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Emergence of beta-lactamase producing anaerobic bacteria in the tonsils during penicillin treatment

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Abstract

The emergence of beta-lactamase producing bacteria in the microflora in the oropharyngeal cavity was studied in ten healthy volunteers treated with 1 g phenoxymethylpenicillin b.i.d. for ten days. Beta-lactamase activity in saliva was also investigated. A significant increase in the number of beta-lactamase producing strains of Bacteroides species and Fusobacterium nucleatum was observed. One beta-lactamase producing Staphylococcus aureus strain was recovered in one of the volunteers before the penicillin administration started and three Staphylococcus aureus strains produced beta-lactamase after ten days of antibiotic treatment. Beta-lactamase-production in Haemophilus influenzae, Haemophilus parainfluenzae or Branhamella catarrhalis was not observed before, during or after the antibiotic treatment. Beta-lactamase activity was noted in the broth cultures from one volunteer colonized with a beta-lactamase producing Escherichia coli strain. Beta-lactamase activity in saliva was observed in all volunteers, the activity increasing significantly in parallel to the increase of betalactamase producing bacterial strains. Beta-lactamase activity in saliva was completely inhibited in vitro by clavulanic acid and p-chloromercurbenzoate and about 70–80 per cent of the activity was inhibited by cefoxitin. The increase of beta-lactamase producing bacteria in the oropharynx as a consequence of penicillin treatment raises doubt as to whether penicillin is the drug of choice in the treatment of tonsillitis caused by group A streptococci when previous treatment has failed.

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Authors and Affiliations

  1. Department of Clinical Microbiology, Huddinge University Hospital, Karolinska Institute, S-141 86, Huddinge, Sweden

    K. Tunér

  2. National Bacteriological Laboratory, S-105 21, Stockholm, Sweden

    C. E. Nord

Authors
  1. K. Tunér
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  2. C. E. Nord
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Tunér, K., Nord, C.E. Emergence of beta-lactamase producing anaerobic bacteria in the tonsils during penicillin treatment. Eur. J, Clin. Microbiol. 5, 399–404 (1986). https://doi.org/10.1007/BF02075694

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