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BACKGROUND: Periapical infections present as symptomatic inflammatory reactions in the periapical tissues due to the presence of polymicrobial organisms and this may result in severe life-threatening infections. These lesions remain a public health concern.
AIM: This study aimed to identify the common bacteria involved in the periapical infections in our environment and to assess their susceptibility patterns to commonly used antibiotics, in the oral and maxillofacial out-patient clinic. METHODS: Consecutive and consenting patients scheduled to have their teeth extracted by intra-alveolar protocol for reason of periapical infections and who claimed not to have taken antibiotics in the preceding one week were recruited into the study population. Nutrient agar, blood agar, chocolate agar and MacConkey agar were used for culture and antibiotic susceptibility tests. Organisms identified were subjected to various antibiotic susceptibility tests, of the commonly prescribed and used antibiotics (cefuroxime, erythromycin, gentamycin, ofloxacin, levofloxacin, amoxicillin and clavulanate, and obatrin) in the Dental Centre, using the disc diffusion method of Bauer and Kirby. RESULTS: A total of eight hundred and ninety-eight (898) swabs were taken for culture, identification and sensitivity test from 530 females and 368 males aged 16-80years, presenting with periapical lesions. Of all the swabs taken, 135(15%) yielded no growths, 610(68%) yielded single organisms and 153(17%) yielded more than one organisms. Isolated bacterial organisms were Staphylococcus albus (22.4% of isolates), Staphylococcus aureus (50.0% of isolates), Streptococcus mutans (14.4% of isolates), Streptococcus viridans (13.0% of isolates) and Klebsiella spp (20.0% of isolates). The susceptibility rate of the tested antibiotics were amoxicillin and clavulanate 75%, cefuroxime 75%, obatrin 68%, ofloxacin 68%, erythromycin 62%, levofloxacin 59% and gentamycin 45%. CONCLUSION: The study has provided evidence to show that facultative Gram positive cocci are the predominant organisms isolated from root apices with periapical lesions. Most of these infective organisms are susceptible to amoxicillin and clavulanate, and cefuroxime. They are resistant mainly to gentamycin.