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Streptococci species of anginosus group isolated from oral and maxillofacial infections.

The aim of the study was to isolate and identify at species level streptococci strains of anginosus group in pus samples collected from 110 patients with oral and maxillofacial (OMF) infections. Gram-stained smears and cultures on selective and nonselective media were done from each of the 111 pus samples (2 samples were collected from one of the patients, who presented 2 oral abscesses at the same time). The isolates were identified on the basis of cultural and biochemical characteristics. Speciation of the anginosus group isolates was performed using the Rapid ID 32 Strep system (Bio Mérieux, France). Fourty-four anginosus group strains were isolated from 42 patients. Fourty of these isolates were identified as Streptococcus anginosus (2 nonidentical isolates were found in 2 patients), 3 isolates as Streptococcus constellatus and only one as Streptococcus intermedius. The study confirmed that the anginosus group is often involved in OMF infections alone or in association with other aerobic and/or anaerobic bacteria. In the investigated cases, Streptococcus anginosus was by far the most frequently isolated species within the anginosus group.

Adolescent↗

Microbiota of rapidly progressive periodontitis lesions in association with clinical parameters.

The microbial population in 73 rapidly progressive periodontitis (RPP) lesions in 10 young adults aged 25 to 35 years (5 males, 5 females) was studied in relation to the clinical parameters probing depth, bleeding on probing, and suppuration, which were recorded at the sampled sites. Porphyromonas gingivalis was found to predominate (26.7%) in 73 periodontal lesions with clinical probing depth > 6 mm, followed by Bacteroides forsythus (23.6%), and Prevotella intermedia (15.7%). The prevalence of P. gingivalis was 91.7%, Fusobacterium nucleatum, 90.4%; Streptococcus intermedius, 87.7%; and B. forsythus, 53.4%. Significant differences between bleeding index 0, 1, and 2 (P < 0.05) in frequency of detection were found for P. intermedia, Campylobacter concisus, Selenomonas sputigena, and Peptostreptococcus micros at bleeding sites and for Streptococcus sanguis, Actinobacillus actinomycetemcomitans, and B. forsythus (P < 0.001) at non-bleeding sites. Between suppurating and non-suppurating sites, significant differences (P < 0.05) in frequency of isolation were found for P. intermedia, Capnocytophaga ochracea, and A. actinomycetemcomitans at suppurating sites and for F. nucleatum at non-suppurating sites.

Adult↗

[Evaluation of a rapid method for the identification of the Enterococcus genus].

BACKGROUND: The evaluation of the reliability of a group of three tests: pyrrolidonil-arilamidase, rapid test in NaCl esculin broth and group D antistreptococci agglutination for the rapid identification of the Enterococcus genus were performed. METHODS: One hundred fifty-eight strains of streptococci: 110 strains of Enterococcus faecalis, 8 E. faecium, 3 E. avium, 16 Streptococcus intermedius, 7 S. salivarius, 4 S. bovis, 4 S. constellatus, 2 S. sanguis and 1 strain of S. equinus, S. mitis, S. uberis and S. mutans were studied. The tests used were: rapid test in NaCl- esculin broth, pyrrolidonyl-arilamidase and antigroup D streptococcus agglutination (Patho Dx Strep D/PYR; Diagnostic Product Corporation). All catalase-negative gram-positive cocci or coccibacilli which were positive in the three tests were considered to belong to the Enterococcus genus. The usefulness of Gram staining in culture in thioglycolate broth was also studied comparing it with the results obtained with solid medium. RESULTS: The results of the proposed identification scheme were evaluated calculating different parameters: sensitivity 98%, specificity 100%, positive predictive value, 100%, and negative predictive value 94%. No significant differences were observed between the results obtained with Gram staining with thioglycolate broth and those obtained with solid medium except in the case of the Streptococcus mutans strain. CONCLUSIONS: The application of a combination of tests: pyrroidonyl-arilamidase, antistreptococci group D agglutination and rapid test in NaCl-esculin broth to catalase-negative gram-positive cocci and coccobacilli allows reliable identification in a maximum of three hours of strains belonging to the Enterococcus genus.

