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Cytokine induction by extracellular products of oral viridans group streptococci.

During an etiological study of Kawasaki disease (mucocutaneous lymph node syndrome [MCLS]), we found that dominant viridans streptococcal strains on tooth surfaces and in the throat of both MCLS patients and non-MCLS control children formed erythrogenic and biologically active, extracellular products. In this study, we demonstrated that erythrogenic culture supernatant concentrates of representative strains (two Streptococcus mitis and two Streptococcus oralis), when injected intravenously, induced serum tumor necrosis factor alpha, interleukin-6 (IL-6), and gamma interferon in muramyldipeptide- or Propionibacterium acnes-primed C3H/HeN mice. The concentrates also induced tumor necrosis factor alpha, IL-6, and thymocyte-activating factor (essentially IL-1) in murine peritoneal macrophage, human monocyte, and human whole-blood cultures. An erythrogenic, heat-labile extracellular protein fraction (F-1) that was concentrated from the culture supernatants of a representative S. mitis strain exhibited the above-mentioned cytokine-inducing activity. This partially purified F-1 fraction also induced thymocyte-activating factor and IL-6 in human umbilical vascular endothelial cell and gingival fibroblast cultures.

Animals↗

Antimicrobial susceptibility of viridans group streptococci in Taiwan with an emphasis on the high rates of resistance to penicillin and macrolides in Streptococcus oralis.

The in-vitro susceptibilities of 13 antimicrobial agents were determined for 207 isolates of viridans group streptococci recovered from patients with significant infections in Taiwan during 1995 and 1997. Variable degrees of susceptibility existed among nine species. High-level penicillin resistance (MIC > or = 4.0 mg/L) was found most frequently in Streptococcus oralis (35%), followed by Streptococcus mitis (20%) and Streptococcus salivarius (8%). However, S. salivarius showed the lowest rate of susceptibility to penicillin (50%). Macrolide resistance also occurred most frequently in S. oralis isolates (55%) but in none of Streptococcus mutans. Penicillin and macrolides tended to be less active against isolates recovered from non-invasive sites than against those isolated from invasive sites. Imipenem was the most active beta-lactam against penicillin-resistant isolates. Ofloxacin, vancomycin and teicoplanin showed good in-vitro activity against all isolates, with MIC90s of 2, 1 and 0.25 mg/L, respectively. None of these isolates displayed high-level resistance to gentamicin and most isolates were susceptible to chloramphenicol. These results indicate the species-related variability of susceptibility, especially to penicillin, macrolides and tetracycline. In addition to S. mitis, S. oralis also displayed high rates of resistance to penicillin and macrolides. The difference in susceptibilities between species of viridans streptococci indicates the importance of accurate identification and the need for continuing surveillance of antimicrobial resistance.

Anti-Bacterial Agents↗

Molecular relationships and antimicrobial susceptibilities of viridans group streptococci isolated from blood of neutropenic cancer patients.

