Prevotella Oralis Research Articles

Age-dependent changes in Porphyromonas gingivalis and Prevotella species/phylotypes in healthy gingiva and inflamed/diseased sub-gingival sites.

Early colonisation of oral surfaces by periodontal pathogens presents a significant risk factor for subsequent development of destructive disease affecting tissues that support the dentition. The aims of the present study were to establish the age-dependent relationship between sub-gingival profiles of 22 Prevotella species/phylotypes in children, adolescents and adults from an isolated Aboriginal community and, further, to use this information to identify Prevotella species that could serve as microbial risk indicators. DNA isolated from sub-gingival plaque samples (three healthy sites and three inflamed/diseased sites) from adults, adolescents and children was screened for Porphyromonas gingivalis load and 22 Prevotella species/phylotypes by species-specific PCR. A noticeable feature in adolescents was the marked increase in colonisation by P. gingivalis across all test sites. The mean number of Prevotella species/phylotypes colonising inflamed/diseased sub-gingival sites increased with age. Progressive partitioning of selected Prevotella species/phylotypes to healthy or inflamed/diseased sites was evident. Prevalence of Prevotella intermedia, Prevotella oral clone P4PB_24 and Prevotella oris increased significantly with age in diseased sites. Similarly, significant age-dependent increase in colonisation of healthy as well as inflamed/diseased sub-gingival sites was apparent for Prevotella oralis, Prevotella multiformis, Prevotella denticola, Prevotella strain P4P_53 and Prevotella oral clone BR014. Early colonisation of children by P. gingivalis, P. intermedia and Prevotella oral clone P4PB_24 provides indication of risk for subsequent development of periodontal disease. In the present study, the complexity of Prevotella species within gingival sites is explored as a basis for evaluating contribution of Prevotella species to disease.

Radiography-based score indicative for the pathogenicity of bacteria in odontogenic infections

Objective. To develop a new radiography-based score to assess the potential of bacteria to cause odontogenic infections derived from the occurrence of bacteria at small or large radiographical lesions. Materials and methods. The patients analyzed were a sub-population from a large randomized clinical trial comparing moxifloxacin and clindamycin in the treatment of inflammatory infiltrates and odontogenic abscesses. Routine radiographs were used to analyze the area of the periapical radiolucent lesions. Lesions were stratified by their radiographically measured area as large (>9 mm2) or small (≤9 mm2). A risk ratio was calculated for each species from the frequency of their occurrence in large vs in small lesions. Results. Fifty-one patients, 19 with abscesses and 32 with infiltrates, were evaluated. Overall, the radiographical lesion areas ranged from 0.4–46.2 mm2 (median = 9 mm2). An increased risk (risk ratio >1) to occur at large abscess lesions was observed for Prevotella (P.) oralis, P. buccae, P. oris, P. intermedia, Fusobacterium nucleatum and Streptococcus (Strep.) anginosus group. An increased risk to occur at large infiltrate lesions was found for Strep. salivarius, Strep. parasanguis, Strep. anginosus group, Capnocytophaga spp., Neisseria (N.) sicca, Neisseria spp., Staphylococcus (Staph.) aureus, P. intermedia, P. buccae, Prevotella spp. and P. melaninogenica. Conclusions. The radiography-based score suggests that certain Prevotella spp., F. nucleatum and Strep. anginosus groups play a crucial role in the pathogenesis of odontogenic abscesses, and that various streptococci, Neisseria spp., Capnocytophaga spp., Staph. aureus and Prevotella spp. are involved in the pathogenesis of odontogenic infiltrates.