Bacteriological Techniques↗

Profile of subgingival microbiota in children with mixed dentition.

A diversity of microbial species has been detected in children's oral flora at an early age. To investigate the composition of the subgingival microbiota of different groups of teeth in children with mixed dentition, 40 systemically healthy children, aged 7-8 years, randomly chosen, were examined. Subgingival plaque samples were taken from the mesiobuccal sites of 21, 41, 16 and 36 permanent teeth and 53, 73, 64 and 84 deciduous teeth. The samples were cultured for bacterial isolation anaerobically and in 10% CO2 plus air using selective and nonselective media. Forty-five different microbial species were isolated from both permanent and deciduous teeth. Streptococcus sanguis (79-70%), Streptococcus mitis (66-65%), Prevotella melaninogenica (51-57%), Eikenella corrodens (51-52%), Capnocytophaga gingivalis (46-34%), Capnocytophaga ochracea (45-45%), Actinomyces naeslundii (39-60%) and Prevotella intermedia (42-35%) were among the most frequently detected species in permanent and deciduous teeth respectively. Several suspected periodontal pathogens, such as Porphyromonas gingivalis, Prevotella loescheii, Campylobacter gracilis, Bacteroides forsythus, Campylobacter concisus, Peptostreptococcus micros and Selenomonas sputigena, albeit less frequently detected, were present in the microbiota of these children. The bacterial species Streptococcus constellatus, Peptostreptococcus micros, Pseudoramibacter alactolyticus, E. corrodens and Fusobacterium nucleatum were associated with non-bleeding permanent and deciduous teeth whereas Streptococcus intermedius, C. concisus, P. intermedia and P. loescheii were associated with bleeding.

Actinomyces↗

Antibacterial activity of fifth-generation dentin bonding systems.

Past concepts that the pulp does not become infected until an actual carious exposure takes place have been challenged. The antibacterial effects of the dentin bonding systems Single Bond, Prime&Bond NT, and Excite were evaluated using the bacteria Streptococcus mutans ATCC 25175, Streptococcus intermedius, Lactobacillus acidophilus, Prevotella oris, Prevotella bivia, Prevotella denticola, Porphyromonas gingivalis, Porphyromonas endodontalis, and Clostridium ramosum with a disk diffusion method. Chlorhexidine (0.2%) was used as a positive control. After incubation zones of inhibited bacterial growth were measured. Prime&Bond NT showed growth inhibition for all bacterial strains. Lactobacillus acidophilus and Streptococcus mutans were remarkably resistant to Single Bond, whereas EX produced no inhibitory effect on Porphyromonas endodontalis, although the adhesive produced the maximum halo inhibition to Streptococcus mutans (15+/-1 mm), showing an antibacterial effect closest to chlorhexidine. The variety of results obtained in this study suggest that antibacterial properties of current dentin adhesives may depend on components that are originally incorporated to promote adhesion.

Anti-Infective Agents, Local↗

Pathological fracture of the femur secondary to haematogenous osteomyelitis in a weimaraner.

A seven-year-old male weimaraner developed an acute-onset non-weightbearing pelvic limb lameness without a history of significant trauma. Radiographs demonstrated an oblique fracture of the femur associated with a lytic bone lesion, while cytology and histopathology of the lesion were consistent with osteomyelitis. A pure growth of Streptococcus intermedius was obtained from culture of affected tissue samples. The fracture healed without complication after rigid internal fixation and antibiotic therapy.

Animals↗

Identification of "Streptococcus milleri" group isolates to the species level with a commercially available rapid test system.

Clinical isolates of the "Streptococcus milleri" species group were examined by conventional methods and a rapid, commercially available method for the identification of these strains to the species level. The levels of agreement between the identifications obtained with the commercially available system (Fluo-Card Milleri; KEY Scientific, Round Rock, Tex.) and conventional methods were 98% for 50 Streptococcus anginosus strains, 97% for 31 Streptococcus constellatus strains, and 88% for 17 isolates identified as Streptococcus intermedius. Patient records were also studied in order to gain information on the frequency and sites of isolation of each of the three "S. milleri" group species.

