Prevalência de Staphylococcus spp na cavidade bucal e seu impacto clínico

Os Staphylococcus aureus são importantes patógenos, responsáveis por diversas infeções sistêmicas, como bacteriemia e endocardite. A origem dessas infecções pode ser do biofilme bucal, onde os microorganismos se tornam menos sensíveis aos antibióticos. Os S. aureus são resistentes a vários antibióticos e resultam em tratamentos complicados. O objetivo deste estudo foi verificar, a prevalência de Staphylococcus spp na cavidade bucal, seu impacto clínico na etiologia das infecções orais e sistêmicas e seu comportamento frente aos antibióticos mais prescritos pelos dentistas. A literatura mostrou que os Staphylococcus spp foram bastante prevalentes na cavidade bucal. A amoxicilina foi o antibiótico mais prescrito, no entanto, na presença de Staphylococcus aureus apresenta uma eficácia reduzida. A associação com o ácido clavulânico pode ter efeito contra algumas estirpes, mas não para as estirpes resistentes à meticilina. E se estas forem para a corrente sanguínea, poderia evoluir para uma endocardite de difícil tratamento.S. aureus is an important pathogen, responsible for several systemic infections, such as bacteremia and endocarditis. The origin of these infections can be from oral biofilm, where microorganisms become less sensitive to the antibiotics. S. aureus is quite resistant to several antibiotics. The objective of this study was to verify the prevalence of Staphylococcus spp in the oral cavity, its clinical impact in the aetiology of oral and systemic infections, as well as to investigate the behaviour of these microorganisms in relation to the antibiotics most prescribed by dentists. Literature suggest that Staphylococci spp are very prevalent in the oral cavity. Amoxicillin was the most prescribed antibiotic, however, in the presence of Staphylococcus aureus it has a reduced efficacy. The association with clavulanic acid may have some effect against some strains, but not for the strains resistant to methicillin., and when into the bloodstream, it could progress to difficult-to-treat endocarditis

Prevalência de Staphylococcus spp na cavidade bucal e seu impacto clínico

Os Staphylococcus aureus são importantes patógenos, responsáveis por diversas infeções sistêmicas, como bacteriemia e endocardite. A origem dessas infecções pode ser do biofilme bucal, onde os microorganismos se tornam menos sensíveis aos antibióticos. Os S. aureus são resistentes a vários antibióticos e resultam em tratamentos complicados. O objetivo deste estudo foi verificar, a prevalência de Staphylococcus spp na cavidade bucal, seu impacto clínico na etiologia das infecções orais e sistêmicas e seu comportamento frente aos antibióticos mais prescritos pelos dentistas. A literatura mostrou que os Staphylococcus spp foram bastante prevalentes na cavidade bucal. A amoxicilina foi o antibiótico mais prescrito, no entanto, na presença de Staphylococcus aureus apresenta uma eficácia reduzida. A associação com o ácido clavulânico pode ter efeito contra algumas estirpes, mas não para as estirpes resistentes à meticilina. E se estas forem para a corrente sanguínea, poderia evoluir para uma endocardite de difícil tratamento.S. aureus is an important pathogen, responsible for several systemic infections, such as bacteremia and endocarditis. The origin of these infections can be from oral biofilm, where microorganisms become less sensitive to the antibiotics. S. aureus is quite resistant to several antibiotics. The objective of this study was to verify the prevalence of Staphylococcus spp in the oral cavity, its clinical impact in the aetiology of oral and systemic infections, as well as to investigate the behaviour of these microorganisms in relation to the antibiotics most prescribed by dentists. Literature suggest that Staphylococci spp are very prevalent in the oral cavity. Amoxicillin was the most prescribed antibiotic, however, in the presence of Staphylococcus aureus it has a reduced efficacy. The association with clavulanic acid may have some effect against some strains, but not for the strains resistant to methicillin., and when into the bloodstream, it could progress to difficult-to-treat endocarditis

Staphylococcus spp. Na cavidade bucal e na bolsa periodontal de indivíduos com periodontite crônica: presença e sensibilidade aos antibióticos