Beta-lactamic Resistance Profiles in Porphyromonas, Prevotella, and Parvimonas Species Isolated from Acute Endodontic Infections

IntroductionSusceptibility to beta-lactamic agents has changed among anaerobic isolates from acute endodontic infections. The aim of the present study was to determine the prevalence of the cfxA/cfxA2 gene in Prevotella spp., Porphyromonas spp., and Parviomonas micra strains and show its phenotypic expression. MethodsRoot canal samples from teeth with acute endodontic infections were collected and Porphyromonas, Prevotella, and Parvimonas micra strains were isolated and microbiologically identified with conventional culture techniques. The susceptibility of the isolates was determined by the minimum inhibitory concentration of benzylpenicillin, amoxicillin, and amoxicillin + clavulanate using the E-test method (AB BIODISK, Solna, Sweden). The presence of the cfxA/cfxA2 gene was determined through primer-specific polymerase chain reaction. The nitrocefin test was used to determine the expression of the lactamase enzyme. ResultsPrevotella disiens, Prevotella oralis, Porphyromonas gingivalis, and P. micra strains were susceptible to benzylpenicillin, amoxicillin, and amoxicillin + clavulanate. The cfxA/cfxA2 gene was detected in 2 of 29 isolates (6.9%). Simultaneous detection of the cfxA/cfxA2 gene and lactamase production was observed for 1 Prevotella buccalis strain. The gene was in 1 P. micra strain but was not expressed. Three strains were positive for lactamase production, but the cfxA/cfxA2 gene was not detected through polymerase chain reaction. ConclusionsThere is a low prevalence of the cfxA/cfxA2 gene and its expression in Porphyromonas spp., Prevotella spp., and P. micra strains isolated from acute endodontic infections. Genetic and phenotypic screening must be performed simultaneously to best describe additional mechanisms involved in lactamic resistance for strict anaerobes.

Coaggregation between Prevotella oris and Porphyromonas gingivalis

The coaggregation of bacteria has been defined as one of the most important processes in the oral infection such as periodontitis. Prevotella oris and Porphyromonas gingivalis, which are two of the periodontopathogens, are frequently detected in severe forms of periodontal diseases. However, the interaction between P. oris and P. gingivalis is still unknown. In this study, the coaggregation of P. oris with nine oral bacterial species including P. gingivalis was examined. All bacteria used in this study were cultured anaerobically and suspended in coaggregation buffer. Each cell suspension was mixed in a test tube and subjected to shaking at room temperature for 1 hour. Subsequently, the coaggregation values were scored. Furthermore, the effects of various chemical reagents, and heat, proteinase K, and serum treatment were examined. In this study, P. oris coaggregated only with P. gingivalis. A heat-stable, nonproteinous component of P. oris and a heat-labile, proteinous component of P. gingivalis play important roles in this coaggregation. In addition, this coaggregation was inhibited by l-arginine, l-lysine, and Nα-p-tosyl-l-lysine. Therefore, it was considered that a cell surface protein on P. gingivalis, such as gingipain, may be involved in the coaggregation. Furthermore, the coaggregation was not inhibited by serum treatment. This is the first report to describe the coaggregation of P. oris and P. gingivalis. Our study proposes the possibility that P. oris may promote the colonization of P. gingivalis in an early stage of biofilm formation. Furthermore, this coaggregation may contribute to the initiation and progression of periodontitis.

Removal of oral Prevotella intermedia Endotoxin by octyl phenyl polyoxyethylene ether extraction method

To investigate an effective purification method for removing endotoxin from Prevotella intermedia. The main protein ingredients of bacteria prepared from ammonium sulfate precipitation were further treated with octyl phenyl polyoxyethylene ether (Triton X-114), and then processed at 4°C, 37°C and 25°C. The obtained aqueous phase after at least two more cycle repeated operations was assayed for endotoxin by Western blotting, LAL-clotting method, in vitro cell stimulation and in vivo animal experiments. Western blotting and LAL-clotting method demonstrated that the reduction in endotoxin level was greater than 99.99% and recovery of the proteins after endotoxin removal was greater than 90% with Triton X-114 treatment for 3 cycles. The cytokines expression level was lower in both in vitro cell stimulation and in vivo animal experiments than in untreated group (P < 0.05). The extraction method provides a new choice for endotoxin removal from large volumes of the oral Prevotella intermedia.

