Pathogens In Oral Cavity Research Articles

MANAGEMENT OF CORNEAL ULCER PRESENTED WITH RARE PATHOGEN : STREPTOCOCCUS MITIS

Introduction : Corneal ulcers can arise from various corneal diseases, including infections, inflammation, and autoimmune disease. Staphylococcus aureus is the most common bacterial pathogen, but lesser- known bacteria like Streptococcus mitis can also cause corneal ulcers. Accurate diagnosis and treatment are essential to prevent vision loss and complications.
 Case Illustration : A 19-year-old female patient presented with a chief complaint of white spots on her right eye for three months. Previously, her right eye was hit by a foreign object and subsequently, the patient experienced redness and pain in the affected eye. One week later, white spot appeared in the patient's eye and reported to enlarge in the last month. The patient also complained of pain, blurry vision with visual acuity of 1/300, redness, glare, and a foreign body sensation. Corneal swab culture discovered Streptococcus mitis to be the causative agent. The patients was given hourly drop of topical levofloxacin. One month after initial treatment, patient’s symptoms was improving with visual acuity of 6/60 on her affected eye and the ulcer was healed.
 Discussion : Streptococcus mitis is a commensal pathogen in oral cavity and not normally cause infection of ocular tissue. It may cause ulcer due to prolonged use of topical steroid and previous ocular trauma, since Streptococcus mitis had low virulence rate.
 Conclusion : Corneal scraping culture should be carried out before treatment of infectious corneal ulcer. Streptococcus mitis is considered rare for corneal ulcer pathogen. Topical quinolones are the first- line drug for bacterial corneal ulcer and worked exceptional for wide range of bacteria.

Beneficial modulation of human health in the oral cavity and beyond using bacteriocin-like inhibitory substance-producing streptococcal probiotics.

The human oral cavity contains a diversity of microbial habitats that have been adopted and adapted to as homeland by an amazingly heterogeneous population of microorganisms collectively referred to as the oral microbiota. These microbes generally co-habit in harmonious homeostasis. However, under conditions of imposed stress, as with changes to the host's physiology or nutritional status, or as a response to foreign microbial or antimicrobial incursions, some components of the oral "microbiome" (viz. the in situ microbiota) may enter a dysbiotic state. This microbiome dysbiosis can manifest in a variety of guises including streptococcal sore throats, dental caries, oral thrush, halitosis and periodontal disease. Most of the strategies currently available for the management or treatment of microbial diseases of the oral cavity focus on the repetitive "broad sweep" and short-term culling of oral microbe populations, hopefully including the perceived principal pathogens. Both physical and chemical techniques are used. However, the application of more focused approaches to the harnessing or elimination of key oral cavity pathogens is now feasible through the use of probiotic strains that are naturally adapted for oral cavity colonization and also are equipped to produce anti-competitor molecules such as the bacteriocins and bacteriocin-like inhibitory substances (viz BLIS). Some of these probiotics are capable of suppressing the proliferation of a variety of recognized microbial pathogens of the human mouth, thereby assisting with the restoration of oral microbiome homeostasis. BLIS K12 and BLIS M18, the progenitors of the BLIS-producing oral probiotics, are members of the human oral cavity commensal species Streptococcus salivarius. More recently however, a number of other streptococcal and some non-streptococcal candidate oral probiotics have also been promoted. What is becoming increasingly apparent is that the future for oral probiotic applications will probably extend well beyond the attempted limitation of the direct pathological consequences of oral microbiome dysbiosis to also encompass a plethora of systemic diseases and disorders of the human host. The background to and the evolving prospects for the beneficial modulation of the oral microbiome via the application of BLIS-producing S. salivarius probiotics comprises the principal focus of the present review.

