ABSTRACT
Background: diabetes has been associated with periodontal disease for many years. Diabetes is recognized as an important risk factor for more severe and progressive periodontitis, infection or lesions resulting in the destruction of tissues and supporting bone that form the attachment around the tooth
Aim: the aim of this study was to detect and identify bacteria of periodontal infection among diabetic patients, L% determine the antimicrobial susceptibility pattern of isolated aerobic and anaerobic bacteria to commonly used antibacterial agents and to evaluate the antibacterial activity of one natural products such as meswak chewing sticks [Salvadora persica] on periodontal isolates
Methods: the study includes 41 diabetic patients suffering from periodontitis. Specimens were examined for aerobic and anaerobic bacterial infections. Isolated bacteria were identified by conventional biochemical tests. Antimicrobial susceptibility was tested for all isolates by agar plate disc diffusion method. Antibacterial activity o f meswak was tested by both cup plate method and micro dilution assay
Result: result revealed that the main etiological agent of periodontitis was alpha-haemolytic streptococci, coagulase negative staphylococci [CNS], Klebseilla spp., Prevotella melaninogenica and Fusobactrium nucleatum. The aqueous extract of S. persica shows good antimicrobial activity using microdilution assay and has week activity by cups plate method. The resistances of all periodontal pathogen were relatively low against Amoxicillin /Clavulanic acid, Piperacillin/Tazobactam, Ertapenem and Chloramephenicol
Conclusion: periodontitis were often polymicrobial and could be associated with potentially pathogenic organisms. Antimicrobial agents such as amoxicillin-clavulanate or piperacillin-tazobactam and ertapenem could be used for empirical treatment of mixed infections particularly those associated with anaerobic organisms