Fatal Prevotella oralis meningitis

Prevotella oralis, an obligate Gram-negative anaerobe, was detected as the cause of acute meningitis in a four-year-old cocker spaniel. Clinical signs included acute onset collapse and severe depression. Despite treatment, the animal died. A post-mortem examination was performed which revealed a fibrinosuppurative meningitis with no significant inflammation of the brain or spinal parenchyma. The aetiological diagnosis was confirmed by anaerobic bacterial culture. This report discusses the nature and extent of the lesions and possible routes of infection of the causative organism.

Vertebral osteomyelitis and epidural abscesses caused by Prevotella oralis: a case report

An interesting case of pyogenic vertebral osteomyelitis with multiple epidural abscesses caused by non-pigmented Prevotella oralis is reported. The patient was a 68-year-old female who presented to the emergency room (ER) with severe pain and tenderness in her lower back with fever. She had recently undergone esophagogastroduodensoscopy (EGD) for complaints of esophageal reflux, which showed submucosal cyst in the esophagus. Magnetic resonance imaging (MRI) of the thoracic spine revealed multiple spinal epidural abscesses with signal enhancement at the level of T6 and T7, suggestive of vertebral osteomyelitis. Two blood cultures drawn one hour apart grew Prevotella oralis. The body fluid aspirated from the abscesses was also positive for the anaerobic commensal P. oralis. Necrosis associated with the submucosal cyst was implicated as the cause of sepsis and osteomyelitis due to this organism.

The release of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) from human erythrocyte membranes lysed by hemolysin of Prevotella oris

We found that a 38-kDa protein was released from erythrocyte membranes lysed by hemolysin of Prevotella oris, although hypotonic hemolysis did not show such a phenomenon. The 38-kDa protein was identified as glyceraldehyde-3-phosphate dehydrogenase (GAPDH) by N-terminal amino acid sequencing. This study discusses the relationship between GAPDH and hemolysis.

Characterization of Invertase Purified from Prevotella oralis Ig4a

Characterization of Invertase Purified from Prevotella oralis Ig4a

Pattern of distribution of Prevotella species/phylotypes associated with healthy gingiva and periodontal disease

The purpose of the present study was to obtain diverse profiles of Prevotella species associated with gingival sites in an isolated Aboriginal and an urban community by phylogenetic analysis and to establish patterns of association of identified Prevotella species in gingival sites. Species/phylotypes identified from the phylogenetic analysis of near full-length Bacteroidetes 16S rRNA gene sequences cloned from subgingival plaque samples obtained from an Aboriginal community were compared with those from an ethnically diverse urban metropolitan population suffering from periodontal disease. Specific primer sets were designed and validated for 22 distinct Prevotella species from the 24 species/phylotypes identified from both populations. Within the isolated Aboriginal community, gingival sites in adults were colonised by a mean of 15 different Prevotella species. Prevotella sp. oral clone P4PB24, Prevotella intermedia, Prevotella oralis, Prevotella denticola and Prevotella sp. strain P4P62 had the highest association with increasing probing depth in diseased sites (p < 0.05). P. intermedia and Prevotella sp. oral clone P4PB24, the Prevotella species significantly associated with increasing probing depth in diseased gingival sites and also strongly associated with P. gingivalis load (p < 0.05) in diseased gingival sites, showed significant correlation for co-colonisation (r = 0.6). Prevotella sp. oral clone B31FD, showing strong association with P. gingivalis load (p < 0.05) in diseased gingival sites, showed no significant correlation for co-colonisation with any other Prevotella species. This study provides a comprehensive analysis of Prevotella species associated with gingival sites for the informative evaluation of the epidemiology of infection by this genus.