In Vitro Activity of Octenidine Dihydrochloride-Containing Lozenges against Biofilm-Forming Pathogens of Oral Cavity and Throat

The disruption of the balance in the composition of oral and throat microbiota due to overgrowth of infectious biofilms may lead not only to severe infections, but also to serious, systemic complications resulting in a permanent loss of health or even in the death of the patient. Therefore, a number of hygienic measures are applied to counter-act such a threat, including the provision of locally active antiseptic agents. In this work, the antimicrobial activity of a well-established drug, octenidine dihydrochloride, in a new formulation of lozenges toward the biofilms formed in vitro by Staphylococcus aureus, Streptococcus pyogenes, Candida albicans, Pseudomonas aeruginosa and Aggregatibacter actinomycetemcomitans was assessed. The metabolic activity and quantitative culturing were performed and also scanning electron and confocal microscopies with regard to these biofilms exposed to the activity of octenidine in lozenges vs. a comparator (octenidine dihydrochloride dissolved in liquid). Biofilms were cultured in different experimental settings, including one in which hydroxyapatite served as the biofilm growth surface and using artificial saliva as the biofilm milieu. The obtained results indicated that the tested formulation of octenidine-containing lozenges displayed a high efficacy towards the analyzed biofilms, regardless of the in vitro setting applied. The current work is of a strictly in vitro nature, and the analyses were performed on reference microbial strains and not on the spectrum of clinical strains. Nevertheless, considering the fact that the time of exposition of biofilm to the octenidine released from the lozenge is significantly longer than the contact time of an antiseptic dissolved in liquid also tested in this study, it can be assumed that stable carriers of octenidine may find its broad application in the maintenance of oral and throat hygiene and the eradication of biofilm-based infections.

Assessment of potential antimicrobial activity of Ocimum basilicum extract and chlorhexidine against Socransky's complex pathogens of oral cavity: An in vitro study.

Periodontitis is a multifactorial disease initiated by periodontal pathogens and progresses further in destruction of periodontium. Hence, the objective of this study was to test the efficacy of Ocimum basilicum seeds extract on periodontal pathogens. O. basilicum seeds were authenticated from a recognized taxonomist. They were coarsely powdered; ethanol-based extract preparation was done by the Soxhlet method and aqueous-based extract by hot infusion procedure. Extracts so obtained were assessed for minimum inhibitory concentration, minimum bactericidal concentration, zone of inhibition, and time-kill assay of O. basilicum seeds extract on periodontal pathogens, and comparatively evaluated the effectiveness against 0.12% chlorhexidine (CHX) gluconate in triplicates. Kruskal-Wallis Test was employed wherein the statistical significance was set at P ≤ 0.05. The concentration of O. basilicum ethanolic extract against periodontal pathogens was determined to be 10 mg/ml, whereas 4.7 mg/ml of aqueous extract was proven effective against periodontal pathogens. Similarly, aqueous extract of O. basilicum developed a wider zone against periodontal pathogens compared to ethanol-based O. basilicum extract. Statistically significant difference found in the effectiveness between both extract and CHX. The antibacterial activity was evident in both the extracts of O. basilicum against anaerobic periodontal pathogens. However, it was more pronounced in aqueous extract, but lower compared to CHX.

