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STUDY REGARDING ANTIBIOTIC RESISTANCE OF PREVOTELLA SPECIES IN PERI-IMPLANTITIS
Abstract
In the present, implant reconstruction is preferred by the majority patients over prosthetic dentures. One of the most important problems than can appear after oral implant insertion is peri-implantitis. The ethiopathogenesis of this disease is complex; one of the major causes is the presence of pathogens bacteria, among which species of Prevotella genus is highly significant. The extent of antibiotic resistance phenomena in peri-implantitis imposes that the choice of antibiotics should be made after the susceptibility test of associated bacteria species. The aim of this study is to determine in vitro antibiotic resistance of Prevotella species isolated from peri-implantitis lesion. Materials and methods: A total of 12 patients (7 males, 5 females) aged 50-55 years, with dental implants, were included in the present study as follows: 5 with 1 implant/subject, 4 with 3 implant/subject, 3 with 5 implant/subject. The microbiological samples were collected by using sterile paper point, which was introduced into each peri-implant site. Bacterial identification was made by biochemical tests- Rapid ID 32 A-bioMerieux, France. Antibacterial susceptibility test was made by E-test (bioMerieux, France) that is a predefined stable gradient of 15 antibiotic concentrations on a plastic strip. We measured the minimum inhibitory concentration for the following antibiotics (breakpoint in $\mu$g/mL): Clindamycin, Metronidazole, Amoxicillin/Clavulanic Acid and Piperacillin/Tazobactam according European Committee on Antimicrobial Susceptibility Testing recomandation (Interpretive Criteria, Etest Quality Control Strains and Ranges, 1962B-2014/01). Results: We identified 10 strains of Prevotella intermedia, 4 strains of Prevotella melaninogenica, 3 strains of Prevotella bivia, from a total of 32 microbiological samples. The strains of Prevotella species were resistent to Metronidazole (R≥4 $\mu$g/mL) in proportion of 52.9\%, Clindamycin (R≥4 $\mu$g/mL) 22\%, Piperacillin/Tazobactam (R≥ 16 $\mu$g/mL) 11\% and Amoxicillin/Clavulanic Acid (R≥8 $\mu$g/ mL) 0\%. Conclusions: Beta-lactam agents with beta-lactamase inhibitors, such as Amoxicillin/Clavulanic Acid and Piperacillin/Tazobactam were the most active antibiotics against Prevotella species isolated in peri-implantitis. The most effective antibiotic was Amoxicillin/Clavulanic Acid, because we have not identified strains resistant to this antibiotic. The high variation of antibiotic resistant level among species of Prevotella genus in peri-implantitis requires us to do antibiotic susceptibility test for the correct antibiotic choice at patients with peri-implantitis.
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