Purification and characterization of hemolysin from Prevotella oris

We observed hemolytic activity in culture supernatant of Prevotella oris. Results from growth-phase experiments show that hemolysin production increased during the logarithmic growth phase and decreased during the stationary phase. The hemolysin produced by P. oris was purified from the culture supernatant by ultrafiltration, diethylaminoethyl (DEAE) and carboxymethyl (CM) ion-exchange chromatography, and gel filtration chromatography; further, we investigated the purified hemolysin characteristics, including its ability to lyse human, horse, sheep, and rabbit erythrocytes. The purified hemolysin was observed as a single, 16-kDa band on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) gel. The specific activity was obtained by concentrating the purified hemolysin by 9200 fold. Although hemolysin was inactivated by heat treatment, ethylenediaminetetraacetic acid (EDTA), l-cysteine, dithiothreitol (DTT), and 2-mercaptoethanol enhanced its activity. Further, treatments using trypsin, MgCl2, CaCl2, and cholesterol did not affect its hemolytic activity. A pH of 6.0 was optimal for inducing the hemolysin activity. To the best of our knowledge, this is the first report describing the purification and characterization of hemolysin produced by P. oris.

Molecular Methods for Diagnosis of Odontogenic Infections

Historically, the identification of microorganisms has been limited to species that could be cultured in the microbiology laboratory. The purpose of the present study was to apply molecular techniques to identify microorganisms in orofacial odontogenic infections (OIs). Specimens were obtained from subjects with clinical evidence of OI. To identify the microorganisms involved, 16S rRNA sequencing methods were used on clinical specimens. The name and number of the clones of each species identified and the combinations of species present were recorded for each subject. Descriptive statistics were computed for the study variables. Specimens of pus or wound fluid were obtained from 9 subjects. A mean of 7.4 ± 3.7 (standard deviation) species per case were identified. The predominant species detected in the present study that have previously been associated with OIs were Fusobacterium spp, Parvimonas micra, Porphyromonas endodontalis, and Prevotella oris. The predominant species detected in our study that have not been previously associated with OIs were Dialister pneumosintes and Eubacterium brachy. Unculturable phylotypes accounted for 24% of the species identified in our study. All species detected were obligate or facultative anaerobes. Streptococci were not detected. Molecular methods have enabled us to detect previously cultivated and not-yet-cultivated species in OIs; these methods could change our understanding of the pathogenic flora of orofacial OIs.

Correlation Network Analysis Applied to Complex Biofilm Communities

The complexity of the human microbiome makes it difficult to reveal organizational principles of the community and even more challenging to generate testable hypotheses. It has been suggested that in the gut microbiome species such as Bacteroides thetaiotaomicron are keystone in maintaining the stability and functional adaptability of the microbial community. In this study, we investigate the interspecies associations in a complex microbial biofilm applying systems biology principles. Using correlation network analysis we identified bacterial modules that represent important microbial associations within the oral community. We used dental plaque as a model community because of its high diversity and the well known species-species interactions that are common in the oral biofilm. We analyzed samples from healthy individuals as well as from patients with periodontitis, a polymicrobial disease. Using results obtained by checkerboard hybridization on cultivable bacteria we identified modules that correlated well with microbial complexes previously described. Furthermore, we extended our analysis using the Human Oral Microbe Identification Microarray (HOMIM), which includes a large number of bacterial species, among them uncultivated organisms present in the mouth. Two distinct microbial communities appeared in healthy individuals while there was one major type in disease. Bacterial modules in all communities did not overlap, indicating that bacteria were able to effectively re-associate with new partners depending on the environmental conditions. We then identified hubs that could act as keystone species in the bacterial modules. Based on those results we then cultured a not-yet-cultivated microorganism, Tannerella sp. OT286 (clone BU063). After two rounds of enrichment by a selected helper (Prevotella oris OT311) we obtained colonies of Tannerella sp. OT286 growing on blood agar plates. This system-level approach would open the possibility of manipulating microbial communities in a targeted fashion as well as associating certain bacterial modules to clinical traits (e.g.: obesity, Crohn's disease, periodontal disease, etc).

