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Use of a methylene blue azide medium for isolation of enterococci.

A methylene blue azide medium (MBA), developed by Schaedler, Dubos, and Costello to isolate enterococci from the gastrointestinal tract of animals, was evaluated. This was done by comparing the isolation of enterococci from feces and saliva on the medium. Fifty-two catalase-negative, gram-positive cocci from human feces isolated from MBA were classified as enterococci. All strains grew in S F, 6.5% NaCl, and streptomycin broths, and all fermented mannitol. The isolates were provisionally subdivided into Streptococcus faecalis and S. faecium groups. S. faecalis-like strains fermented glycerol and pyruvate aerobically and produced acid in Snyder's medium (initial pH, 4.8). The S. faecium group fermented raffinose. Among all strains, several tests were variable. These included growth at 45 C, in 0.1% tellurite and in methylene blue milk. Three methods were employed to isolate and identify enterococci from the oral cavity. Direct streaking of MBA with saliva failed to produce any growth on the medium. Two other methods, with the use of various selective broths to promote the recovery of oral enterococci, failed to produce any bacteria capable of growing on MBA. The MBA-isolated fecal strains and oral viridans streptococci were generally indistinguishable on Mitis-Salivarius and K F agars. In experiments with fecal material, no gram-negative bacilli were found among the isolates selected. The MBA medium was judged as a high selectivity-low yield medium, and may provide a means of separating fecal and nonfecal enterococci.

Journal Article↗

Efficiency of various growth media in recovering oral bacterial flora from human dental plaque.

MM10 sucrose blood agar (MM10 SB agar), N(2)C agar, Schaedler agar (SH agar), and mitis salivarius agar (MS agar) were tested for their ability to recover human dental plaque flora by a continuous anaerobic procedure and by a conventional anaerobic method. MM10 SB agar yielded higher recovery of bacteria from plaque samples as determined by the enumeration of colony-forming units (CFU). The CFU on N(2)C agar, SH agar, and MS agar were lower than MM10 SB agar when the continuous anaerobic procedure was used. The superior performance of MM10 SB agar was much more apparent when used for the cultivation of dental plaque by the conventional anaerobic method. Under these conditions the counts were consistently higher on MM10 SB agar as compared to the other media tested. However, the differential counts of Streptococcus sanguis and S. mutans from carious plaque samples were in general comparable on all culture media. Deletion of blood from MM10 SB agar did not lower counts. The elimination of dithiothreitol from this medium resulted in a significantly lower recovery of bacteria from the plaque samples when cultured by the conventional anaerobic method. The storage of MM10 SB agar for varying periods of time aerobic conditions did not seem to affect its performance. These findings suggest that MM10 SB agar is an ideal culture medium for the isolation, nonselective enumeration, and differential counts of bacteria present in normal and disease-associated plaques.

Anaerobiosis↗

Human leukocyte antigens in relation to colonization by mutans streptococci in the oral cavity.

Mutans streptococci are well established as caries-inducing microorganisms in man. Most humans carry the bacteria, but in highly different numbers. This cannot be explained by environmental factors only. The aim of this study was to investigate a possible association between levels of colonization by mutans streptococci and the presence of certain B and DR human leukocyte antigens (HLA). Altogether, 170 subjects who had their HLA antigens determined (76 renal transplant patients and 94 healthy blood donors) were selected for the investigation. Paraffin-stimulated saliva samples were taken using the wooden spatula method with subsequent cultivation of mutans streptococci on mitis salivarius bacitracin agar plates. An association between the absence of HLA-DR 4 antigens and low, or undetectable, levels of mutans streptococci was found. This was statistically significant for the immunosuppressed renal transplant subjects. The same trend was observed among the healthy blood donors.

Adult↗

The predominant cultivable microbiota of active and inactive lesions of destructive periodontal diseases.

Subgingival plaque samples were taken from active and inactive lesions in 33 subjects exhibiting active destructive periodontal diseases. Active diseased sites were those which showed a significant loss of attachment within a 2-month interval as computed by the "tolerance method". The predominant cultivable species from 100 active sites were compared with those found in 150 inactive sites of comparable pocket depth and attachment level loss. Among the 33 subjects, W. recta, B. intermedius, F. nucleatum, B. gingivalis and B. forsythus were elevated more often in active sites; whereas, S. mitis, C. ochracea, S. sanguis II, V. parvula and an unnamed Actinomyces sp. were elevated in inactive sites. The likelihood of a site being active was increased if B. forsythus, B. gingivalis, P. micros, A. actinomycetemcomitans, W. recta, or B. intermedius were detected in that site, and decreased if S. sanguis II, the Actinomyces sp., or C. ochracea were detected.

