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Periodontal disease as reservoir for multi-resistant
and hydrolytic enterobacterial species

Authors: Gonçalves, M.O.; Coutinho-Filho, W.P.; Pimenta, F.P.; Pereira, G.A.; Pereira, J.A.A.; Mattos-Guaraldi, A.L.; Hirata, R.
Source: Letters in Applied Microbiology, Volume 44, Number 5, May 2007 , pp. 488-494(7) This investigation aimed to isolate enteric rods from subgingival sites of patients presenting chronic periodontitis lesions, and to assess antimicrobial resistance and expression of hydrolytic enzymes.

Methods and Results:  Enterobacteriaceae were isolated from 20% patients, and assayed for antimicrobial susceptibility and hydrolytic enzymes with specificity to different substrates. Isolates comprised seven Enterobacter cloacae (43·75%), five Serratia marcescens (31·25%), one Klebsiella pneumoniae (6·25%), one Enterobacter aerogenes (6·25%), one Pantoea agglomerans (6·25%), and one Citrobacter freundii (6·25%). Gelatinase activity was observed for 75% strains; caseinase and elastase was produced by six and two strains, respectively. DNase, lecithinase and lipase were expressed by S. marcescens. Most of strains were resistant to ampicillin (93·75%) and amoxicillin/clavulanic acid (81·25%). The majority of strains were susceptible to cephalosporins and aztreonam. Enterobacteria remained susceptible to imipenem, streptomycin and fluoroquinolones. Resistance to gentamicin, amikacin, sulfamethoxazole/thrimethoprim, tetracycline, and chloramphenicol were also observed. Eight strains presented multiple drug resistance. Conclusions: 

Subgingival sites from periodontal diseases contain multi-resistant and hydrolytic enzyme-producing enterobacteria that may contribute to overall tissue destruction and spreading. Significance and Impact of the Study: 

Enterobacteria isolated from patients generally considered as healthy individuals poses periodontal diseases as reservoir for systemic infections particularly in immunocompromised and hospitalized hosts.

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