A RARE CASE OF NATIVE TRIPLE-VALVE INFECTIVE ENDOCARDITIS

SESSION TITLE: Medical Student/Resident Cardiovascular Disease Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: Infective endocarditis (IE) is a life-threatening infection. Despite medical advances, mortality from IE remains high. Enterococcal IE is becoming more prevalent in elderly patients with degenerative valvular disease and bloodstream infections from gastrointestinal (GI) or genitourinary (GU) tracts. We present a rare case of native triple-valve infective endocarditis. CASE PRESENTATION: A 58-year-old man with a history of squamous cell carcinoma of tongue post hemiglossectomy with chemoradiation therapy and small bowel obstruction post open laparotomy a month earlier presented for altered mental status. Initial vitals showed tachycardia and was otherwise normal. Positive examination findings were cachexia, a healed partial tongue resection, decreased air entry over lung bases and left upper abdominal tenderness without peritonitis. The rest of the physical exam was unremarkable. Initial lab results were significant for leukocytosis, mild anemia, elevated BUN and creatinine. Computed tomography (CT) of chest and abdomen showed a large left lower lobe consolidation, right lower lobe patchy parenchymal disease and gastric wall thickening. He was started empirically on Zosyn, vancomycin and fluconazole. Blood cultures grew Enterococcus faecalis and transthoracic echocardiogram (echo) showed an acute-on-subacute endocarditis with vegetations on the tricuspid, mitral and aortic valves with ejection fraction 65-70%. Bronchoscopy with bronchoalveolar lavage (BAL) culture was positive for Candida Glabrata 3 days after his death. He later developed septic shock with multiorgan failure and was considered ineligible for surgery. Despite optimal medical therapy and no worsening of echo findings, he ultimately died. DISCUSSION: Multivalvular IE increases the likelihood of complications from congestive heart failure, acute renal failure, embolic events, disseminated intravascular anticoagulation and death (1). Enterococcus faecalis is an opportunistic pathogen in oral cavity, the GI and GU tracts. Manipulation of the GI and GU tracts, cancer and previous treatment with antibiotics increase the risk of enterococcal bacteremia. Our patient’s overall immunocompromised state and recent surgical intervention placed him at higher risk of Enterococcus faecalis infection. Enterococcus faecalis bacteremia is a common cause of IE that has had no survival improvement in the past decade (2). Ultimately, his BAL culture was positive for Candida glabrata, which if resulted in fungemia, could be complicated by a rare but aggressive form of IE with a mortality rate of 80% requiring both medical and early surgical intervention (3). CONCLUSIONS: Triple valve endocarditis is rare with few studies in literature to guide the best management. Further research is necessary to identify patients at increased risk of multivalve IE, in regards to optimal screening methods to facilitate early detection and therapy. Reference #1: Kim, N., Lazar, J., Cunha, B., Liao, W., & Minnaganti, V. (2000). Multi-valvular endocarditis. Clinical Microbiology and Infection, 6(4), 207–212. doi: 10.1046/j.1469- 0691.2000.00065.x Reference #2: Dahl, A., Rasmussen, R. V., Bundgaard, H., et al. (2013). Enterococcus faecalis Infective Endocarditis. Circulation, 127(17), 1810–1817. doi: 10.1161/circulationaha.112.001170 Reference #3: Baddley, J. W., Benjamin, D. K., et al. (2008). Candida infective endocarditis. European Journal of Clinical Microbiology & Infectious Diseases, 27(7), 519–529. doi: 10.1007/s10096-008-0466-x DISCLOSURES: No relevant relationships by Sahai Donaldson, source=Web Response No relevant relationships by Lorenzo Leys, source=Web Response No relevant relationships by Alem Mehari, source=Web Response No relevant relationships by Lamiaa Rougui, source=Web Response

An Evaluation of Norspermidine on Anti-fungal Effect on Mature Candida albicans Biofilms and Angiogenesis Potential of Dental Pulp Stem Cells.

Norspermidine (Nspd) is a kind of polyamine molecule, which is common in eukaryotes and prokaryotes. It has been reported as a potential anti-biofilms agent of bacteria, but its anti-fungal effect remains unclear. Candida albicans (C. albicans) is a common opportunistic pathogen in oral cavity of human beings. C. albicans biofilm is often seen in dental caries. In this work, we aimed to study the effect of Nspd on mature Candida albicans biofilms and to investigate how Nspd would influence human dental pulp stem cells (DPSCs). Our biofilm assays indicated that 111.7 and 55.9 mM Nspd dispersed 48 h mature fungal biofilms and showed significant fungicidal effect. 27.9 and 14.0 mM Nspd showed moderate fungicidal effect. Live/dead staining echoed the fungicidal effect. 111.7–14.0 mM Nspd showed a dose- inhibitory effect on mature fungal biofilm, where 14.0 mM Nspd reduced the metabolic activity by half compared with blank control. Moreover, we demonstrated that 111.7–27.9 mM Nspd restrained the production of hyphae form of C. albicans via SEM. Low dose Nspd (27.9 and 14.0 mM) could significantly reduce virulence related gene expression in C. albicans biofilms. MTT assay displayed a dose effect relation between 2.5–0.08 mM Nspd and DPSCs viability, where 0.63 mM Nspd reduced the viable level of DPSCs to 75% compared with blank control. Live/dead staining of DPSCs did not show distinctive difference between 0.63 mM Nspd and blank control. Vascular differentiation assay showed capillary-like structure of inducted DPSCs culture with and without 0.63 mM Nspd suggesting that it did not significantly affect angiogenic differentiation of DPSCs. Nspd can penetrate remaining dentin at low level, which is confirmed by an in vitro caries model. In conclusion, our study indicated high dosage Nspd (111.7 and 55.9 mM) could effectively disrupt and kill mature fungal biofilms. Low dosage (27.9 and 14.0 mM) showed mild anti-fungal effect on mature C. albicans biofilms. Human DPSCs were tolerate to 0.08–0.63 mM Nspd, where viability was over 75%. 0.63 mM Nspd did not affect the proliferation and angiogenetic differentiation of DPSCs.