Actinomyces↗

[Investigation of the bacterial flora in the tonsillar lacunae and serum levels of streptococcal antigen-specific antibodies in patients with pustulosis palmaris et plantaris].

The purpose of this study was to clarify the relationship between bacterial flora in tonsillar lacunae and antistreptococcal antibody in sera of the patients with pustulosis palmaris et plantaris (PPP). Since the pustules develops or worsens after tonsillitis in many patients with PPP, a pathogenic role of tonsillar bacteria is suggested, but no significant association has been proven so far. In this study, the aerobes in the tonsillar lacunae were identified and quantitated in 15 adult patients with PPP and 9 adult patients with chronic tonsillitis (CT). In addition, serum streptococcal antigen-specific antibody levels in 40 adult patients with PPP, 18 adult patients with chronic tonsillitis, and 11 healthy volunteers (controls) were examined by enzyme-linked immunosorbent assay (ELISA). The results were as follows. 1. A total of 53 strains (17 species) of aerobes were isolated and identified from the tonsillar lacunae in patients with PPP, while 35 strains (12 species) of aerobes were found in the patients with CT. 2. S. salivarius and S. pneumoniae were the dominant aerobes isolated from patients with PPP or CT. 3. Although the rates of isolation for Staphylococcus and S. pneumoniae were lower in PPP patients than in CT patients, the rate for S. sanguis I was higher in PPP patients than in CT patients. 4. The percentage of alpha, gamma-streptococci to total aerobes in PPP patients was higher than in CT patients. 5. The IgG antibody titers against S. sanguis and S. mitis, and the IgM antibody titers against all streptococci investigated in PPP patients were higher than those in both CT patients and controls. 6. Moreover, both the IgG antibody titers against S. pyogenes T4 and S. sanguis I and the IgM antibody titers against S. sanguis I and S. sanguis II of the patients in which PPP markedly improved after tonsillectomy were higher than those in which PPP showed less improvement postoperatively.

Adult↗

Penicillin-induced effects on streptomycin uptake and early bactericidal activity differ in viridans group and enterococcal streptococci.

In vitro studies with penicillin and [3H]streptomycin in four strains of streptococci (S. faecalis, S. sanguis, and S. mitis) were performed by simultaneously measuring the rates of bacterial killing and uptake of streptomycin. In S. faecalis, penicillin stimulated streptomycin uptake, as has been shown by Moellering and Weinberg (R. C. Moellering, Jr., and A. N. Weinberg, J. Clin. Invest. 50:2580-2584, 1971). Moreover, the antibiotic combination was associated with an enhanced bactericidal rate which temporally correlated with beta-lactam-induced aminoglycoside uptake. In contrast, in viridans group streptococci (S. sanguis and S. mitis) penicillin had no effect on streptomycin uptake and a minimal effect on bactericidal rate when compared with either drug alone. These data suggested that the stimulation of streptomycin uptake in streptococci by penicillin is strain or species specific and that important differences exist between enterococci and viridans group streptococci regarding the mechanisms of beta-lactam-aminoglycoside potentiation.

Aminoglycosides↗

Chairside decontamination of endodontic files.

Chairside decontamination. of files and reamers is attempted during root canal treatment. The purpose of this study was to evaluate some techniques for reducing the number of microorganisms of artificially contaminated endodontic files. Endodontic files were artificially contaminated with about 10,000 colony-forming units of either B. subtilis spores or S. mitis. The files containing the bacteria were then subjected to various decontamination procedures. Although sterilization was not achieved with any procedure, the bead sterilizer was found to be the most effective decontamination method tested. All gauze wipings showed reductions greater than 90 per cent. It was concluded that wiping with 2 by 2 inch gauze is a highly efficient and practical method of chairside decontamination

1-Propanol↗

Streptococcus viridans septicaemia: a comparison study in patients admitted to the departments of infectious diseases and haematology in a university hospital.