From January 1995 to May 1998, 57 episodes of bacteremia due to viridans group streptococci were identified in 50 febrile neutropenic patients with hematologic malignancies. Four patients experienced two separate episodes of streptococcal bacteremia, and one patient had four separate episodes of streptococcal bacteremia. Strains were identified to species level as Streptococcus mitis (n = 37), Streptococcus oralis (n = 19), and Streptococcus salivarius (n = 1). Epidemiologic relatedness of these strains was studied by using PCR-based fingerprinting with M13 and ERIC-2 primers and pulsed-field gel electrophoresis with restriction enzyme SmaI. All strains that were isolated from different patients exhibited unique fingerprint patterns, thus suggesting that viridans group streptococcal bacteremia usually derives from an endogenous source. Cross-transmission of strains between patients could not be established. Four S. mitis isolates recovered during four separate bacteremic episodes in a single patient had identical fingerprint patterns. Susceptibility testing was carried out by broth microdilution technique according to National Committee for Clinical Laboratory Standards guidelines. The MICs at which 90% of the isolates are inhibited were (in milligrams per liter) as follows: 0. 5 (penicillin), 0.5 (amoxicillin), 0.25 (cefotaxime), 2 (chloramphenicol), 4 (erythromycin), 0.5 (clindamycin), >/=32 (tetracycline), >/=32 (trimethoprim-sulfamethoxazole), 4 (ciprofloxacin), 0.5 (sparfloxacin), 0.5 (vancomycin), 0.25 (teicoplanin), and 1 (quinupristin-dalfopristin). High-level penicillin resistance (MIC, >/=4 mg/liter) was found in one isolate only, but intermediate penicillin resistance was noted in 11 isolates (19%). Resistance rates to other drugs were as follows: 7% (amoxicillin), 4% (cefotaxime), 4% (chloramphenicol), 32% (erythromycin), 9% (clindamycin), 39% (tetracycline), 68% (trimethoprim-sulfamethoxazole), 23% (ciprofloxacin), 0% (sparfloxacin), 0% (vancomycin), 0% (teicoplanin), and 0% (quinupristin-dalfopristin).

Adolescent↗

Association of selected bacteria with the lesions of root surface caries.

Plaque from the root surfaces of 165 subjects (mean age 65.5 years, 22-26 teeth/subject) was analysed for specific bacteria. Five subject groups were defined: A (DMFS 16.4), B (DMFS 55.9), C1 (DMFS 55.6), C2 (DMFS 57.0) and C3 (DMFS 48.1). Groups C1 and C2 had unrestored root surface lesions; Group A, B and C3 were free of unrestored root caries and differed in their coronal caries experience. Streptococcus mutans was isolated more frequently from the root lesions in Groups C1 and C2 than from intact root surfaces in Group A. Streptococcus oralis, Streptococcus mitis 1 and Streptococcus sanguis were isolated more frequently from Group A. The percentage contribution that S. mutans made to plaque from lesions in Groups C1 and C2 was higher than that from plaque in Group A and Actinomyces viscosus serovar 2 contributed more to plaque in Group C1 than in samples from Group A. The percentage counts of Lactobacillus in plaque from lesions in Groups C1 and C2 were higher than those from intact roots in Groups A, B, and C3. Subjects were also grouped on the presence of Lactobacillus and S. mutans in plaque samples. Samples with both organisms (n = 17) showed significantly higher isolation frequencies of specific strains of S. mitis 1 and also A. viscosus serovar 2 compared with samples of plaque containing S. mutans or Lactobacillus. Actinomyces naeslundii serovar 1 was not isolated from samples containing both S. mutans and Lactobacillus. The results confirm an association of S. mutans and Lactobacillus with root surface lesions and suggest a relationship between lesions and A. viscosus serovar 2.

Actinomyces↗

Evidence that glucose and sucrose uptake in oral streptococcal bacteria involves independent phosphotransferase and proton-motive force-mediated mechanisms.

Sugar transport and glycolysis in Streptococcus sanguis NCTC 7865, Streptococcus mitis ATCC 903, Streptococcus salivarius NCTC 8606 and several strains of Streptococcus mutans were investigated by following the rate of acid production by washed bacteria at a constant pH of 7.0. The phosphoenolpyruvate-phosphotransferase system (PTS) was inhibited by low concentrations of chlorhexidine. When this PTS-inhibitory concentration of chlorhexidine was added to cells washed and re-suspended in KCl, glucose uptake and glycolysis continued at a greatly-reduced rate. Chlorhexidine abolished glucose and sucrose uptake and metabolism in bacteria washed and incubated in saline. The Na+-inhibition was reproduced in KCl-washed bacteria using the cyclic peptide ionophores, valinomycin and gramicidin, to dissipate K+ and H+ gradients across the cell membrane. Glucose metabolism by Strep. mutans B13 was more resistant to chlorhexidine than that of Strep. mutans NCTC 10449 or Strep. sanguis but was more sensitive to the ionophores. Valinomycin had a greater inhibitory effect on strain B13 than the other two. That ion gradients are important in the chlorhexidine-resistant glucose-uptake mechanism was confirmed using the classical uncoupling agents, carbonylcyanide-m-chlorophenylhydrazone, 2,4-dinitrophenol and KSCN. Glucose metabolism was inhibited in the presence of both the uncouplers and the PTS-inhibitory concentration of chlorhexidine and significant inhibition was also observed in the absence of the PTS inhibitor. Lactate or the ATPase inhibitor, dicyclohexyl carbodiimide (DCCD), had similar inhibitory effects on the non-PTS uptake system.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphatases↗