Bacterial Typing Techniques↗

Transverse leukonychia with systemic infection.

Transverse white nail bands (leukonychia) have been described in association with systemic illnesses and exposure to toxins, and medications. We describe the occurrence of transverse nail bands in two patients following acute systemic illnesses. In the first case, transverse white nail bands developed in a 30-year-old human immunodeficiency virus-positive man following acute pulmonary tuberculosis. In the second case, transverse white nail bands were noted in an 80-year-old patient following Streptococcus intermedius empyema.

Acute Disease↗

Species belonging to the "Streptococcus milleri" group: antimicrobial susceptibility and comparative prevalence in significant clinical specimens.

The association between the three species belonging to the "Streptococcus milleri" group and different sites of isolation was examined for 73 successive strains recovered from clinically significant, purulent infections. Susceptibility testing was performed on 64 of these strains. The present study supports the association of particular species with different clinical sources. Susceptibility data suggest that emerging penicillin resistance among Streptococcus anginosus and Streptococcus intermedius isolates may represent a potential clinical problem in the therapeutic management of infections caused by these species.

Anti-Bacterial Agents↗

The isolation and characterization of milleri group streptococci from dental periapical abscesses.

Reports of the isolation of streptococci from dental abscesses have shown an association of the "S. milleri" group with such lesions. There has been considerable confusion regarding the taxonomy of these organisms, but the milleri group has recently been reclassified into three distinct species: Streptococcus anginosus, Streptococcus constellatus, and Streptococcus intermedius. In this study, 45 samples from dental periapical abscesses were examined. Milleri group streptococci were isolated from 16 patients (37%), 15 being identified as S. anginosus and one as S. intermedius. In one patient, S. anginosus was isolated in pure culture, and it would appear that this is the predominant species of milleri group streptococci associated with periapical abscesses.

Adult↗

Profile of subgingival microbiota in children with primary dentition.

Eruption of primary teeth has a great influence on the oral environment by providing suitable niches for bacterial colonization. The aim of the study was to investigate the composition of the subgingival microbiota of primary incisors, canines and molars in 40 systemically healthy children aged 4-5 yr, chosen randomly. Subgingival plaque samples were taken from the mesiobuccal sites of primary incisors (61, 81), canines (53, 73) and molars (64, 84). The samples were cultured for bacterial isolation anaerobically and in 10% CO2 plus air using selective and non-selective media. Forty-one different microbial species were isolated. Gemella morbillorum and Peptostreptococcus magnus were statistically significantly more frequently detected in incisors while P. micros, Streptococcus intermedius, Bacteroides forsythus, Fusobacterium nucleatum, Prevotella loeschei, P. melaninogenica and Selenomonas sputigena were more frequently detected in molars. The bacterial species S. constellatus, G. morbillorum and P. magnus were isolated in greater numbers in incisors and P. micros, S. intermedius, Campylobacter concisus, Bacteroides egertheii, B. forsythus, P. oralis and S. sputigena were isolated in greater numbers in molars, respectively. Cluster analysis revealed 4 clusters in which 6-7 bacterial species were elevated above mean levels. Cluster I was predominated by S. constellatus, S. mitis, S. sanguis, G. morbillorum, P. melaninogenica and P. oralis; cluster II was predominated by S. sanguis, Actinomyces naeslundii, Capnocytophaga gingivalis, C. ochracea and P. intermedia; cluster III was predominated by S. mitis, C. ochracea, F. nucleatum, P. loeschei, P. melaninogenica and P. oralis; and finally cluster IV was predominated by S. sanguis, C. gingivalis, Veillonella parvula, Campylobacter gracilis, F. nucleatum and P. intermedia. The bacterial species S. constellatus, P. micros, Pseudoramibacter alactolyticus, Eikenella corrodens and F. nucleatum were associated with non-bleeding sites while S. intermedius, C. concisus, P. intermedia and P. loescheii were found more frequently in bleeding sites.