Effectiveness of coconut oil pulling as an adjuvant to oral hygiene procedure on plaque-induced gingivitis among middle-aged adults – An interventional study

Objectives: Oral health correlates with systemic health, and maintaining oral health is very important because the oral cavity is considered as a reflection of the general well-being of a human body. Daily plaque removal with a toothbrush is an important component of most oral hygiene programs intended to prevent and control two globally leading oral afflictions dental caries and periodontal diseases. Failure to comply and lack of technical skills of the patient has lessened the effectiveness of conventional tooth brushing. Because of this, research efforts have focused on adjuvant therapy along with brushing for reducing and controlling plaque-induced oral diseases. One such measure is oil pulling. Oil pulling has been used extensively as a traditional Indian folk remedy for many years to prevent decay, oral malodor, bleeding gums, dryness of throat, cracked lips, etc. Most of the studies have been done using sesame oil. Since coconut oil also has many health effects such as boosting the immune system and antimicrobial properties, this can also help in fighting against various pathogens of oral cavity that will in turn act as an effective plaque control agent. Hence, with this background, this study is contemplated to evaluate the benefit of oil pulling along with normal brushing techniques in adults under the age group of 35–44 years. Materials and Methods: Forty healthy subjects belonging to both the sexes who presented with plaque-induced gingivitis will be selected for the study and will be divided into control and study groups. The patients will be informed about the nature and purpose of the study. Health education will be provided to all the students. The modified bass technique will be demonstrated to the participants and they are directed to brush twice daily for 3 min. Toothbrush and toothpaste will be provided to all participants. Among them, 20 subjects were instructed to continue their normal oral hygiene procedures along with coconut oil pulling. Data collected were subjected to appropriate statistical tests using SPSS version 20. Results: A highly statistical difference was seen between the two groups and within the groups. Conclusion: The usage of coconut oil pulling as an adjuvant to oral hygiene gives a promising result.