An evaluation of the action of different root canal irrigants on facultative aerobic-anaerobic, obligate anaerobic, and microaerophilic bacteria.

The aim of this study was to test the effect of different concentrations of sodium hypochlorite, chlorhexidine, and cetrimide on the following bacterial strains: Facultative aerobes-anaerobes: Candida albicans ATCC 10231; Enterococcus faecalis ATCC 29212; Escherichia coli ATCC 25,922; Pseudomonas aeruginosa ATCC 27,853; Streptococcus mitis ATCC 9811; Streptococcus mutans ATCC 35668; Streptococcus salivarius ATCC 13419; and Streptococcus sanguis ATCC 10556. Microaerophiles: Actinobacillus actinomycetemcomitans ATCC 29522. Obligate anaerobes: Actinomyces odontolyticus ATCC 17929; Fusobacterium nucleatum ATCC 25,586; Porphyromonas gingivalis ATCC 33277; and Prevotella melaninogenica ATCC 25845. Each irrigant was kept in contact with the bacterial species used for the experiment for 10, 20, or 30 min. Results showed that all irrigants had a bactericidal effect on both facultative aerobes-anaerobes and on microaerophilic and obligate anaerobic strains, in all concentrations and even after short periods of contact.

Anti-Infective Agents, Local↗

Utilization and acid production of beta-galactosyllactose by oral streptococci and human dental plaque.

Beta-galactosyllactose is a trisaccharide containing the beta-galactosidic linkage at the nonreducing end. The purpose of this study was to determine whether certain oral streptococci could utilize four kinds of beta-galactosyllactoses. Three of four beta-galactosyllactoses were unable to support growth of the oral streptococci and to be a substrate for producing acid from the cell suspensions and dental plaque. 4'-beta-Galactosyllactose supported growth of Streptococcus sanguis ATCC 35105, ATCC 49298, Streptococcus mitis ATCC 15914, Streptococcus oralis ATCC 35037, ATCC 10557 and Streptococcus milleri 10707 and produced acid from dental plaque. Although beta-galactosidase activities were observed in all the strains, 4'-beta-galactosyllactose could not be used as a carbon source for the growth of mutans streptococci. Enzymes metabolizing 4'-beta-galactosyllactose were induced when S. oralis ATCC 10557 was cultured in medium containing galactose. These results suggested that 4'-beta-galactosyllactose could be as cariogenic as lactose if it is consumed frequently and retained for a long period in the mouth.

Acids↗

A retrospective investigation of advanced periodontal disease as a risk factor for septicemia in hematopoietic stem cell and bone marrow transplant recipients.