Antimicrobial efficacy of denture adhesives on some oral malodor-related microbes

The objective of the study was to determine the antimicrobial efficacy of three denture adhesives toward Streptococcus oralis, mutans, Prevotella oralis and Fusobacterium nucleatum. Adhesives used were Corega Ultra(®), Fixodent Pro Original(®) and Biotene(®) Denture Grip. For Streptococcus oralis and Streptococcus mutans, four tubes of Trypticase Soy Broth 10mL and 1g denture of adhesive were used. In addition four tubes of Trypticase Soy Broth 10mL without any denture adhesive was employed as control. For Prevotella oralis and Fusobacterium nucleatum, four tubes of thioglycolate 10mL and 1g denture adhesive were used for each one, while four tubes of thioglycolate 10mL without adhesive served as control. All samples were incubated for 48h at 37°C. After 48h, the number of colonies was counted and the mean was extracted as cfu/mL. The results were evaluated with ANOVA on ranked data and Tukey's post hoc test at α=0.05. Streptococcus oralis, mutans, Prevotella oralis and Fusobacterium nucleatum showed decreased number of colonies for each denture adhesive compared to the control. Under the conditions of this in vitro study, all the tested denture adhesives showed antimicrobial efficacy. However, in contrast to the hypothesis, there were differences among them. Corega Ultra(®) and Biotene(®) Denture Grip were more effective for all the tested oral malodor-related microbes than Fixodent Pro Original(®).

Biliary Actinomycosis Mimicking a Klatskin Tumor

A 59-year-old White woman presented with painless jaundice, pruritus, and 10-lb weight loss over a month to an outside facility. She did not have any fever. There was no past history of pancreatitis, abdominal surgery, or trauma. She had no history of smoking. Her labs were: total bilirubin 11.0 mg/dL, direct bilirubin 10.2 mg/dL, alkaline phosphatase (ALP) 655 U/L, aspartate aminotransferase (AST) 92 U/L, and alanine aminotransferase (ALT) 96 U/L. Magnetic resonance imaging showed a 4.5-cm mass at the porta hepatis with compression of the common bile duct and portal lymphadenopathy. CA 19-9 was elevated at 96 U/ml. She underwent a placement of two external biliary drains and had resolution of the jaundice. She was presumed to have Klatskin tumor, based on her clinical and radiological presentation, and the mass was unresectable given its proximity to the portal vein and hepatic artery. She was referred to our center for medical management of cholangiocarcinoma. Patients initially choose to be palliative and refused biopsy considering the high mortality of the tumor. She presented a few days later with abdominal pain and agreed for a biopsy. A few days after a computed tomography (CT)-guided biopsy of the mass, she developed fever, chills, hematemesis, and abdominal pain. On examination, she had a temperature of 99.6°F, blood pressure of 105/60 mmHg, pulse of 105/min, and respiration of 20/min. Her lungs were clear to auscultation. She had tenderness in the right upper quadrant of the abdomen. A repeat CT scan showed a 4.7-cm porta hepatis mass with encasement of the hepatic artery and with loss of fat planes between the mass and the gall bladder and duodenum (Fig. 1). A 1.7-cm gall stone was visualized. A 1-cm gastrohepatic lymph node was seen along with scattered lymph nodes measuring up to 1 cm in the retrocaval, aortocaval, and periaortic regions. Two biliary stents were in place. Upper gastrointestinal endoscopy showed fresh blood oozing from the ampulla of Vater, which was felt to be due to her mass. Digital subtraction angiography of the celiac trunk and superior mesenteric artery showed an 8-mm pseudoaneurysm of the third segmental branch of the left hepatic artery (Fig. 2). The bleeding was successfully stopped with coil and gel foam embolization. The pathology of the bile duct mass was negative for malignancy but showed acute and chronic inflammation and granulomas with gram-positive filamentous bacteria consistent with actinomycetes species (Fig. 3). Cultures grew Streptococcus constellatus, Prevotella intermedia, and Prevotella oris. The patient was started on IV penicillin, oral metronidazole and levaquin while in the hospital and made a slow recovery. M. Bansal (*) :A. Agarwal Department of Internal Medicine, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205, USA e-mail: mbansal@uams.edu

