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Journal of Clinical Microbiology, July 2009, p. 2218-2225, Vol. 47, No. 7
0095-1137/09/$08.00+0     doi:10.1128/JCM.00388-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Occurrence, Population Structure, and Antimicrobial Resistance of Enterococci in Marginal and Apical Periodontitis{triangledown}

Jinglu Sun,1,{dagger}* Xiaobo Song,1,{dagger} Bjørn Erik Kristiansen,1,2 Anne Kjæreng,3 Rob J. L. Willems,4 Harald M. Eriksen,5 Arnfinn Sundsfjord,1,6 and Johanna E. Sollid1*

Department of Medical Biology, Medical Faculty, University of Tromsø, Tromsø, Norway,1 A/S Telelab, Telemark Biomedical Centre, Skien, Norway,2 Endodontist Anne Kjæreng AS, Tromsø, Norway,3 Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands,4 Institute of Clinical Dentistry, Medical Faculty, University of Tromsø, Tromsø, Norway,5 Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway6

Received 20 February 2009/ Returned for modification 10 April 2009/ Accepted 30 April 2009

Subgingival plaque samples and root canal samples were collected from 2,839 marginal periodontitis (MP) patients and 21 apical periodontitis (AP) patients. Enterococcus species were identified by a series of phenotypic and genotypic tests. Antimicrobial susceptibility assays were performed by an agar disk diffusion test. Multilocus sequence typing (MLST), eBURST, and minimum spanning tree were used for enterococcal genetic clustering and population analysis. Enterococcus faecalis was recovered from 3.7% MP patients and 9.5% AP patients, and Enterococcus faecium was recovered from 0.04% MP patients. Enterococci were detected more often in older male patients. E. faecalis isolates of MP were found resistant to tetracycline (49.1%), erythromycin (8.5%), trimethoprim (2.8%), and gentamicin (1.9%), while one AP isolate was resistant to tetracycline. A total of 40 sequence types (STs) were resolved in 108 E. faecalis isolates. Comparison with E. faecalis international MLST database revealed that 27 STs were previously found, 13 STs were novel, and several major clonal complexes in the database were also found in MP isolates. The tetracycline-resistant isolates distributed mainly in the major clonal complexes and singletons, whereas the erythromycin-resistant isolates were more dispersed. Although the rate of occurrence of enterococci recovered in the MP and AP samples was low, 50% of these isolates are resistant to at least one antimicrobial agent, which is most often tetracycline. This implies that subgingival E. faecalis might represent a reservoir of resistance to tetracycline and erythromycin. The subgingival E. faecalis isolates show high genetic diversity but are grouped, in general, with the known isolates from the international database.

* Corresponding author. Mailing address: Department of Medical Biology, Medical Faculty, University of Tromsø, 9037 Tromsø, Norway. E-mail for Jinglu Sun: jinglu.sun{at}uit.no. E-mail for Johanna E. Sollid: johanna.e.sollid{at}uit.no

{triangledown} Published ahead of print on 6 May 2009.

{dagger} J.S. and X.S. contributed equally to this study.

Journal of Clinical Microbiology, July 2009, p. 2218-2225, Vol. 47, No. 7
0095-1137/09/$08.00+0     doi:10.1128/JCM.00388-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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