OBJECTIVE: Septicemia is a cause of death in hematopoietic stem cell transplant (HSCT) recipients. Extraction of teeth with advanced periodontitis has been advocated before HSCT to prevent septicemia in myeloablated hosts. The primary aim of the present study was to determine impact of chronic periodontitis, as measured by radiographic alveolar bone loss, on septicemia and transplant mortality. STUDY DESIGN: A retrospective design was used to study 77 subjects who received pretransplant dental evaluation, panoramic radiography, and full myeloablative allogeneic HSCT to treat hematologic malignancies. Radiographic crestal alveolar bone loss was measured with a Schei ruler on all teeth. Microorganisms isolated from positive blood cultures within the first 100 days after transplant were categorized as of likely origin from periodontal, oral, or any body sites. Spearman correlation and logistic regression analysis assessed associations between positive blood cultures, mean subject whole-mouth percent radiographic crestal alveolar bone loss, and 100-day survival. RESULTS: Radiographic crestal alveolar bone loss per study subject averaged 13% +/- 7%, with 18.2% exhibiting bone loss of 20% or greater. During the initial 100 days after transplant, 63.6% subjects yielded septicemia-associated positive blood cultures, with Staphylococcus epidermidis, Streptococcus mitis, Enterococcus faecalis, Streptococcus sanguis, Staphylococcus aureus, and Escherichia coli as the most common isolates recovered. No statistically significant associations were found between mean subject radiographic alveolar bone loss and septicemia of likely periodontal or oral origin. CONCLUSION: In this preliminary study, no relationship was found between radiographic periodontal status and septicemia or mortality within the initial 100 days after transplant. A larger-sized, prospective study is warranted to further delineate the risk of septicemia from periodontal and other oral diseases in immunocompromised patients.

Adult↗

Expression of the short fimbriae of Porphyromonas gingivalis is regulated in oral bacterial consortia.

The Mfa1 protein of Porphyromonas gingivalis is the structural subunit of the short fimbriae and mediates coadhesion between P. gingivalis and Streptococcus gordonii. We utilized a promoter-lacZ reporter construct to examine the regulation of mfa1 expression in consortia with common oral plaque bacteria. Promoter activity of mfa1 was inhibited by S. gordonii, Streptococcus sanguinis and Streptococcus mitis. In contrast, Streptococcus mutans, Streptococcus cristatus, Actinomyces naeslundii, Actinobacillus actinomycetemcomitans and Fusobacterium nucleatum did not affect mfa1 expression. Expression of SspA/B, the streptococcal receptor for Mfa1, was not required for regulation of mfa1 promoter activity. Proteinaceous molecule(s) in oral streptococci may be responsible for regulation of Mfa1 expression. Porphyromonas gingivalis is capable of detecting heterologous organisms, and responds to selected organisms by specific gene regulation.

Actinomyces↗

In vitro activities of fluoroquinolones against antibiotic-resistant blood culture isolates of viridans group streptococci from across Canada.

Among 418 blood culture isolates of viridans group streptococci obtained between 1995 and 1997, the in vitro rates of nonsusceptibility to penicillin, erythromycin, tetracycline, and trimethoprim-sulfamethoxazole were 28, 29, 24, and 14%, respectively. The most prevalent group (125 strains) was Streptococcus mitis, followed by Streptococcus sanguis (56 strains). For 236 (56%) strains resistant to one or more antibiotics, the ciprofloxacin MIC at which 90% of the isolates were inhibited (MIC(90)) was 4 microg/ml, whereas the MIC(90)s of trovafloxacin, grepafloxacin, and gatifloxacin were 0.25 microg/ml.

Anti-Infective Agents↗

Cumulative correlations of lysozyme, lactoferrin, peroxidase, S-IgA, amylase, and total protein concentrations with adherence of oral viridans streptococci to microplates coated with human saliva.

