Antibiotic Susceptibility of Bacteria Isolated from Infected Root Canals

감염근관에서 분리 배양한 세균의 수종 항생제에 대한 감수성 조사

  • Lim, Sang-Soo (Department of Conservative Dentistry College of Dentistry, Chosun University) ;
  • Kim, Mi-Kwang (Department of Oral Biochemistry, College of Dentistry, Chosun University) ;
  • Min, Jeong-Beom (Department of Conservative Dentistry College of Dentistry, Chosun University) ;
  • Kim, Min-Jung (Department of Oral Biochemistry, College of Dentistry, Chosun University) ;
  • Park, Soon-Nang (Department of Oral Biochemistry, College of Dentistry, Chosun University) ;
  • Hwang, Ho-Keel (Department of Conservative Dentistry College of Dentistry, Chosun University) ;
  • Kook, Joong-Ki (Department of Oral Biochemistry, College of Dentistry, Chosun University)
  • 임상수 (조선대학교 치과대학 치과보존학교실) ;
  • 김미광 (조선대학교 치과대학 구강생화학교실) ;
  • 민정범 (조선대학교 치과대학 치과보존학교실) ;
  • 김민정 (조선대학교 치과대학 구강생화학교실) ;
  • 박순낭 (조선대학교 치과대학 구강생화학교실) ;
  • 황호길 (조선대학교 치과대학 치과보존학교실) ;
  • 국중기 (조선대학교 치과대학 구강생화학교실)
  • Published : 2006.09.30

Abstract

The aim of this study was to identify the bacteria isolated from endodontic lesions by cell culture and to determine the antimicrobial susceptibility of them against 8 antibiotics. The necrotic pulpal tissues were collected from 27 infected root canals, which were diagnosed as endodontic infection. Samples were collected aseptically from the infected pulpal tissue of the infected root canals using a barbed broach and a paper point. The cut barbed broaches and paper points were transferred to an eppendorf tube containing $500{\mu}l\;of\;1{\times}PBS$. The sample solution was briefly mixed and plated onto a BHI-agar plate containing 5% sheep blood. The agar plates were incubated in a $37^{\circ}C$ anaerobic chamber for 2 to 5 days. The bacteria grown on the agar plates were identified by comparison of 16S rRNA gene (rDNA) sequencing method at the species level. To test the sensitivity of the bacteria isolated from the infected root canals against 8 antibiotics, minimum inhibitory concentrations (MIC) were determined using broth dilution assay. The data showed that 101 bacterial strains were isolated and were identified. Streptococcus spp. (29.7%) and Actinomyces spp. (21.8%) were predominantly isolated. The 9 strains were excluded in antimicrobial susceptibility test because they were lost during the experiment or were not grown in broth culture. The percentage of bacteria susceptible for each antibiotic in this study was clindamycin, 87.0% (80 of 92); tetracycline, 75.0% (69 of 92); cefuroxime axetil, 75.0% (69 of 92); amoxicillin + clavulanic acid (5:1), 71.7% (66 of 92); penicillin G, 66.3% (61 of 92); erythromycin, 66.3% (61 of 92); amoxicillin, 44.6% (41 of 92); and ciprofloxacin, 31.5% (29 of 92). The susceptibility pattern of 8 antibiotics was dependent on the host of the bacteria strains rather than the kinds of bacterial species. These results indicate that antibiotic susceptibility test should be performed when antibiotics are needed for the treatment of infected root canals.

본 연구는 치근관 감염병소에서 세균을 분리 및 동정하고, 8종의 항생제들에 대한 분리균주들의 감수성을 조사하기 위하여 실시하였다. 세균에 감염된 27개 치아의 괴사된 치근부 치부소직을 바비드 브로치나 페이퍼 포인트로 무균적으로 채취하였다. 치수가 채취된 부위의 바비드 브로치와 페이퍼 포인트를 500 ul의 $1{\times}PBS$ 용액에 담아 잘 혼합하고, 이를 5% 양혈이 포함된 BHI 한천배지(혈액한천배지)에 도말하여 $37^{\circ}C$ 혐기성 배양기에서 2-5일 동안 배양하였다. 혈액한천배지에서 자라난 세균은 16S rRNA 유전자(rDNA) 염기서열결정법을 이용하여 종수준으로 동정하였다. 이들 균주들의 8종 항상제에 대한 감수성은 최소성장억제농도 측정법으로 조사하였다. 본 연구결과, 101개의 세균 집락이 생겼고, Streptococcus spp. (29.7%)와 Actinomyces spp. (21.8%)가 가장 많이 검출되었다. 이들 균주들 중 9균주는 실험 도중 소실되거나 액체배지에 자라지 않아서 항생제 감수성 심험에서는 제외되었다. 각 항생제들에 대한 감수성을 조사한 결과, 분리된 균주들 중 80(87.0%) 균주가 클린다마이신에 감수성을 보였으며, 세프록심 아세틸과 테트라사이클린에 69(75.0%)가, 오그멘틴에 66(71.7%) 균주가, 페니실린 G에 63(68.5%) 균주가, 에리트로마이신에 61(66.3%) 균주가, 아목시실린에 41(44.6%) 균주가 감수성을 보였다. 그러나 시플록사신에는 29(31.5%) 균주만이 감수성을 보였다. 이러한 8종 항생제에 대한 균주들의 감수성 양상은 세균 종의 종류보다는 분리된 숙주에 따라 차이가 있었다. 이러한 결과는 치근관 감염질환의 치료에 항생제가 필요할 경우 항생제 감수성검사를 병행하는 것이 효과적임을 시사한다.

Keywords

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