Występowanie metycylinoopornych Staphylococcus aureus u dorosłych pacjentów z objawami infekcji jamy ustnej
[Prevalence of methicillin-resistant Staphylococcus aureus among adult patients with symptoms of oral infection]

STRESZCZENIE

Najnowsze badania pokazują, że obecność metycylinoopornych S. ureus nie ogranicza się jedynie do nosa czy gardła. Skąpa wiedza na temat roli jaką odgrywa S. aureus w jamie ustnej powoduje brak stosownej diagnostyki mikrobiologicznej i odpowiednich schematów leczenia w stomatologii. Niniejsza praca miała na celu określenie częstości występowania oraz lekowrażliwości metycylinoopornych S. aureus (MRSA) w jamie ustnej dorosłych pacjentów z objawami infekcji.

ABSTRACT

Introduction: Despite the numerous studies on staphylococcal infections, relatively little attention has been paid to the oral cavity as a reservoir of Staphylococcus aureus. The aim of the study was to analyze the prevalence of S. aureus and their antibiotic resistance among adult patients with symptoms of oral infection.

Materials and Methods: A total of 1560 oral specimens (tongue swabs, oral mucosal swabs, angle of mouth and denture swabs) from 535 adult patients with oral infection were studied. The materials were subcultured onto Columbia blood agar and Chapman agar incubated at 37°C for 48 hours. The resistance of S. aureus isolates to antimicrobial agents was determined by disk diffusion and interpreted according to the EUCAST. Suspected methicillin-resistant S. aureus (MRSA) isolates were further examined for the presence of modified PBP2a protein.

Results: For the period 2016-17, from 1560 oral specimens 188 (12,1%) S. aureus were isolated, of which 28 (14,9%) isolates were resistant to methicillin. MRSA was isolated more frequent from patients with denture. The most common oral specimen type from which S. aureus was isolated was a tongue swab. The MRSA isolates showed resistance to gentamicin (71,4%), tetracycline (42,8%), erythromycin (35,7%), clindamycin (28,6%), ciprofloxacin (7%), and cotrimoxazol (7%).

Conclusions: This study demonstrates that oral cavity in adult patients with symptoms of infection may be reservoir of methicillin resistant S. aureus, and justifies microbiological diagnostic and monitoring of staphylococcal colonization in dental treatment.

Key words: Staphylococcus aureus, methicillin-resistance, oral infection