Infective endocarditis caused by viridans streptococci is a well-described disease. Streptococcus viridans is also an important etiologic agent causing septicaemia in neutropenic patients with haematological diseases. In this study we retrospectively reviewed charts from 111 patients with 121 episodes of viridans streptococci septicaemia during the period 1992-97 for clinical data, presence of endocarditis, subtype and outcome. Forty-seven episodes of S. viridans septicaemia were documented in 45 non-neutropenic patients treated at the Department of Infectious Diseases (Group A). Thirty of these episodes were defined as definite and 9 as possible infective endocarditis, using Duke's critera. Seventy-four episodes of S. viridans septicaemia were identified in 66 patients treated at the Department of Haematology (Group B), only 1 of which fulfilled the criteria for possible infective endocarditis. S. sanguis was the most common subtype (18/47; 38%) in Group A and S. mitis was the major subtype (51/74; 69%) in Group B.

Adult↗

In vitro activity of A-16686, a new glycopeptide.

A-16686 is a novel glycopeptide antibiotic derived from Actinoplanes. A-16686 inhibited hemolytic streptococci groups A, B, C, F, and G at concentrations of less than or equal to 0.06 to 0.5 microgram/ml, with 90% inhibited by 0.5 microgram/ml, including erythromycin-resistant isolates. S. bovis, various viridans groups streptococci, S. mitis, S. mutans, and S. sanguis were inhibited by less than or equal to 1 microgram/ml, and MICs of S. faecalis and S. faecium were 0.5-2 micrograms/ml. Most staphylococci, including methicillin-resistant strains, were inhibited by 1 or 2 micrograms/ml. A-16686 was bactericidal with minimal difference between MIC and MBC for gram-positive species. A-16686 did not inhibit Enterobacteriaceae or Pseudomonas.

Anti-Bacterial Agents↗

Differences in the detection and enumeration of mutans streptococci due to differences in methods.

Different methods reported for assessing mutans streptococci (MS) make the direct comparisons of results across studies difficult. To quantitate the variations of MS estimates attributable to differences in method, stimulated and unstimulated saliva samples and oral swab samples were compared with pooled dental-plaque samples. Detection of MS in stimulated saliva samples was in excellent agreement with the presence of MS in pooled plaque samples. MS detection in unstimulated saliva samples, however, was significantly discordant with that in either pooled plaque or oral swab samples. When caries status was used as the criterion of validity of MS estimates, stimulated saliva samples demonstrated a sensitivity (94%) similar to that of pooled plaque samples, but exhibited a lower specificity (11%) than that of pooled plaque samples (17%). As a result, the measure of association between MS and caries was biased (towards null) when MS status was based on stimulated saliva samples. Interestingly though, in enumerating MS, stimulated saliva samples yielded significantly higher levels of MS (about 1.5 log10 increase) with a lower variability compared to unstimulated saliva samples. The use of different culture media for detection of MS gave different results as well. MS detection was poor (kappa = 0.31) and MS levels were lower (p = 0.0001) when samples were grown on glucose-sucrose-potassium tellurite-bacitracin agar compared to mitis-salivarius-bacitracin agar. Together with the relative ease of sampling and processing, these findings collectively justify the use of plaque samples for the qualitative assessment of MS and stimulated saliva samples for the quantitative assessment of MS, while providing a basis for adjustment of estimates when comparing results across studies.

Analysis of Variance↗

Evaluation of the API 20 STREP system for species identification of "viridans" streptococci isolated from bacteremia.

Species identifications of 71 strains of viridans streptococci isolated from blood and 4 reference strains were made by the API 20 STREP system (API system S. A., Montalieu-Vercien, France) and the conventional method. There are high levels of agreement between results obtained with the both methods for determining acidification from carbohydrate except inulin. The API 20 STREP system correctly identified 74.7% of the viridans streptococci with 9.3% low descrimination, 12% incorrect and 4% unidentified. All strains of S. mitis, S. mutans, S. salivarius and S. anginosus-constellatus were correctly identified. The correct identification rates for S. sanguis I, S. sanguis II and S. MG-intermedius were 88.9%, 68% and 61% respectively. The difference of inulin reaction and the taxonomy discrepancy may be the cause of different identification. The study indicates that the API 20 STREP system has a good potentiality for species identification of viridans streptococci at present time, however, further refinement in needed.

Bacteriological Techniques↗

Cross-contamination of the PSP sensor in a preclinical setting.