Characterization of the Porphyromonas gingivalis conjugative transposon CTnPg1: determination of the integration site and the genes essential for conjugal transfer

In our previous study, extensive genomic rearrangements were found in two strains of the Gram-negative anaerobic bacterium Porphyromonas (Por.) gingivalis, and most of these rearrangements were associated with mobile genetic elements such as insertion sequences and conjugative transposons (CTns). CTnPg1, identified in Por. gingivalis strain ATCC 33277, was the first complete CTn reported for the genus Porphyromonas. In the present study, we found that CTnPg1 can be transferred from strain ATCC 33277 to another Por. gingivalis strain, W83, at a frequency of 10(-7) to 10(-6). The excision of CTnPg1 from the chromosome in a donor cell depends on an integrase (Int; PGN_0094) encoded in CTnPg1, whereas CTnPg1 excision is independent of PGN_0084 (a DNA topoisomerase I homologue; Exc) encoded within CTnPg1 and recA (PGN_1057) on the donor chromosome. Intriguingly, however, the transfer of CTnPg1 between Por. gingivalis strains requires RecA function in the recipient. Sequencing analysis of CTnPg1-integrated sites on the chromosomes of transconjugants revealed that the consensus attachment (att) sequence is a 13 bp sequence, TTTTCNNNNAAAA. We further report that CTnPg1 is able to transfer to two other bacterial species, Bacteroides thetaiotaomicron and Prevotella oralis. In addition, CTnPg1-like CTns are located in the genomes of other oral anaerobic bacteria, Porphyromonas endodontalis, Prevotella buccae and Prevotella intermedia, with the same consensus att sequence. These results suggest that CTns in the CTnPg1 family are widely distributed among oral anaerobic Gram-negative bacteria found in humans and play important roles in horizontal gene transfer among these bacteria.

Exploring Bacterial Diversity of Endodontic Microbiota by Cloning and Sequencing 16S rRNA

Introduction The characterization of microbial communities infecting the endodontic system in each clinical condition may help on the establishment of a correct prognosis and distinct strategies of treatment. The purpose of this study was to determine the bacterial diversity in primary endodontic infections by 16S ribosomal-RNA (rRNA) sequence analysis. Methods Samples from root canals of untreated asymptomatic teeth (n = 12) exhibiting periapical lesions were obtained, 16S rRNA bacterial genomic libraries were constructed and sequenced, and bacterial diversity was estimated. Results A total of 489 clones were analyzed (mean, 40.7 ± 8.0 clones per sample). Seventy phylotypes were identified of which six were novel phylotypes belonging to the family Ruminococcaceae. The mean number of taxa per canal was 10.0, ranging from 3 to 21 per sample; 65.7% of the cloned sequences represented phylotypes for which no cultivated isolates have been reported. The most prevalent taxa were Atopobium rimae (50.0%), Dialister invisus, Prevotella oris, Pseudoramibacter alactolyticus, and Tannerella forsythia (33.3%). Conclusions Although several key species predominate in endodontic samples of asymptomatic cases with periapical lesions, the primary endodontic infection is characterized by a wide bacterial diversity, which is mostly represented by members of the phylum Firmicutes belonging to the class Clostridia followed by the phylum Bacteroidetes.

