These data indicated that, in this population, the presence of P. gingivalis in plaque after treatment might be indicative of progressive alveolar bone loss.

High frequencies of antimicrobial drug resistance were observed in O157 and non-O157 Shiga toxin-producing E. coli strains recovered from patients in Michigan during 2010-2014. Resistance was more common in non-O157 strains and independently associated with hospitalization, indicating that resistance could contribute to more severe disease outcomes. Shiga toxin-producing Escherichia coli (STEC) contributes to 265,000 cases of foodborne illness annually in the United States (1). Most infections are caused by O157 strains; however, non-O157 STEC infections have increased (2). Antimicrobial drug resistance among STEC has been reported (3-5) but is probably underestimated. Given the importance of resistance in E. coli pathotypes, we sought to determine the prevalence of resistant STEC infections and assess the effects of resistance on disease.We obtained 358 STEC isolates from the Michigan Department of Health and Human Services (MDHHS) Reference Laboratory (Lansing, MI, USA), collected during 2010-2014. Of these, 14 were outbreak associated. We examined 1 strain per outbreak using protocols approved by Michigan State University (MSU; Lansing, MI, USA; IRB #10-736SM) and MDHHS (842-PHALAB). Overall, 31 (8.8%) strains (23 non-O157, 8 O157) were resistant to antimicrobial drugs (Table). Resistance to ampicillin (7.4%) was most common, followed by trimethoprim/sulfamethoxazole (SXT) (4.0%) and ciprofloxacin (0.3%). Compared with national rates, resistance to ampicillin and SXT was higher, but not significantly different, for O157 isolates from Michigan (online Technical Appendix Figure 1, https://wwwnc. cdc.gov/EID/article/23/9/17-0523-Techapp1.pdf) (6). One strain was resistant to all drugs, and all resistant strains had high MICs (ampicillin, >64 μg/mL; ciprofloxacin, >32 μg/ mL; SXT, in 1:19 ratio, >32/608 μg/mL). Notably, resistance was twice as common for non-O157 (11.1%) than for O157 (5.5%) strains. O111 strains (n = 7) had significantly higher resistance frequencies (24.1%) than other non-O157 serogroups (p = 0.03). We found variation by year and season; resistance frequencies were highest in 2012 (online Technical Appendix, Figure 2) and during winter/spring (online Technical Appendix Table 1), but neither trend was significant. We also observed a strong but nonsignificant association between resistance and hospitalization but no association for urban versus rural residence (7) or county after stratifying by prescription rates (8) in the univariate analyses.We conducted a multivariate analysis using logistic regression, with hospitalization as the dependent variable; we included variables with significant (p<0.05) and strong (p<0.20) associations from the univariate analysis as independent variables. Forward selection indicated that hospitalized patients were more likely to have resistant infections (odds ratio [OR] 2.4, 95% CI 1.00-5.82) and less likely to have non-O157 infections (OR 0.4, 95% CI 0.21-0.61) (online Technical Appendix Table 2), suggesting that resistant infections or O157 infections may cause ...

Studies were performed to evaluate the detection of disease-associated bacterial colonization in adult periodontitis patients by the antibody-based Evalusite TestTM (Eastman Kodak Company). The association of test results with disease was assessed by collecting 104 duplicate subgingival plaque samples from 26 patients. Samples were tested for Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia using both microbiological culture and the immunoassay test. The sensitivity and specificity of the 2 methods was calculated using %s of positive results in deep periodontal pockets and negative results in shallow subgingival sites. A cutoff >10(4) cultivable counts yielded the greatest discrimination between health and disease on a cross-sectional basis and established this threshold as clinically relevant for the detection of disease-associated levels of bacterial colonization by these three microorganisms. The clinical detection limit of the immunoassay test was observed to coincide with this threshold of >10(4) cultivable counts. Microbiological testing of the 4 deepest pockets using the immunoassay test was determined to be sufficient to yield a 90% confidence of detecting positive patients in a study with 59 adult subjects. The immunoassay test method was also demonstrated to be effective at detecting bacterial colonization in sets of paper point samples that were pooled for analysis. An overall agreement of 94% (288 of 306) was observed when comparing test results for duplicate sets of pooled and individual samples collected from 51 patients. These studies demonstrate that the Evalusite Test is an effective method for detecting clinically relevant colonization by the test bacteria in patients at risk for periodontal disease.

High frequencies of antimicrobial drug resistance were observed in O157 and non-O157 Shiga toxin–producing E. coli strains recovered from patients in Michigan during 2010–2014. Resistance was more common in non-O157 strains and independently associated with hospitalization, indicating that resistance could contribute to more severe disease outcomes.

The purpose of the present study was to compare an enzyme immunoassay with culture samples from untreated and non‐surgically treated periodontal pockets and to assess the clinical and microbiological effects of citric acid irrigation as a supplement to scaling and root planing. The enzyme immunoassay used in this study is a chairside diagnostic tool aimed at identifying the presence of P. gingivalis, P. intermedia, and A. actinomycetemcomitans. Six sites with pocket depths ≥6 mm in each of 16 patients were monitored for 24 weeks using clinical and microbiological parameters. In two out of the six sites, scaling and root planing was supplemented with subgingival citric acid irrigation of the pocket after completion of the mechanical treatment. The sensitivity of the immunoassay in relation to culture was calculated to 85.5% and the specificity to 90.2%. The immunoassay corresponded to a detection level of 104 as estimated by culture. Sites treated with a combination of scaling and irrigation with citric acid demonstrated a similar healing pattern as sites treated with scaling and root planing alone. The profile of the marker bacteria was almost parallel for the two groups. The results of this investigation thus indicated that the immunoassay can be used as a screening tool for selected periodontal pathogens and that adjunctive irrigation with citric acid has no measurable clinical or microbiological effects. J Periodontol 1997;68:346–352.