Resistencia a la amoxicilina de cepas de Streptococcus mutans aisladas de individuos con antibioticoterapia previa y sin esta / Amoxicillin Resistance of Streptococcus mutans Isolated from Individuals with and without Antibiotic Therapy
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Antecedentes: El desarrollo de resistencia a los antimicrobianos es un fenómeno natural que los microrganismos desarrollan ante la presión selectiva, entre los cuales se encuentra la exposición a antibióticos. Este acontecimiento lleva a la ineficacia de los tratamientos con antibióticos convencionales. Objetivo: Determinar la frecuencia en la boca de cepas de Streptococcus mutans (S. mutans) resistentes a la amoxicilina en individuos con tratamiento previo y sin esta con antibióticos β-lactámicos. Métodos: se realizó un estudio observacional analítico para el que se aislaron cepas de S. mutans de cavidad oral en 200 individuos sin antecedentes sistémicos y sin historia de terapia antibiótica reciente, 100 personas con tratamiento antibiótico profiláctico por alto riesgo de endocarditis infecciosa y 110 pacientes bajo tratamiento con antibióticos β-lactámicos durante más de tres semanas. Se observó la sensibilidad a amoxicilina con la técnica de Kirby-Bauer. Resultados: Se encontró que del total de individuos, 4,4 % eran portadores de cepas resistentes a amoxicilina: 2,2 % del grupo I y 2,2 % del grupo II. El análisis en los individuos en los que se aisló S. mutans (82 % del grupo I y 60 % del grupo II) mostró que los porcentajes de individuos portadores subieron a 5,5 % en el grupo I y 7,1 % en el grupo II. Conclusiones: El tratamiento con antibióticos β-lactámicos continúa siendo efectivo para la mayoría de las infecciones orales y para profilaxis de endocarditis infecciosa, aunque su uso modifica los ecosistemas orales y disminuye la recuperación de S. mutans en la cavidad oral.
Background: Antimicrobial resistance is a natural phenomenon that microorganisms develop under selective pressures like exposure to antibiotics. This yields conventional antibiotic treatments ineffective. Purpose: To determine the frequency of amoxicillin-resistant Streptococcus mutans (S. mutans) in the mouth of individuals with and without previous treatment with β-lactam antibiotics. Methods: A descriptive cross-sectional study was performed, isolating S. mutans strains from the mouth of 200 healthy individuals with no history of recent antibiotic therapy, 100 persons who underwent antibiotic prophylactic treatment due to high risk of infectious endocarditis and 110 patients treated with β-lactam antibiotics for more than three weeks. Amoxicillin sensitivity was analyzed through Kirby-Bauer testing. Results: We found that of all individuals, 4.4% were carriers of amoxicillin-resistant strains: 2.2% in group I and group II, respectively. The analyses of individuals in which S. mutans was isolated (82% in group I and 60% in group II) showed that the percentage of carriers rose to 5.5% in group I and 7.1 % in group II. Conclusions: Treatment with β-lactam antibiotics remains effective for most oral infections and prophylaxis of infectious endocarditis; however, oral use changes ecosystems and reduces the recovery of S. mutans in the mouth.
2. World Health Organization. Antimicrobial resistance: global report on surveillance [internet]; 2014. Disponible en: http://www.who.int/mediacentre/factsheets/fs194/es/
3. McCaig LF, Besser RE, Hughes JM. Antimicrobial drug prescription in ambulatory care settings, United States, 1992-2000. Emerg Infect Dis. 2003 Apr; 9(4): 432-7.
4. Sussmann O, Mattos L, Restrepo A. Resistencia bacteriana. Univ Med. 2002 Ene; 43(1): 20-6.
5. Cvitkovitch DG. Genetic competence and transformation in oral streptococci. Crit Rev Oral Biol Med. 2001 May; 12(3): 217-43.
6. Nan J, Brostromer E, Liu XY, Kristensen O, Su XD. Bioinformatics and structural characterization of a hypothetical protein from Streptococcus mutans: implication of antibiotic resistance. PLoS One. 2009 Oct; 4(10): e7245. doi:10.1371/journal.pone.0007245.
7. Usui H, Takao A, Nakayama A, Nagashima H, Sasaki F, Maeda N, Ishibashi K. Detection of penicillin-binding protein 2b gene alteration in Streptococcus mitis by polymerase chain reaction. J Infect Chemother. 2004 Feb; 10(1): 19-24.
8. Nakayama A, Takao A. Beta-lactam resistance in Streptococcus mitis isolated from saliva of healthy subjects. J Infect Chemother. 2003 Dec; 9(4): 321-7.