Redundancy refers to the observation that many salivary proteins exhibit similar properties in vitro. It is possible that bacterial adherence to salivary pellicle occurs as a cumulative effect of multiple proteins. This study determined the joint and individual contributions of salivary amylase, S-IgA, lysozyme, salivary peroxidase, lactoferrin, and total protein concentrations to adherence by oral viridans streptococci in microplates coated with whole saliva from 123 persons. Strains used were: Streptococcus gordonii Blackburn, 10558, Streptococcus mitis 10712, 903, Streptococcus oralis 10557, 9811, and Streptococcus sanguis 10556, 13379. Rabbit antibody against 13379 was used for the detection of adherence. This antibody cross-reacted with all strains. Absorbance was standardized against saliva pooled from five donors. All saliva samples had been previously assayed for amylase, lactoferrin, lysozyme, secretory IgA, peroxidase, and total protein. Adherence scores for all strains except 13379 were significantly and positively correlated. Salivas binding high or low levels of one strain tended to bind others correspondingly. Multiple regression indicated significant contributions to 10558 adherence from total protein and lactoferrin (positive), and peroxidase and lysozyme (negative). Similar results were obtained for Blackburn and 903. Significant individual correlations were seen for 9811 and total protein (positive), 10557 and peroxidase (negative), and 13379 and lactoferrin (negative). Salivas with high adherence scores contained significantly more protein and lactoferrin, and significantly less peroxidase, than salivas with low adherence scores. These findings support the hypothesis that multiple proteins contribute to the adherence of streptococcal strains in vivo.

Amylases↗

Study of viridans streptococci and Staphylococcus species in cleft lip and palate patients before and after surgery.

OBJECTIVE: To determine the effect of surgery on types and colony count of Streptococcus and Staphylococcus species in cleft lip and palate (CLP) patients. DESIGN: Saliva samples were collected after the morning meal by placing a sterile cotton swab in the vestibule of the oral cavity from cleft lip and palate patients immediately preoperative and 12 weeks postoperative. Normal children were examined as a control group. Samples were cultured; Staphylococcus and Streptococcus isolates were identified and quantified. PATIENTS: Fifteen cleft lip and palate patients and 22 normal children, aged 3 to 39 months were examined. RESULTS: Streptococcus mitis biovar 1, Streptococcus salivarius and Streptococcus oralis of the viridans group of streptococci were the most commonly found in normal children, as well as in cleft lip and palate children. In the cleft lip and palate group, mean streptococcal count was 32.41 (29.80) and 46.46 (42.80) in the pre- and postoperative periods, respectively; in the normal group, the count was 20.93 (27.93) and 49.92 (34.72) at 0 week and 12 weeks, respectively. Staphylococcus aureus was the most common Staphylococcus species found in CLP patients, representing 47.4% postoperatively. In the cleft lip and palate children, mean staphylococcal count was 5.34 (8.13) and 0.56 (0.92) in the pre- and postoperative periods, respectively; in normal children, the count was 0.82 (1.98) and 0.60 (2.55) at 0 and 12 weeks, respectively. The differences were statistically significant only for the staphylococcal count between pre- and postoperative periods in children with cleft lip and palate as tested by analysis of variance (p < .05). CONCLUSIONS: Cleft lip and palate patients had more colonization by S. aureus compared with normal children, and the colony count decreased significantly following surgical repair of the cleft lip and palate.

Analysis of Variance↗

[Alpha-hemolytic streptococci and root canal irrigants. An evaluation of the bactericidal efficacy of sodium hypochlorite and chlorhexidine gluconate plus cetrimide].

BACKGROUND AND AIMS: The main bacterial species present in pulpal and periapical microbic flora is alpha-hemolytic streptococci. They are regarded as facultative anaerobes which prefer to grow in anaerobiosis. Canal irrigation plays an important role in the success of endodontic treatment given that, on the one hand, it encourages the gradual elimination of the smear layer, and on the other it neutralises microbic flora in the root canal. The aim of this study was to test the microbiological efficacy of sodium hypochlorite 1% and s new generation irrigant based on chlorhexidine 0.2% and cetrimide 0.2%. METHODS: The test was performed on the following alpha-hemolytic streptococci bacteria (Dasit, Cornaredo, Italy): Streptococcus mitis ATCC 9811; Streptococcus mutans ATCC 35668; Streptococcus salivarius ATCC 13419; Streptococcus sanguis ATCC 10556. The working concentration (CFU/ml) was defined as 0.5 Mc Farland which corresponds to a concentration of microorganisms of approximately 1.5 x 10(8) bacteria. The following canal irrigants were used: 1) cetrimide 0.2% + chlorhexidine 0.2% (Cetrexidin Vebas, S. Giuliano Milanese, Italy); 2) NaOCl 1% (Ogna, Milan, Italy). Each individual substance remained in contact with the bacterial species used in the test for 10'-20'-30'. RESULTS: The results obtained show the bactericidal efficacy of both the irrigants used, even after a short period of contact. CONCLUSIONS: This does not mean that all irrigants are equal and/or promise the same results. This was a microbiological study, but it is nonetheless important to take other variables into account, such as contact time. Moreover, in order to increase the probabilities for the success of endodontic treatment, canal irrigants must also present other characteristics, namely: biocompatibility, scarce toxicity, high proteolytic power.