Study on periodontal status of patients with pre-diabetes

Objective: To investigate periodontal status of patients with pre-diabetes and evaluate the prevalence of periodontal pathogens in oral cavity. Methods: All the subjects were under regular care in urban area of Beijing, including 88 subjects with normal blood glucose (normal blood glucose group), 27 pre-diabetic patients (pre-diabetic group), 58 well-controlled diabetic patients (glucose well controlled group) and 72 poor-controlled diabetic patients (glucose poor controlled group). Whole unstimulated saliva samples were collected before periodontal examination. Periodontal parameters, including plaque index (PLI), probing depth (PD), bleeding index (BI), bleeding on probing (BOP) and clinical attachment loss (CAL), were examined at mesial-buccal and distal-lingual sites of each tooth. Number of missing teeth was recorded. DNA was extracted from the salivary deposition, Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td), Campylobacter rectus (Cr), and Prevotella nigrescens (Pn) were detected by using PCR method based on 16SrRNA. Periodontal status and prevalence and quantity of the pathogens under various blood glucose states were compared. Results: The PD scores of four groups had no statistical differences. The CAL [(2.29±1.35) mm] and the number of missing teeth[2.0 (7.0)] in pre-diabetic group were significantly lower than that in glucose poor controlled group [(3.07±1.45) mm, P=0.04 and 5.0 (10.0), P=0.04, respectively]. The number of missing teeth in pre-diabetic group [2.0 (7.0)] was significantly lower than that in glucose well controlled group [5.0 (9.0), P=0.02]. The percent of bleeding on probing [BOP(+)%] in pre-diabetic group [(63.89±20.03)%] was significantly higher than that in normal blood glucose group [(54.51±22.29)%, P=0.04] and glucose well controlled group [(53.12±21.77)%, P=0.03]. The prevalence of Pg in pre-diabetic group (81.5%) was significantly higher than that in glucose poor controlled group (54.2%, P=0.02). The prevalence of Tf in pre-diabetic group (96.3%) was significantly higher than that in glucose poor controlled group (76.4%, P=0.01). Meanwhile the quantity of Pg [1.58 (4.75)] and Tf [5.46 (7.77)] in pre-diabetic group were significantly higher than that in glucose poor controlled group [0.60 (1.87), P=0.01 and 1.63 (3.06), P<0.01, respectively]. The quantity of Pn [0.85 (1.68)] in pre-diabetic group was significantly higher than that in normal blood glucose group [0 (1.02), P=0.04]. Conclusions: Pre-diabetic patients showed severe periodontal infection and BOP(+)% than other three groups and had high risk-level of periodontitis.

Actinomyces naeslundii causing pulmonary endobronchial Actinomycosis – A case report

Actinomyces naeslundii is a commensal flora of the oral cavity and is generally considered as an avirulent saprophytic bacterium in immunocompetent patients. It can become an opportunistic anaerobic pathogen in oral cavity in patients with poor oral hygiene or tooth extraction and can cause periodontal disease. Pulmonary Actinomycosis is a rare manifestation and may be suspected in middle-aged male patients with cough and hemoptysis showing radiological findings of a peripheral mass or chronic consolidation in whom repeated aerobic cultures have yielded negative results. Here, we report isolation of A. naeslundii from the bronchoalveolar lavage sample from an immunocompetent patient who presented with chronic nonresolving pneumonia of 6 months duration.

EPOP-150 - Implementation of a Comprehensive Process to Reduce Total Joint Surgical Infections by Reducing Pathogens in Oral Cavity, Nares and Skin

Background: Surgical site infection (SSI) after total joint arthroplasty (TJA) can result in repeated surgeries, delayed mobility, prolonged antibiotic use, all devastating for the patient, family and hospital. A three-year analysis of all TJA infections was reviewed by a multiply root cause process. The analysis resulted in implementation of a preoperative antiseptic bundle for the nose, mouth and skin.

Antibacterial activity of a novel characterized and purified bacteriocin extracted from Bifidobacterium adolescentis

