Prevalence and antibiotic susceptibility trends of periodontal pathogens in the subgingival microbiota of German periodontitis patients: A retrospective surveillance study

Abstract

Objective This retrospective surveillance study aimed to follow periodontitis‐associated bacterial profiles and to identify time‐dependent changes in antibiotic susceptibility patterns. Materials and Methods From 2008 to 2015, bacterial specimen from deep periodontal pockets were collected from a total of 7804 German adults diagnosed with periodontitis. Presence of selected bacteria was confirmed by anaerobic culture and nucleic acid amplification. Antimicrobial susceptibility of clinical isolates was tested by disc diffusion with antibiotics used for the treatment of periodontitis and oral infections. The prevalences of periodontal pathogens were calculated and temporal evolution of antimicrobial susceptibility towards amoxicillin, amoxicillin/clavulanic acid, metronidazole, doxycycline, clindamycin, azithromycin, ciprofloxacin and ampicillin was analysed with logistic regression. Results The prevalence of patients harbouring bacteria was 95.9% Fusobacterium nucleatum, 88.0% Tannerella forsythia, 76.4% Treponema denticola, 76.5%, Campylobacter rectus, 76.0% Eikenella corrodens, 75.0% Capnocytophaga spp., 68.2% Porphyromonas gingivalis, 57.7% Peptostreptococcus micros, 43.1% Prevotella intermedia, 30.4% Eubacterium nodatum and 21.5% Aggregatibacter actinomycetemcomitans. In 63.5% of patients, one or more isolates were not susceptible to at least one of the antibiotics tested. The data further revealed a trend towards decreasing susceptibility profiles (p < 0.05) with antibiotic non‐susceptibilities in 37% of patients in 2008 and in 70% in 2015. Conclusions The present study confirmed a high prevalence of periodontal pathogens in the subgingival microbiota of German periodontitis patients. The data revealed an incremental increase in isolates displaying resistance to some antibiotics but no relevant change in susceptibility to amoxicillin and metronidazole.

The Antimicrobial Susceptibility of Porphyromonas gingivalis: Genetic Repertoire, Global Phenotype, and Review of the Literature

“…Striking for many studies is the delay between the isolation of strains and publication of susceptibility data, which can be more than 5 years. Assuming that the antibiotic resistance would increase by the same rate as measured by Jepsen et al [ 60 ], presently (2021) the number of non-susceptible strains for doxycycline, azithromycin, and ciprofloxacin could have reached 0.1%, 2.5%, and 19%, respectively. However, this is highly speculative, as the counteracting antibiotic stewardship might break this tendency.…”

“…However, the results of these six studies will be discussed below for further comparison. Jepsen et al tested antibiotic susceptibility of 5323 P. gingivalis isolates from 2008–2015 by agar diffusion only [ 60 ]. The average non-susceptibility in 2008–2011 versus 2012–2015 for doxycycline, azithromycin, and ciprofloxacin was: 0% versus 0.04%, 0.64% versus 1.56%, and 4.55% versus 11.51%, respectively.…”

Classic vs. Novel Antibacterial Approaches for Eradicating Dental Biofilm as Adjunct to Periodontal Debridement: An Evidence-Based Overview

“…Although development of bacterial resistance of key periodontal pathogens is continually being reported, susceptibility to AMX and MET was not significantly changed [ 82 ]. In contrast, bacterial resistance of A. actinomycetemcomitans and different strains of Enterococcus .…”

Mucosal Vaccination Against Periodontal Disease: Current Status and Opportunities

“…Antimicrobial resistance has evolved as one of the most urgent threats to public health, causing treatment failures, prolonged hospital admissions, and increases in healthcare costs (52). Moreover, several studies indicate high and increasing levels of antimicrobial resistance in subgingival PD-associated bacteria, further exposing the unsustainability of antibiotics-based PD management (53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63). Another drawback of antimicrobials is their non-specific effect on both pathogenic (e.g., keystone and accessory pathogens) and protective oral bacteria (homeostatic commensals) (46).…”