Anti-Bacterial Agents↗

Comparison of the initial streptococcal microflora on dental enamel in caries-active and in caries-inactive individuals.

This study compared the initial (4 h) microflora on enamel in 7 caries-active and in 7 caries-inactive adolescents. In both groups the microflora was dominated by streptococci which comprised 61 and 78% (median values) of the total viable counts in caries-active and caries-inactive individuals, respectively (p less than 0.01). Identification of a total of 700 streptococcal isolates according to a recently revised classification showed that the predominant streptococci belonged to the species Streptococcus oralis, Streptococcus mitis biovar 1, and Streptococcus sanguis. Early plaque from caries-inactive individuals differed from that of caries-active individuals by significantly higher proportions of S. sanguis (p less than 0.05) and IgA1 protease producing streptococci (p less than 0.05). In caries-active individuals, there was a tendency to elevated levels of S. mitis biovar 1 (p less than 0.10). In addition, caries-active individuals were colonized by significantly higher numbers of mutans streptococci on the enamel surfaces (p less than 0.01). However, in both groups Streptococcus mutans (serotype c) comprised less than or equal to 2% of the early streptococcal flora. Streptococcus gordonii, S. mitis biovar 2, and Streptococcus salivarius were present in low proportions and did not show differences in distribution that could be related to caries activity. The observed differences in the composition of the early streptococcal microflora may be a factor that governs the eventual cariogenic potential of dental plaque.

Adolescent↗

Peptide utilization by oral streptococci.

Streptococcus mitis ATCC 903 and Streptococcus sanguis 804 could utilize large peptides present in proteose peptone as their sole source of nitrogen but grew poorly in amino acid medium. By contrast, Streptococcus mutans BHT and S. mutans IB grew in amino acid medium but could not utilize large peptides. Streptococcus sp. strain Bravato had requirements for both peptides and amino acids. Peptide size did not seem important for the utilization of peptides by S. mitis except that dipeptides were not utilized. Large peptides were essential for depressed hyaluronidase synthesis in nongrowing S. mitis. Intracellular aminopeptidase activities were high in S. mitis ATCC 903 and Streptococcus sp. strain Bravato, intermediate in S. sanguis 804, and low in S. mutans BHT and S. mutans IB.

Aminopeptidases↗

A comparison between the elemental surface compositions and electrokinetic properties of oral streptococci with and without adsorbed salivary constituents.