Actinomyces↗

Chondroitin sulfate depolymerase and hyaluronidase activities of viridans streptococci determined by a sensitive spectrophotometric assay.

Sensitive spectrophotometric assays for the detection of bacterial chondroitin sulfate depolymerase and hyaluronidase activities were developed by using Stains-all (1-ethyl-2-[3-(1-ethylnaphtho-[1,2-d]thiazolin-2-ylidene)-2- methylpropenyl]naphtho-[1,2-d]thiazolium bromide). Stains-all interacts with hyaluronic acid to produce a shift in the absorption spectrum with a distinct absorption peak between 620 and 660 nm, while chondroitin sulfate interacts to form a distinct shoulder between 440 and 500 nm. Assays measure undegraded substrate. A collection of 110 strains of viridans streptococci, including representatives of all the currently recognized species, was studied. Streptococcus intermedius and S. constellatus degraded hyaluronic acid, while only strains of S. intermedius, primarily isolated from brain and liver abscesses, produced chondroitin sulfate depolymerase. S. intermedius, of all the viridans streptococci, produces the widest range of glycoprotein- and glycosoaminoglycan-degrading enzymes, which may contribute to the virulence of this species.

Chondroitinases and Chondroitin Lyases↗

Clinical, microbiological and immunological characteristics of subjects with "refractory" periodontal disease.

The aim of the present study was to analyze the relationship between attachment loss and clinical, microbiological, and immunological parameters in a group of 21 human subjects exhibiting poor response to previous periodontal therapy. All had been treated with periodontal surgery, tetracycline, and subsequent maintenance recalls to periodontists who, upon detection of disease progression, referred the subjects to our clinic. In our clinic, each subject received oral hygiene instruction and a thorough subgingival scaling and root planing utilizing as many appointments as necessary. Clinical indices, including gingival index, bleeding on probing, suppuration, plaque index, pocket depth, and duplicate measurements of attachment level from an acrylic stent, were collected at monthly intervals. Probing measurements were performed using the Florida Probe. When significant attachment loss (0.8-1.2 mm) was detected in at least 1 site, a bacterial sample was taken from that site and from a comparably deep, but non-progressing, control site. Microbial samples were enumerated by darkfield microscopy, on selective and non-selective media, and by predominant cultivable technique. Blood samples were also collected to determine antibody levels against potential pathogens. There was no difference in the amount of plaque present in sites gaining or losing attachment, but losing sites exhibited more bleeding and suppuration. 20 of the 21 subjects were tested; of these, 17 exhibited elevated serum antibody against one or more of the following microorganisms: Actinobacillus actinomycetemcomitans, Bacteroides, gingivalis, and Eikenella corrodens. However, few, if any, of the "classical" pathogens were detected in the plaque samples obtained at the time progressive disease was diagnosed. The only exception was Streptococcus intermedius, which occurred in slightly higher numbers in active sites.

Actinobacillus↗

Streptococcus MG-intermedius endocarditis.

Subspeciation of penicillin susceptible alpha-hemolytic streptococci is not routinely performed. However, Streptococcus MG-intermedius is an extremely virulent organism in this strep subgroup and is associated with abscess formation. Our patient, who had endocarditis due to this organism, remained chronically ill despite appropriate antibiotic therapy, and had a perforated aneurysm of the sinus of Valsalva with a myocardial abscess that required extensive surgical debridement. Persistent fever in patients with S MG-intermedius endocarditis should warrant further work-up for metastatic or myocardial abscess formation.

Endocarditis, Bacterial↗

Haemagglutinating activities of oral strains of Streptococcus milleri group.