Staphylococcus are not usually studied in the oral cavity, when this happens, they are considered to belong to transitory microflora. Individuals that present periodontal disease represent possibles reservoirs of these opportunist bacteria in the oral cavity. The use of antibiotics whether for treatment of periodontal disease or due to hospital infections, may predispose the increase of the Staphylococcus spp. in the oral cavity because they easily become resistant to antibiotics, resulting in superinfection. The study was made with 88 patients, minimum age- 25 years old, presenting chronical periodontitis, with, at least, two sites having a probing pocket bigger or equal to 5mm. After anamnese and clinical periodontal examination samples were taken from the periodontal pocket using paper cones and from the oral cavity using mouth rinse. Of the total patients 37,50% presented Staphylococcus spp. in the periodontal pocket and 61,36% in lhe oral cavity; 27,27% presented bacteria in the two sites, not necessarily of the same specie. S. epidermidis was the most prevailing specie in periodontal pocket (15,9%) and oral cavity (27,27%). Positive for S. aureus in the periodontal pocket were 4,5% and for the oral cavity 25%, and 3,4% were positive for the two sites. There was not found significative statistical difference referring to the presence of the microorganisms as to age, smoking habit and increase of the probing depth. The majority of the isolated Staphylococcus samples showed resistance to the tested antibiotics, indicating that the drugs as an adjunct to periodontal therapy, must be seen with cautionStaphylococcus não são usualmente estudados na cavidade bucal. Quando presentes são considerados pertencentes à microbiota transitória. Indivíduos que apresentam doença periodontal representam possíveis reservatórios dessas bactérias oportunistas na cavidade bucal. O uso de antibióticos, quer seja para tratamento da doença periodontal, ou em consequência de infecções hospitalares, pode predispor o aumento do número de Staphylococcusspp. naboca, pois estes adquirem facilmente resistência aos antibióticos, podendo resultar em super-infecção. Participaram deste estudo 88 pacientes, com no mínimo 25 anos de idade e apresentando periodontite crônica, com pelo menos dois sítios com profundidade de sondagem maior ou igual a 5mm. Após anamnese e exame clínico periodontal foram feitas coletas de material da bolsa periodontal com cones de papel e da cavidade bucal por meio de bochechos. Do total de pacientes 37,50% apresentaram Staphylocaccusspp. na bolsa periodontal e 61,36% na cavidade bucal, sendo que 27,27% apresentaram a bactéria nos 2 sítios, não sendo necessariamente a mesma espécie. S. epidermidisfoi a espécie mais prevalente para bolsa periodontal (15,9%) e cavidade bucal (27,27%). Foram positivos para S. aureus na bolsa periodontal, 4,5% e para cavidade bucal 25%, sendo 3,4% positivos para os dois sítios. Não houve diferença estatística significante quanto à presença desses microrganismos entre as faixas etárias, hábito de fumar e aumento da profundidade de sondagem. A maioria das cepas de Staphylococcus isoladas mostrou resistência aos antibióticos testados, indicando que a utilização sistêmica destas drogas, como adjunto à terapia periodontal. deve ser vista com cautel

Periodontal disease in a rural community in Minas Gerais, Brazil

The aim of this study was to evaluate the prevalence and severity of periodontal disease and treatment needs in a Brazilian rural community, using the Community Periodontal Index of Treatment Needs (CPITN). This study included 183 individuals who were clinically evaluated. The results showed that 45% of the individuals between ages 0-5 years had bleeding upon probing, and 34% of individuals ages 6-12 presented dental calculus. Among the individuals ages 13-18, 15% of pathological pockets were found with probing depth (PD) of 4-5 mm. However, among individuals ages 19-34, 50% showed a PD of 4-5 mm and 12.5% PD ≥ 6 mm. In the group of individuals ages 35-44, 17% showed PD ≥ 6 mm. Ninety percent of the individuals up to 13 years old needed only oral hygiene instructions. Dental scaling was indicated to 70% and 95% of the individuals aged 13-18 and 19-34 respectively. A more complex periodontal therapy was indicated to 17% of individuals aged 35-44. These results showed the necessity of the implementation of dental preventive programs to this community, especially to individuals under 12 years, and curative programs for individuals ages older than 13 years old

In vitro antifungal susceptibility of Candida spp. isolates from patients with chronic periodontitis and from control patients

Superinfection by Candida can be refractory to conventional periodontal treatments in specific situations, such as in immunocompromised patients. In these cases, the systemic therapy with antifungal drugs could be indicated. The aim of this study was to analyse antifungal susceptibility of Candida spp. strains isolated from chronic periodontitis patients and from control individuals. A total of 39 C. albicans isolates, 9 C. tropicalis, 2 C. glabrata and 5 Candida spp. from control individuals and 30 C. albicans, 3 C. tropicalis and 2 C. glabrata from periodontitis patients were tested. In the control group, 1 isolate of C. glabrata was resistant to ketoconazole and 1 Candida spp. was resistant to amphotericin B, ketoconazole and miconazole. Among the isolates of periodontitis group, 1 (3.33%) C. albicans isolate was resistant to flucytosine and ketoconazole. According to the obtained results, it could be concluded that fluconazole was the most effective drug against the several Candida species studied. There were not expressive differences in the susceptibility of isolates from periodontitis patients or from control individuals