Lactic acid bacteria and their own bacteriocin are great promising in health and industry; hence, too many lactic acid bacteria species and metabolites are involve in health maintenance and treatment of infectious disease as well as food preservation and dairy production. Current study sought to produce, isolate, purify and characterize novel bacteriocin from oral Bifidobacterium adolescentis and studying its effect on antibiotic-resistant pathogenic bacteria. Saliva of 18 volunteers postmenopausal women with their age ranging from 49 to 58 years was included. Bifidobacterium spp. cultivates in anaerobic conditions and identified by API50. Bifidobacterium bacteriocin prepared in De Man, Rogosa and Sharpe broth (MRS) broth as a crude preparation then concentrated by ammonium sulphate precipitation and purified by ion exchange and gel filtration chromatography. The molecular weight of B. adolescentis bacteriocin was estimated by gel filtration chromatography. The effect of temperature and pH value on purified bacteriocin activity was estimated using Escherichia coli American Type Culture Collection (ATCC) and Staphylococcus aureus ATCC. To determine the nature of produced bacteriocin and whether or not the bacteriocin contain lipid or carbohydrate moiety, it was treated with some enzymes (pepsin, lipase, α-amylase, papain and chemotrypsin). Challenged pathogenic bacteria were surveyed for occurrence of antibiotic resistance genes by PCR and to verify the inhibitory effect of B. adolescentis bacteriocin on challenged pathogenic bacteria, disc diffusion method was used. The result of anaerobic culture showed that, 35 Bifidobacterium isolates were obtained, the predominant species was B. adolescentis other species was lesser, namely Bifidobacterium dentium, Bifidobacterium longum and Bifidobacterium urinalis. The purified B. adolescentis bacteriocin was 14 600-Da protein and was active at wide range of pH value (3–8), thermostable and has no lipid or carbohydrate moiety. Almost all of pathogenic bacteria, whether or not they carry antibiotic resistance genes, appeared to be sensitive to crude and purified bacteriocin but purified bacteriocin was more effective as antimicrobial agent. The results suggest that Bifidobacterium spp. was dominant in oral cavities of postmenopausal women who have no caries it may prevent dental caries via antimicrobial activities of their own bacteriocin. Bifidobacterium bacteriocin is protein in nature, without lipid or carbohydrate moiety, heat-stable and active at wide range of pH values and can be classified as type II bacteriocin and so-called bifidoadocin. The antimicrobial activity of bifidoadocin makes it probable food preservative and antagonistic agent against pathogens of oral cavity and causative agents of dental caries as well as other pathogens.

Microbiological Speciation of Aerobic Bacteria in Patients undergoing treatment for Oral Malignancy

AIM and OBJECTIVE :The aim of the study is to identify the microbiological speciation of aerobic bacteria in patients undergoing treatment for oral malignancy . BACKGROUND : Cancer patients remain at substantial risk for developing serious infections despite significant advances in cancer therapy and supportive care.Moreover, the oral cavity infections in cancer patients usually result from the combination of neutropenia and mucositis. In any cases of infection involving the oral cavity , the oral micro flora may be subsequently replaced by potentially pathogenic microorganisms.Hence, the aim of this study was to determine infectious pathogens in oral cavity of oral cancer patients undergoing different treatment protocols. REASON : To create awareness about the side effects of the treatment protocols in cancer treatment so as to stipulate a harmless treatment .

Oral Cavity Infection: An Underestimated Source of Pyogenic Spondylodiscitis?

The incidence of pyogenic spondylodiscitis is increasing; however, the source of infection often remains obscure. We analyzed predisposing factors, pathogens, and outcome of patients undergoing surgical and/or conservative treatment of spondylodiscitis with a focus on the diagnostic work-up including a comprehensive maxillofacial assessment. The analysis of prognostic factors comprised comorbidities, nicotine dependence, symptom duration, and oral cavity peculiarities. After a standardized diagnostic work-up, a detailed examination of the oral cavity was also performed. The outcome analysis included assessment of the patients' clinical status. Forty-one patients with pyogenic spondylodiscitis were investigated of whom 24% had undergone spinal surgery within 4 weeks before the infection. A total of 29% of patients were found to have a concomitant bacterial oral cavity disease, and in 22% the definitive source of infection remained unidentified. Among the 12 patients with oral cavity infections, 10 patients had periodontitis; 8, root canal pathologies; 6, periapical lesions, and another 8 patients, caries. In 25% of these patients, typical oral cavity pathogens were found in the intervertebral disk. The prevalence of oral cavity infections was associated with a history of nicotine dependence (p = 0.003). All other analyzed comorbidities did not differ compared with patients without an oral cavity focus. Oral cavity infections appear to be a frequent source of pyogenic spondylodiscitis, with smoking its most relevant associated risk factor. In case of an unidentified infection focus, a detailed diagnostic work-up including a mandatory maxillofacial assessment is strongly recommended.

An Overview of the Carbonic Anhydrases from Two Pathogens of the Oral Cavity: Streptococcus mutans and Porphyromonas gingivalis.

