RESUMO
ABSTRACT We compared the effect of two therapeutic approaches (marketed toothpaste and addition of Bulgarian propolis extract to the toothpaste) on gingival inflammation, plaque formation and oral microbial flora on Bulgarian adolescents with moderate plaque-induced gingivitis. The participants were divided randomly into two groups of 35 students. The first group was instructed to use marketed toothpaste in their routine oral hygiene. The second group was instructed to add 10 drops of Propolin® to the toothpaste before every brushing. The Gingival index and Plaque index were registered and dental plaque samples were collected on the first visit and on the 20th day of the study. After the treatment, the number of students with Gingival index = 1.1-2.0 in the second group was significantly lower than the respective number in the first group. Neisseria spp. and Streptococcus spp. were present in all samples before and after treatment. The addition of propolis resulted in the complete eradication of Streptococcus mutans, Candida albicans, Fusobacterium varium, Gram-negative cocci, Gram-positive rods, Porphyromonas asaccharolyticus, Prevotella bivia, Prevotella intermedia, Prevotella melani and Streptococcus intermedius. The analyses of Propolin® composition revealed it was a black poplar type propolis and is rich in compounds with pronounced antimicrobial activity. In conclusion, the addition of Bulgarian propolis to the toothpaste improved the gingival health in adolescents with moderate plaque-induced gingivitis and resulted in increased activity against potential periodontal and cariogenic pathogens.
RESUMO
Abstract The 10-valent pneumococcal conjugate vaccine (PCV10) has been included in Bulgarian Childhood Immunization Program since 2010. This study aimed to assess serotype distribution and antimicrobial resistance of 198 invasive and non-invasive Streptococcus pneumoniae strains that had been isolated in Bulgaria during 2011-2016 from patients with invasive (IPD) and non-invasive (NIPD) pneumococcal diseases. The most common invasive serotypes were 3 (10.1%), 19F (4.0%), and 7F (3.0%). A significant decrease in the proportion of invasive vaccine types (VTs) from 64.2% to 35.2% was found in comparison with pre-vaccine era. The most common serotypes among middle ear fluids were 3, 19A and 19F (5.6% each), and VTs fell down from 66.4% to 40.0% in post-PCV10 period. Among respiratory isolates, the most prevalent serotypes were some emergent serotypes such as 15A/B/C (5.0%), 19A, and 6C (4.0% each). VTs decreased significantly (16.3%) among vaccinated children compared to unvaccinated children and adults (44.0%). Two non-VTs (19A and 6C) have increased significantly more (p < 0.05) in vaccinated children than in unvaccinated patients. The rates of antibiotic nonsusceptible S. pneumoniae in Bulgaria remained high in post-PCV10 era. Among all source of isolates, antimicrobial nonsusceptibility rates were: oral penicillin - 46.5%, trimethoprim-sulfamethoxazole - 45.4%, erythromycin - 43.9%, tetracycline - 37.4%, and multidrug-resistance (MDR) was 44%. The most common MDR serotypes were 19F, 19A, 6A/C, 15A/B/C and 23A. Our results proved that PCV10 vaccination substantially reduced VTs pneumococcal IPD and NIPD. There has been a shift in the distribution of S. pneumoniae serotypes mostly in vaccinated children but also in the whole population and strong serotype-specific antibiotic resistance was observed after vaccine implementation. Therefore, it is important to continue monitoring serotype changes and pneumococcal resistance among all patient ages in addition to aid in determining the long-term effectiveness of PCV10 interventions.