clavulanic acid, Ampicillin, Clindamycin, Doxycycline, Erythromycin, Oxacillin, PenicillinV, and Tetracycline). The majority of these isolates were susceptible to ciprofloxacin. Ten isolates (4.1%) were phenotypically classified as ESBL positive. The ESBL isolates were predominantly found among isolates of S. maltophilia, while only one ESBL positive isolate was found among Enterobacteriaceae.ConclusionsPhenotypically identified ESBL isolates can occasionally be present among oral AGNB strains isolated in abundance from the dysbiotic microbiota occurring in cases with oral mucosal lesions, severe periodontitis, or peri-implantitis.
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spelling doaj-art-6383514e02cb4d13a9299c913740651c2025-02-11T10:50:44ZengFrontiers Media S.A.Frontiers in Dental Medicine2673-49152024-03-01510.3389/fdmed.2024.12932021293202Antibiotic resistance among Aerobic Gram-Negative Bacilli isolated from patients with oral inflammatory dysbiotic conditions—a retrospective studyA. BasicS. BlomqvistG. CharalampakisG. DahlénIntroductionAerobic gram-negative bacilli (AGNB) are not part of the resident oral microflora but are occasionally found in high abundance under inflammatory dysbiotic conditions at various oral niches. The aim of the present study was to investigate the identity and antibiotic susceptibility of AGNB isolated from patients in Sweden with mucosal lesions, periodontitis, and peri-implantitis, with special attention to antibiotic resistance and on the presence of phenotypic Extended Spectrum Beta-Lactamase (ESBL) isolates.Materials and methodsMicrobiolgical samples were harvested from 211 patients in total, experiencing mucosal lesions (N = 113), periodontitis (N = 62), or peri-implantitis (N = 36). The growth of AGNBs was semiquantified by selective and non-selective culture and the strains were isolated, identified, and tested for antibiotic susceptibility. A total of 251 AGNB strains, occurring in moderate to heavy growth (>100 CFU/ml sample), indicating a dysbiotic microbiota, were identified. The disc diffusion method was used for screening of the antibiotic susceptibility of the isolates. Phenotypic identification of ESBL isolates was based on resistance to ceftazidime and/or cefotaxime.ResultsThe most commonly detected AGNB isolates in oral inflammatory dysbiotic conditions were fermentative species belonging to Enterobacteriaceae e.g. Citrobacter spp., Enterobacter spp., Escherichia coli, Klebsiella spp, and the non-fermentative environmental Burkholderia cepacia, Pseudomonas spp., and Stenotrophomonas maltophilia. No clear trends were seen in frequency of the various species in samples from mucosal lesions, severe periodontitis, and peri-implantitis cases. The 138 Enterobacteriaceae isolates and 113 environmental AGNB isolated showed a high antibiotic resistance in general against antibiotics commonly used in dentistry (Amoxicillin, Amoxicillin + Clavulanic acid, Ampicillin, Clindamycin, Doxycycline, Erythromycin, Oxacillin, PenicillinV, and Tetracycline). The majority of these isolates were susceptible to ciprofloxacin. Ten isolates (4.1%) were phenotypically classified as ESBL positive. The ESBL isolates were predominantly found among isolates of S. maltophilia, while only one ESBL positive isolate was found among Enterobacteriaceae.ConclusionsPhenotypically identified ESBL isolates can occasionally be present among oral AGNB strains isolated in abundance from the dysbiotic microbiota occurring in cases with oral mucosal lesions, severe periodontitis, or peri-implantitis.https://www.frontiersin.org/articles/10.3389/fdmed.2024.1293202/fulloral mucosaperiodontitisperi-implantitisGram-negative aerobic bacteriaantibiotic resistanceExtended Spectrum Beta-Lactamase (ESBL)
spellingShingle A. Basic
S. Blomqvist
G. Charalampakis
G. Dahlén
Antibiotic resistance among Aerobic Gram-Negative Bacilli isolated from patients with oral inflammatory dysbiotic conditions—a retrospective study
Frontiers in Dental Medicine
oral mucosa
periodontitis
peri-implantitis
Gram-negative aerobic bacteria
antibiotic resistance
Extended Spectrum Beta-Lactamase (ESBL)
title Antibiotic resistance among Aerobic Gram-Negative Bacilli isolated from patients with oral inflammatory dysbiotic conditions—a retrospective study
title_full Antibiotic resistance among Aerobic Gram-Negative Bacilli isolated from patients with oral inflammatory dysbiotic conditions—a retrospective study
title_fullStr Antibiotic resistance among Aerobic Gram-Negative Bacilli isolated from patients with oral inflammatory dysbiotic conditions—a retrospective study
title_full_unstemmed Antibiotic resistance among Aerobic Gram-Negative Bacilli isolated from patients with oral inflammatory dysbiotic conditions—a retrospective study
title_short Antibiotic resistance among Aerobic Gram-Negative Bacilli isolated from patients with oral inflammatory dysbiotic conditions—a retrospective study
title_sort antibiotic resistance among aerobic gram negative bacilli isolated from patients with oral inflammatory dysbiotic conditions a retrospective study
topic oral mucosa
periodontitis
peri-implantitis
Gram-negative aerobic bacteria
antibiotic resistance
Extended Spectrum Beta-Lactamase (ESBL)
url https://www.frontiersin.org/articles/10.3389/fdmed.2024.1293202/full
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AT gcharalampakis antibioticresistanceamongaerobicgramnegativebacilliisolatedfrompatientswithoralinflammatorydysbioticconditionsaretrospectivestudy
AT gdahlen antibioticresistanceamongaerobicgramnegativebacilliisolatedfrompatientswithoralinflammatorydysbioticconditionsaretrospectivestudy