In order to characterize the functional cell surface, isoelectric points and elemental surface concentration, the ratios of nitrogen, oxygen and phosphorus to carbon of saliva-coated strains were determined by pH-dependent zeta potential measurements and X-ray photoelectron spectroscopy and compared with those of uncoated strains. The measurements of potential were carried out on completely hydrated cells, whereas the spectroscopy was on freeze-dried micro-organisms. The small increase in the nitrogen:carbon surface concentration ratio of saliva-coated streptococci in comparison to uncoated strains varied from 0.001 (Streptococcus mitis BA) to 0.029 (Streptococcus sanguis CH3) and was concurrent with an increase of the isoelectric point, ranging from 0.0 to 0.9. Increases in the oxygen:carbon ratio ranged from 0.006 (Strep. mitis BA) to 0.041 (Streptococcus mutans NS), whereas the phosphorus:carbon surface concentration ratio was unchanged after saliva treatment. Despite the fact that isoelectric and compositional measurements were made in different states of surface hydration, a decrease in the nitrogen:carbon ratio accompanied by an increase in oxygen:carbon ratio, was related to a decrease of the isoelectric point of the saliva-coated strains, and so analogous with previous observations for uncoated strains. Although there were changes in the physico-chemical properties of the strains upon saliva coating, all more or less kept their own surface identity despite adsorption of salivary constituents, possibly indicating some capacity to protect their own physico-chemical identity.

Adsorption↗

Identification of clinically relevant viridans streptococci by analysis of transfer DNA intergenic spacer length polymorphism.

The utility of PCR analysis of transfer DNA intergenic spacer length polymorphism (tDNA-ILP) for the identification to the species level of clinically relevant viridans streptococci was evaluated with a collection of reference strains of 15 species of the salivarius, anginosus, mitis and mutans rRNA homology groups. PCR products generated by using fluorescent, outwardly directed, consensus tDNA primers were analysed by electrophoresis on denaturating polyacrylamide gels and by laser fluorescence scanning. Eleven species showed specific and distinct tDNA patterns: Streptococcus cristatus, Streptococcus gordonii, Streptococcus oralis, Streptococcus mitis, Streptococcus pneumoniae, Streptococcus sanguinis, Streptococcus parasanguinis, Streptococcus anginosus, Streptococcus mutans, Streptococcus criceti and Streptococcus ratti. Indistinguishable patterns were obtained among two groups of species: Streptococcus vestibularis and Streptococcus salivarius on the one hand and Streptococcus constellatus and Streptococcus intermedius on the other. S. mitis strains produced heterogeneous patterns that could be separated into three groups: a group containing S. mitis biovar 1 and two S. mitis biovar 2 groups, one of which clustered with S. parasanguinis strains while the other showed patterns unrelated to other species. These results agree in part with protein electrophoretic analysis showing that S. mitis biovar 2 strains belong to several streptococcal taxa. In conclusion, PCR analysis of tDNA-ILP holds promise for rapid identification of viridans streptococci that are difficult to identify by phenotypic tests.

Bacterial Typing Techniques↗

Ecology of viridans streptococci in the oral cavity and pharynx.

Recently published taxonomic studies of viridans streptococci have resulted in several changes in the nomenclature and definition of oral streptococcal species. With this background, the ecology of streptococci in the oropharyngeal cavities was reinvestigated. The results based on the examination of 1426 streptococcal isolates confirmed and extended earlier findings. Apart from mature supragingival plaque, which contained a mixture of all orally encountered streptococci, each site showed a characteristic streptococcal flora. Initial dental plaque formation is primarily associated with Streptococcus sanguis, Streptococcus mitis biovar 1 and Streptococcus oralis. Our investigation showed that S. sanguis and S. mitis biovar 1 were the most prominent streptococci, also on buccal mucosa. In contrast, S. oralis was almost exclusively found in initial dental plaque. Streptococcus gordonii, formerly part of S. sanguis, was found in small numbers on the oropharyngeal mucosa and in mature supragingival plaque. The dorsum of the tongue was dominated by S. mitis biovar 2 and Streptococcus salivarius, the latter of which was predominant also on the pharyngeal mucosa. Streptococcus anginosus was by far the most predominant streptococcus in subgingival plaque. Immunoglobulin A1 (IgA1) protease-producing streptococci were primarily isolated from initial dental plaque and from the buccal mucosa. This lends further support to the concept of IgA1 proteases being important for the ability of streptococci to evade the local immune defence during their initial colonization of certain oral surfaces.

Adult↗