Stimulants of Toll-like receptors 2 and 4 are elevated in saliva of periodontitis patients compared with healthy subjects

Because the absorption of stimulants of Toll-like receptor (TLR)2 and TLR4 from the gastrointestinal tract into the circulation has been proposed to promote the development of atherosclerosis and insulin resistance, we aimed to quantify the abundance of stimulants of TLR2 and TLR4 in human saliva. A recently developed bioassay based upon measurement of NF-κB activation in TLR-deficient human embryonic kidney (HEK)-293 cells transfected with human TLR2 or TLR4 and calibrated with synthetic bacterial lipopeptide (Pam(3) CSK(4) ) or Escherichia coli lipopolysaccharide (LPS), was used to establish the normal range of TLR stimulants in saliva of 20 healthy subjects and 20 subjects with periodontal disease. Median soluble stimulants of TLR2 and TLR4 were significantly higher in saliva of periodontitis patients compared with saliva of healthy subjects; 3450 versus 77 ng/ml Pam(3) CSK(4) equivalents (p<0.0001) and 138 versus 7 ng/ml LPS equivalents, respectively (p<0.0001). Salivary TLR stimulant levels remained relatively stable in healthy subjects over several days. Six strains of oral Gram-negative bacteria, including Tannerella forsythensis, Lysobacter enzymogenes, Prevotella intermedia, Prevotella oris and Porphyromonas gingivalis, from a panel of nine examined did not stimulate TLR4-dependent signalling. Elevated salivary TLR stimulants may represent a novel mechanism by which periodontitis increases the risk of developing cardiovascular disease and insulin resistance.

Genetic analysis of mobile tetQ elements in oral Prevotella species

Prevotella species are members of the bacterial oral flora and are opportunistic pathogens in polymicrobial infections of soft tissues. Antibiotic resistance to tetracyclines is common in these bacteria, and the gene encoding this resistance has been previously identified as tetQ. The tetQ gene is also found on conjugative transposons in the intestinal Bacteroides species; whether these related bacteria have transmitted tetQ to Prevotella is unknown. In this study, we describe our genetic analysis of mobile tetQ elements in oral Prevotella species. Our results indicate that the mobile elements encoding tetQ in oral species are distinct from those found in the Bacteroides. The intestinal bacteria may act as a reservoir for the tetQ gene, but Prevotella has incorporated this gene into an IS21-family transposon. This transposon is present in Prevotella species from more than one geographical location, implying that the mechanism of tetQ spread between oral Prevotella species is highly conserved.

Trends in antibiotic resistance in Prevotella species from patients of the University Hospital of Maxillofacial Surgery, Sofia, Bulgaria, in 2003–2009

Head-and-neck infections often involve anaerobes such as Prevotella species. Aim of the present study was to assess the evolution and the factors associated with resistance in Prevotella species to penicillin, clindamycin, metronidazole, tetracycline and β-lactams/β-lactamase inhibitors (BL/BLIs). In total, 192 Prevotella strains, isolated from patients with oral and head-and-neck infections, were evaluated. Common isolates were Prevotella intermedia and Prevotella melaninogenica within the pigmented species as well as Prevotella oris and Prevotella oralis group within the non-pigmented species. Overall resistance was 43.2% for penicillin, 10.9% for clindamycin, 0% for metronidazole. Nonsusceptibility to tetracycline was 29.1% without significant differences in resistance rates between pigmented and other species. Penicillin resistant strains were β-lactamase positive. From 2003–2004 to 2007–2009, penicillin resistance rates increased about four-fold (from 15.4% to 60.6%). Clindamycin resistance did not show evolution, whereas tetracycline nonsusceptibility decreased from 43.3% in 2003–2004 to 20.7% in 2007–2009. Except for one (0.5%) P. oralis strain with intermediate susceptibility to BL/BLIs, the other strains were susceptible to the agents. In conclusion, in Prevotella strains from patients with head-and-neck infections, the resistance rate to penicillin increased, that to clindamycin remained stable and the nonsusceptibility rate to tetracycline decreased during the period. Activity against >99% of Prevotella strains was observed with metronidazole and BL/BLIs. The penicillin resistance and tetracycline nonsusceptibility were associated with the year of study, national antibiotic consumption and possibly with previous treatment (for tetracycline). The evolution of penicillin resistance in Prevotella strains was highly dynamic.