9. Heimdahl A, von Konow L, Nord CE. Isolation of beta-lactamase-producing Bacteroides strains associated with clinical failures with penicillin treatment of human orofacial infections. Arch Oral Biol. 1980 Oct; 25(10): 689-92.
10. Alcaide F, Liñares J, Pallares R, Carratala J, Benitez MA, Gudiol F, Martin R. In vitro activities of 22 beta-lactam antibiotics against penicillin-resistant and penicillin-susceptible viridans group streptococci isolated from blood. Antimicrob Agents Chemother. 1995 Oct; 39(10): 2243-7.
11. Fleming P, Feigal RJ, Kaplan EL, Liljemark WF, Little JW. The development of penicillin-resistant oral streptococci after repeated penicillin prophylaxis. Oral Surg Oral Med Oral Pathol. 1990 Oct; 70(4): 440-4.
12. Groppo FC, Castro FM, Pacheco AB, Motta RH, Filho TR, Ramacciato JC, Florio FM, Meechan JG. Antimicrobial resistance of Staphylococcus aureus and oral streptococci strains from high-risk endocarditis patients. Gen Dent. 2005 Nov-Dec; 53(6): 410-3.
13. Suehara AB, Gonçalves AJ, Alcadipani FA, Kavabata NK, Menezes MB. Deep neck infection: analysis of 80 cases. Braz J Otorhinolaryngol. 2008 Mar-Apr; 74(2): 253-9.
14. Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, Bolger A, Cabell CH, Takahashi M, Baltimore RS, Newburger JW, Strom BL, Tani LY, Gerber M, Bonow RO, Pallasch T, Shulman ST, Rowley AH, Burns JC, Ferrieri P, Gardner T, Goff D, Durack DT, American Heart Association Rheumatic Fever, Endocarditis and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, Quality of Care and Outcomes Research Interdisciplinary Working Group, American Dental Association. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. J Am Dent Assoc. 2007 Jun; 138(6): 739-45, 747-60.
15. Mokaddas EM, Salako NO, Philip L, Rotimi VO. Discrepancy in antimicrobial susceptibility test results obtained for oral streptococci with the E-test and agar dilution. J Clin Microbiol. 2007 Jul; 45(7): 2162-5.
16. Fani MM, Kohanteb J, Dayaghi M. Inhibitory activity of garlic (Allium sativum) extract on multidrug-resistant Streptococcus mutans. J Indian Soc Pedod Prev Dent. 2007 Oct-Dec; 25(4): 164-8.
17. Warnke PH, Becker ST, Springer IN, Haerle F, Ullmann U, Russo PA, Wiltfang J, Fickenscher H, Schubert S. Penicillin compared with other advanced broad spectrum antibiotics regarding antibacterial activity against oral pathogens isolated from odontogenic abscesses. J Craniomaxillofac Surg. 2008 Dec; 36(8): 462-7. doi:10.1016/j.jcms.2008.07.001.
18. Loyola-Rodriguez JP, Garcia-Cortes JO, Martinez-Martinez RE, Patiño-Marin N, Martinez-Castañon GA, Zavala-Alonso NV, Amano A. Molecular identification and antibiotic resistant bacteria isolated from primary dentition infections. Aust Dent J. 2014 Dec; 59(4): 497-503. doi:10.1111/adj.12213.
19. Kuriyama T, Williams DW, Yanagisawa M, Iwahara K, Shimizu C, Nakagawa K, Yamamoto E, Karasawa T. Antimicrobial susceptibility of 800 anaerobic isolates from patients with dentoalveolar infection to 13 oral antibiotics. Oral Microbiol Immunol. 2007 Aug; 22(4): 285-8.
20. Karbach J, Callaway AS, Willershausen B, Wagner W, Al-Nawas B. Multiple resistance to betalactam antibiotics, azithromycin or moxifloxacin in implant associated bacteria. Clin Lab. 2013; 59(3-4): 381-7.
21. Feres M, Haffajee AD, Allard K, Som S, Goodson JM, Socransky SS. Antibiotic resistance of subgingival species during and after antibiotic therapy. J Clin Periodontol. 2002 Aug; 29(8): 724-35.
22. Woolhouse M, Ward M, van Bunnik B, Farrar J. Antimicrobial resistance in humans, livestock and the wider environment. Philos Trans R Soc Lond B Biol Sci. 2015 Jun 5; 370(1670): 20140083. http://dx.doi.org/10.1098/rstb.2014.0083.
23. Lee CR, Lee JH, Kang LW, Jeong BC, Lee SH. Educational effectiveness, target, and content for prudent antibiotic use. Biomed Res Int. 2015; 2015: 214021. doi:10.1155/2015/214021.