Of a total 148 strains of Streptococcus milleri group, 66 agglutinated sheep erythrocytes. The haemagglutinating strains were confined to serotypes g, h, i, j or were untypeable, and had no Lancefield group antigens (A to G and K), all of which have been shown to belong to Streptococcus intermedius. Cell surface hydrophobicity did not significantly differ even between the agglutinating and non-agglutinating S. intermedius strains. The haemagglutinating activity of strain 0813-1 (serotype i) was partially sensitive to heat (100 degrees C, 30 min) or trypsin (1 mg/ml, 30 min) treatment, but completely lost after the heat and subsequent trypsin treatments. Only L-arginine, L-lysine (100 mM), mucin, and fetuin (1 mg/ml) partially inhibited the haemagglutination with native bacterial cells but completely inhibited that with heated cells, whereas none was inhibitory in the reaction with trypsin-treated cells. The results suggest that at least two haemagglutinins are involved in the agglutination of the S. intermedius strain and that the heat-stable but trypsin-sensitive haemagglutinin recognizes the receptors on the erythrocyte surface which contain L-arginine and L-lysine at the reactive site.

Amino Acids↗

Development of a clindamycin-impregnated fiber as an intracanal medication in endodontic therapy.

The effectiveness of traditional endodontic intracanal medications in reducing bacterial numbers and preventing acute flare-ups and pain continues to be questioned. In the present study, a new local delivery device was developed that releases a substantive dose of clindamycin into root canals. Clindamycin-impregnated ethylene vinyl acetate (EVA) fibers were produced, and the sensitivity of common endodontic microbes to the fibers were established. An in vitro model was developed to persistently infect 32 extracted human teeth with endodontic pathogens to test the efficacy of the clindamycin/EVA fibers in reducing the number of colony-forming units. The clindamycin/EVA fibers were shown to be effective in reducing growth of common endodontic microbes on blood agar plates, and in significantly reducing growth of Prevotella intermedia, Fusobacterium nucleatum, and Streptococcus intermedius in extracted human teeth, thus indicating merit in further exploring the potential of these fibers as intracanal medications.

Anti-Bacterial Agents↗

Five-year analysis of antimicrobial susceptibility of the Streptococcus milleri group.

Susceptibility to 17 antibiotics was studied in 180 strains of the Streptococcus milleri group (88 Streptococcus anginosus, 63 Streptococcus constellatus, and 29 Streptococcus intermedius) isolated over a 5-year period. Minimum inhibitory concentrations of penicillin were in the intermediate range for 5.6% of the strains. Resistance to erythromycin and clindamycin was found in 17.1% and 16.6% of the isolates, respectively. A steady increase in the susceptibility to ciprofloxacin was observed over the study period. Imipenem was the most active beta-lactam agent tested. Glycopeptide antibiotics showed excellent activity. Only slight differences between the three species were found in terms of antibiotic susceptibility. Intermediate resistance to penicillin is appearing among the Streptococcus milleri group in our area; consequently, care must be taken when choosing a macrolide for the management of infections caused by these microorganisms.

Anti-Bacterial Agents↗

Does an intracervical infection influence the fibrinolytic activity and the collagen content of the fetal membranes? A study of ascending infections in pregnant ewes.

Apart from solely mechanical explanations, premature rupture of the membranes (PROM) has been suggested to be caused by an ascending infection. In order to investigate the role of infection in the mechanism of PROM, pregnant ewes were experimentally inoculated endocervically with either Bacteroides fragilis, Streptococcus intermedius or group B streptococci. These microorganisms were previously reported to be implicated in PROM in humans. The present investigation concerns the possible effect of an experimentally induced ascending infection on the collagen content and fibrinolytic activity (FA) of the fetal membranes. No relationship was observed between an ascending infection during pregnancy and the collagen content content of the fetal membrane specimens. It was concluded that changes in the collagen content bear no etiological significance in the mechanism of premature membrane rupture irrespective of an ascending infection's being present or not. Concerning FA in only one case, experiencing a Strept. intermedius amnionitis, was an elevated FA value observed. This finding indicates that the involvement of FA in the process of membrane rupture following ascending infection during pregnancy cannot be ruled out.

Animals↗