JAC Advance Access originally published online on December 12, 2002
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Journal of Antimicrobial Chemotherapy (2003) 51, 107-112
© 2003 The British Society for Antimicrobial Chemotherapy
Emergence of penicillin resistance among Fusobacterium nucleatum populations of commensal oral flora during early childhood
1 Anaerobe Reference Laboratory, Department of Microbiology and 3 Department of Vaccines, National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki; 4 Department of Education, University of Helsinki, PO Box 39, FIN-00014 Helsinki, Finland; 2 Department of Surgical Sciences, Kuwait University, PO Box 24923, Safat 13110, Kuwait
Received 13 May 2002; returned 2 September 2002; revised 24 September 2002; accepted 26 September 2002
Penicillin resistance due to ß-lactamase production is surprisingly common among oral bacteria in childhood. Fusobacterium nucleatum, a Gram-negative anaerobic bacillus, is a member of the developing oral commensal flora. As part of the investigation on the emergence of oral bacterial resistance, the aim of the present study was to examine longitudinally the penicillin resistance among salivary F. nucleatum populations as related to age, day care attendance and sibling history, and exposure to antimicrobial agents. Altogether 1492 F. nucleatum isolates from saliva of 44 healthy infants followed at a study clinic at 2, 6, 12, 18 and 24 months of age were tested for ß-lactamase production. Furthermore, the 276 ß-lactamase-positive isolates were examined for their in vitro susceptibility to penicillin G by the NCCLS-approved agar dilution method. Statistical analysis of the associations between penicillin-resistant isolates and infants’ age, day care attendance, number of siblings and their ear infections, and exposure to antimicrobial agents was performed by SPSS Windows Version 10. The prevalence of infants harbouring ß-lactamase-producing F. nucleatum strains increased from 2% to 49% during the follow-up time. In nearly all cases ß-lactamase-producing F. nucleatum isolates were found simultaneously with ß-lactamase-negative isolates. Most ß-lactamase-producing isolates (80%) showed an MIC of 
8 mg/L. In conclusion, the prevalence of infants harbouring penicillin-resistant F. nucleatum due to ß-lactamase production increased with age and usage of antimicrobial agents during the first year of life.
Keywords: Fusobacterium nucleatum, in vitro susceptibility, MIC, penicillin resistance, ß-lactamase production
* Corresponding author. Tel: +358-9-47448254; Fax: +358-9-47448238; E-mail: SusanNyforsUK{at}aol.com
Deceased in June 2002.
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