Detection of enterococcus faecalis in subgingival biofilm of patients with chronic refractory periodontitis.

OBJECTIVES: Refractory periodontitis is the occurrence of additional clinical attachment loss after repeated attempts to control the infection with conventional periodontal therapy. Some microorganisms seem to be involved in the pathogenesis of chronic refractory periodontitis. The prevalence of Enterococcus faecalis in the oral cavity seems to be higher in individuals with periodontitis. Therefore, the present study investigated the presence of E. faecalis in subgingival biofilm of patients with chronic refractory periodontal disease. STUDY DESIGN: Periodontal treatment was instituted for 100 patients suffering from chronic periodontitis. Then samples were obtained from 27 successfully treated and 27 chronic refractory periodontitis subjects and then cultured. Statistical evaluation was performed for descriptive purposes. RESULTS: 27% of the patients had chronic refractory periodontitis. The difference in the presence of E. faecalis in the pockets between the successfully treated (11.1%) and chronic refractory (51.8%) groups by culture methods was statistically significant (p<0.05). CONCLUSION: Data showed that E. faecalis is probably involved in the pathogenesis of refractory periodontitis. Accurate knowledge about the pathogen and its role in the pathogenesis of refractory infections helps develop effective treating strategies.

Antibacterial Effect of Diclofenac Sodium on Enterococcus faecalis.

OBJECTIVE: Non-steroidal anti-inflammatory drugs (NSAIDs) have shown antibacterial activity in some recent studies. The aim of this study was to evaluate the antibacterial effect of diclofenac against Enterococcus faecalis (E. faecalis) as a resistant endodontic bacterium in comparison with ibuprofen, calcium hydroxide and amoxicillin. MATERIALS AND METHODS: The antibacterial activity of materials was evaluated using agar diffusion test and tube dilution method. Mixtures of 400 mg/ml of materials were prepared. The bacteria were seeded on 10 Muller-Hinton agar culture plates. Thirty microliter of each test material was placed in each well punched in agar plates. After incubation, the zone of bacterial inhibition was measured. Minimum inhibitory concentration (MIC) of the test materials was determined by agar dilution method. One-way Analysis of Variance (ANOVA) followed by Sidak post hoc test was used to compare the mean zone of microbial growth in the groups. RESULTS: There were significant differences between the two groups (p< 0.05). Results of the agar diffusion test showed that antibiotics (amoxicillin, gentamycin) had the greatest antibacterial activity followed by NSAIDs (ibuprofen, diclofenac). Ca(OH)2 failed to show antibacterial activity. Diclofenac and ibuprofen showed distinct antibacterial activity against E. faecalis in 50 µg/ml and above concentrations. CONCLUSION: Within the limitations of this in vitro study, it is concluded that diclofenac and ibuprofen have significantly more pronounced antibacterial activity against E. faecalis in comparison with Ca(OH)2.

Evaluation of Genetic Pattern of Gentamicin-resistant Enterococci Isolated from Clinical Samples.

BACKGROUND AND AIMS: Enterococci are among resistant microorganisms to antibiotics and are responsible for some of acute gingival infections. This study aimed at molecular evaluation of gentamicin-resistant enterococcus species and determining the resistance genes. MATERIALS AND METHODS: Clinical samples were cultured on BHI medium and enterococci were isolated by specific methods and antibiograms were prepared. DNA was derived from gentamicin-resistant species by alkaline lysis method and replicated by PCR method. Four gentamicin-resistant genes were evaluated by electrophoresis method on agarose gel. RESULTS: From 105 Enterococcus faecalis isolates, 36.2% and from 38 Enterococcus faecium isolates, 78.2% were resistant to gentamicin. 60% of these species bore aac (6')- le - aph(2")- la gene. ph(2")- Ib,Ic,Id genes were not seen in any of the evaluated species. CONCLUSION: In gentamicin-resistant species of E. faecalis and E. faecium, the aac (6')- le - aph(2")- la gene was identified as the main cause of resistance.