Among the crowd of bacteria provoking disease of the oral cavity during the weakened of immune system, Streptococcus mutans and Porphyromonas gingivalis are the main microorganisms implicated in caries formation and periodontitis, respectively. The life cycle of the pathogens, such as protozoa, fungi and bacteria, is influenced by a superfamily of enzymes, called carbonic anhydrases (CAs, EC 4.2.1.1). These metalloenzymes, being crucial for the survival of the pathogen, have been considered as novel anti-infective targets. In fact, bicarbonate and protons, produced by the CA catalyzed carbon dioxide as substrate, are two fundamental ions implicated in the pH regulation, biosynthetic reactions, and adaptation of the pathogen to the host or in the possibility of the pathogen to avoid the host immune system. Bacteria genome encodes for the α-, β- and γ-CAs. Recently, our groups using the recombinant DNA technology prepared and characterized the CAs belonging to the &#946;- and γ-classes encoded by the genome of the two oral cavity pathogens S. mutans and P. gingivalis. An extensive inhibition study was carried out using typical anion/sulfonamide inhibitors of these classes of CAs. We discovered numerous inhibitors, which had in vitro an effective inhibitory activity against the bacterial CAs considered, here, as alternative anti-infective targets.

Antibacterial activity of Miswak Salvadora persica extracts against isolated and genetically identified oral cavity pathogens.

Despite medical progress worldwide, dental caries are still widespread. Miswak is derived from the plant Arak (Salvadora persica). It is used by Muslim peoples as a natural product for the cleansing of teeth, to ensure oral and dental hygiene. This study was conducted to evaluate the antimicrobial effects of ethanol, methanol, and ethanol/methanol extracts of Miswak against three bacterial pathogens of the oral cavity. The pathogens were isolated from the oral cavity of volunteers/patients and were identified on the basis of 16S rRNA gene amplification data. Sequence comparisons were made with 16S rRNA gene sequences available in the GenBank database. The results of sequence alignment and phylogenetic analysis identified the three pathogens as being Staphylococcus aureus strain KKU-020, Enterococcus faecalis strain KKU-021 and Klebsiella pneumoniae strain KKU-022. All Miswak extracts showed powerful antimicrobial activity against the three pathogens. The maximum zone of inhibition (40.67 ± 0.88 mm) was observed against E. faecalis KKU-021 with ethanolic extracts whilst methanolic extracts showed the minimum zone of inhibition (10.33 ± 0.88 mm) against K. pneumonia KKU-022. Based upon the significant effects of the Miswak extracts, against the oral cavity pathogens in our study, we recommend that Miswak could be used as a dental hygiene method to prevent tooth caries.

The identification of bacterial flora in oral cavity of snakes

Snakebites are a great public health concern in tropical and subtropical countries. It cannot only cause poisoning but also yield some infections in victims. There are some pathogenic agents in snake’s oral flora. This study was carried out to determine bacterial agents existing in the oral cavity of venomous and non-venomous snakes in Kashan, Iran. Using sterile swabs, the samples were obtained in two stages from the oral cavity of 11 venomous and non-venomous snakes before feeding and 3 weeks later. Then, they were cultured on Mac Conkey blood agar mediums. Gram staining of all samples was performed. Appropriate mediums and tests were fulfilled to determine gram-positive and gram-negative bacteria. The highest rate of infection belonged to coagulase-negative Staphylococcus (34.5 %) and the lowest rate was for Pseudomonas (3.1 %). Salmonella (18.8 %); Escherichia and Providencia (each 12.5 %); and Proteus, Enterococcus, and Bacillus (each 6.2 %) were other contributing pathogens found in snakes oral cavity. The obtained findings demonstrated significant bacterial pathogens in oral cavity of venomous and non-venomous snakes. Therefore, not only anti-venom treatment but also, due the probability of infections, the diagnosis and treatment should be considered in victims.

