Do quaternary ammonium monomers induce drug resistance in cariogenic, endodontic and periodontal bacterial species?

OBJECTIVES: Antibacterial monomers were developed to combat oral biofilm acids and caries; however, little is known on whether quaternary ammonium monomers (QAMs) would induce drug resistance in oral bacteria. The objective of this study was to investigate the effects of new antimicrobial monomers dimethylaminohexadecyl methacrylate (DMAHDM) and dimethylaminododecyl methacrylate (DMADDM) on the induction of drug resistance in eight species of cariogenic, endodontic and periodontal bacteria for the first time.

METHODS: Streptococcus mutans (S. mutans), Streptococcus sanguis, Streptococcus gordonii, Enterococcus faecalis (E. faecalis), Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Fusobacterium nucleatum (F. nucleatum), Porphyromonas gingivalis (P. gingivalis), and Prevotella intermedia (P. intermedia) were tested. Minimum inhibitory concentration (MIC) was assessed using chlorhexidine (CHX) as control. Minimal bactericidal concentration (MBC), bacterial growth and membrane permeability properties were also investigated.

RESULTS: CHX induced drug resistance in four species. DMAHDM did not induce any resistance. DMADDM induced drug resistance in only one benign species S. gordonii. The DMADDM-resistant and CHX-resistant S. gordonii had the same MIC and MBC values as S. gordonii parental strain against DMAHDM (p>0.1), hence DMAHDM effectively inhibited the resistant strains. The resistant strains had slower growth metabolism than parental strain.

SIGNIFICANCE: DMAHDM induced no drug resistance, and DMADDM had much less drug resistance than the commonly-used CHX in the eight common oral species. With its potent antimicrobial functions shown previously, the new DMAHDM is promising for applications in restorative, preventive, periodontal and endodontic treatments to combat cariogenic and pathological bacteria with no drug resistance in all tested species.