PURPOSE: This study tested an infection control protocol for photostimulable phosphor (PSP) sensors while simulating multiple uses. METHODS: Dental hygiene students (n=36) were randomly assigned to a control group (dry wipe) or test group (disinfectant wipe). A sterile, barriered sensor was placed in a peer patient's mouth to simulate an exposure. After simulation, the barriered sensors were disinfected, placed into a new barrier, and inserted into the same peer patient's mouth. Following the fourth placement and treatment, sensors were vortexed in specimen cups containing trypticase soy broth (TSB) and incubated at 37 degrees C to detect contamination by oral bacteria. RESULTS: Bacterial growth in TSB was monitored as a change in optical density and by quantitation of oral streptococci on Mitis-salivarius agar. The barrier-protected sensors were minimally contaminated (<10(5) colony forming units/ml at baseline) regardless of treatment. After culture amplification, the control TSB had more samples that remained negative through 48 hours (5/18 vs. 0/18 for test group, p<0.05). CONCLUSION: Barrier envelopes used with the PSP sensors appeared to be an effective way of reducing microbial contamination.

Biphenyl Compounds↗

Bacteriology of viridans streptococcal bacteremia.

In order to assess the species distribution and the antibiotic susceptibility of viridans streptococci in various human infections, we reviewed 164 cases of viridans streptococcal bacteremia seen at the National Taiwan University Hospital between May 1981 and April 1987. The organisms were isolated from 83 patients with endocarditis. Among 81 nonendocarditis patients, only 54 had clinically recognizable foci of suppurative inflammation. Mainly based on API 20 STREP system of species identification, S. sanguis II accounted for 24.4%; S. mitis, 20.7%; S. sanguis I, 20.1%; and S. milleri 2, 11.6% of the 164 cases studied. Of 83 endocarditis patients, 27.7% were S. sanguis I; 21.7%, S. sanguis II; and 16.9%, S. mitis. In nonendocarditis bacteremia with known suppurative lesions, 3 most often isolated organisms were S. sanguis II (24.0%), S. mitis (24.0%), and S. milleri 2 (24.0%). In nonendocarditis bacteremia without suppurative infection, the most frequent isolates were S. sanguis II (33.3%) and S. mitis (25.9%). In terms of relative frequency between endocarditis and nonendocarditis cases, S. mutan, S. sanguis I, and S. bovis had the highest frequency ratio of 7:1, 3.5:1, and 1.5:1, respectively. All isolates were susceptible to penicillin G, ampicillin, and cephalothin. Tetracycline resistance, however, were observed in 35.4% of the isolates; oxacillin resistance, 11.0%; and erythromycin resistance, 9.1%.

Adolescent↗

Retention of oral microorganisms on conventional and resin-modified glass-ionomer cements.

Secondary caries are a worldwide public and socioeconomic problem. The placement of restorations can lead to the development of environmental conditions favorable to microbial colonization, especially on the tooth/restoration interface, which is a predisposing factor for secondary caries. The aim of this study was to evaluate microbial retention on conventional (Chelon-Fil and Vidrion R) and resin-modified (Vitremer and Fuji II LC) glass-ionomer cements, in situ, using a hybrid composite resin (Z100) as a control. Twelve volunteers wore Hawley appliances with specimens made of all tested filling materials for 7 days. The specimens were then removed from the appliances and transferred to tubes containing 2.0 ml of Ringer-PRAS. Microorganisms from the samples were inoculated onto blood agar and Mitis Salivarius Bacitracin agar and incubated under anaerobiosis (90% N2, 10% CO2), at 37 degrees C, for 10 and 2 days, respectively. The resin-modified glass-ionomer cements and the composite resin retained the same levels of microorganisms on their surfaces. The resin-modified glass-ionomers retained less mutans streptococci than the composite resin and conventional glass-ionomer cements. The conventional glass-ionomer cements retained less mutans streptococci than the composite resin, but that difference was not statistically significant.

Adult↗

In vitro adherence of microorganisms to denture base resin with different surface texture.

We examined the effects of various denture base resin surface textures on the adherence of microorganisms. S. sanguis and B. gingivalis adhered in greater amounts to the denture base resin than the other microorganisms tested. As to bacterial adherence according to polishing state, S. oralis, B. gingivalis C-101, and B. intermedius C-001 more adhered to the No. 400 paper-polished surface than to the buff-polished and smoothening-treated surfaces. S. sanguis less adhered to the smoothening-treated surface. S. mitis and C. albicans, on the other hand, more adhered to the smoothening-treated surface. For the other microorganisms tested, no relationship was observed between surface texture and bacterial adherence. The fall-off test revealed no remarkable differences in the fall-off of S. sanguis and B. gingivalis C-101 by the types of surface treatment. However, the fall-off of C. albicans was poorest from the No. 400 paper-polished surface. These results indicate that smoothening the denture base surface is important for denture plaque control.

Bacterial Adhesion↗

Survival of bacteria from human dental plaque under various transport conditions.

The effects of transport media, temperature, and anaerobiosis on the survival of bacteria from human supragingival dental plaque were studied. Individual samples were obtained by passing sterile, unwaxed dental floss through the interproximal spaces. The plaque-bearing portion of floss was immediately placed in vials containing reduced transport fluid, viability-preserving microbistatic medium, or reduced salt solution transport fluid. Plaque samples were dispersed by ultrasonic oscillation, serially diluted, and plated in duplicate on MM10-sucrose-blood agar, mitis salivarius bacitracin agar, and Rogosa tomato juice agar. Initial viable counts (time 0) were compared with viable count determinations after 48- and 72-h storage. Quantitative recovery (>30%) of various groups of oral bacteria was accomplished from both reduced transport fluid and viability-preserving microbistatic medium after 48- and 72-h storage. Storage of dental plaque in reduced salt solution proved unsatisfactory for most bacteria (less than 10% survival). Since growth of some bacteria may occur in viability-preserving microbistatic medium and the charcoal present interferes with colonly enumeration on low-dilution plates, we found reduced transport fluid to be the most suitable medium for transport and recovery of bacteria from supragingival dental plaque. Subzero storage (-196 and -40 degrees C) did not enhance the survival of bacteria from dental plaque; storage at moderate (5 and 20 degrees C) temperatures gave better recovery of viable bacteria. Survival after anaerobic or aerobic storage was comparable for total colony-forming units; however, anaerobic storage enhanced survival of Streptococcus mutans and Lactobacillus. Since these organisms are specifically associated with dental caries, anaerobic techniques are preferred for caries activity testing of plaque.

Aerobiosis↗

Biologically active extracellular products of oral viridans streptococci and the aetiology of Kawasaki disease.

A bacteriological study of isolates from the oral cavity of patients with Kawasaki disease (KD), age-matched non-KD patients and healthy children, showed that over half the KD and control isolates had gram-positive, catalase-negative cocci. About 50% of these organisms were identified as viridans streptococci by means of an API Strep 20 kit. Further identification by fluorometric DNA-DNA hybridisation demonstrated that the predominant species were S. oralis and S. mitis, each of which accounted for 25% of the isolates of viridans streptococci; 40% of viridans strains were unidentifiable; and S. sanguis and S. parasanguis were minor components. Studies in vivo showed that insertion of culture supernates of most of the viridans streptococci increased capillary permeability and induced redness with swelling and occasional bleeding in rabbit skin. One-third of S. mitis strains and one-fifth of the unidentified strains caused aggregation of human blood platelets, whereas S. oralis and other strains had no such effect. The distribution of extracellular lipoteichoic acids and glucan produced in the presence of sucrose was also examined. There were no significant differences in the recovery rate of viridans streptococci forming these biologically active extracellular products between KD and control groups.

Adult↗

Sucrose metabolism by prominent members of the flora isolated from cariogenic and non-cariogenic dental plaques.

Sucrose metabolism by resting-cell suspensions of pure cultures of representative members of the predominant cultivable flora isolated from cariogenic and non-cariogenic dental plaque was investigated by means of radiochemical techniques. Streptocococcus mutans utilized sucrose at a considerably faster rate than S. sanguis, S. mitis, Actinomyces viscosus, A. naeslundii, or Lactobacillus casei, forming lactic acid, intracellular polysaccharide, insoluble extracellular glucan, and lactic acid from intracellular polysaccharide catabolism at faster rates than the other bacteria. The Actinomyces formed more volatile acids than the streptococci, mostly acetic, and S. sanguis formed more soluble extracellular polysaccharide than the other bacteria. The metabolic activity of S. mutans resembled the pattern of sucrose metabolism of cariogenic plaque, whereas the metabolic activity of the Actinomyces species, the predominant members of non-cariogenic plaque flora, resembled the sucrose metabolism of non-cariogenic plaques.

Actinomyces↗