口腔内空気分析による歯周病原性細菌レベルの評価

口腔内空気分析による歯周病原性細菌レベルの評価

Incidence and risk factors for infection in oral cancer patients undergoing different treatments protocols.

BackgroundOver the past decade, advances in cancer treatments have been counterbalanced by a rising number of immunosuppressed patients with a multitude of new risk factors for infection. Hence, the aim of this study was to determine risk factors, infectious pathogens in blood and oral cavity of oral cancer patients undergoing different treatment procedures.MethodsThe present prospective cohort analysis was conducted on the patients undergoing treatment in the radiotherapy unit of Regional Cancer Institute, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, during the period of January 2007 to October 2009. Total 186 patients with squamous cell carcinoma of oral cavity were analyzed in the study. Based on treatment procedures patients were divided into three groups, group I were under radiotherapy, group II under chemotherapy and group III were of radio chemotherapy together. Clinical isolates from blood and oral cavity were identified by following general microbiological, staining and biochemical methods. The absolute neutrophile counts were done by following the standard methods.ResultsPrevalent bacterial pathogens isolated were Staphylococcus aureus, Escherichia coli, Staphylococcus epidermidis, Pseudomonas aeruginosa, Klebsiella pneumonia, Proteus mirabilis, Proteus vulgaris and the fungal pathogens were Candida albicans, Aspergillus fumigatus. The predominant gram negative bacteria, Pseudomonas aeruginosa and Klebsiella pneumonia were isolated from blood of radiotherapy and oral cavity of chemotherapy treated cases respectively. The predominance of gram positive bacteria (Staphylococcus aureus and Staphylococcus epidermidis) were observed in blood of chemotherapy, radio chemotherapy cases and oral cavity of radiotherapy, radio chemotherapy treated cases. Our study also revealed the presence of C. albicans fungi as most significant oral cavity pathogens in radiotherapy and radio chemotherapy cases.ConclusionGram positive bacteria and Gram negative were reported from the blood of all the three groups of patients. Oral mucositis played a significant role in oral cavity infection and make patients more prone to C. albicans infection.

Acetyl-11-keto-β-boswellic acid (AKBA); targeting oral cavity pathogens.

BackgroundBoswellic acids mixture of triterpenic acids obtained from the oleo gum resin of Boswellia serrata and known for its effectiveness in the treatment of chronic inflammatory disease including peritumor edema. Boswellic acids have been extensively studied for a number of activities including anti inflammatory, antitumor, immunomodulatory, and inflammatory bowel diseases. The present study describes the antimicrobial activities of boswellic acid molecules against oral cavity pathogens. Acetyl-11-keto-β-boswellic acid (AKBA), which exhibited the most potent antibacterial activity, was further evaluated in time kill studies, mutation prevention frequency, postantibiotic effect (PAE) and biofilm susceptibility assay against oral cavity pathogens.FindingsAKBA exhibited an inhibitory effect on all the oral cavity pathogens tested (MIC of 2-4 μg/ml). It exhibited concentration dependent killing of Streptococcus mutans ATCC 25175 up to 8 × MIC and also prevented the emergence of mutants of S.mutans ATCC 25175 at 8× MIC. AKBA demonstrated postantibiotic effect (PAE) of 5.7 ± 0.1 h at 2 × MIC. Furthermore, AKBA inhibited the formation of biofilms generated by S.mutans and Actinomyces viscosus and also reduced the preformed biofilms by these bacteria.ConclusionsAKBA can be useful compound for the development of antibacterial agent against oral pathogens and it has great potential for use in mouthwash for preventing and treating oral infections.

4-epi-Pimaric acid: a phytomolecule as a potent antibacterial and anti-biofilm agent for oral cavity pathogens

The present study focused on the antibacterial and biofilm inhibitory potential of 4-epi-pimaric acid isolated from aerial parts (stem and leaves) of Aralia cachemirica L. (Araliaceae) against oral cavity pathogens. 4-epi-Pimaric acid exhibited minimum inhibitory concentration (MIC) in the range of 4-16μg/ml and minimum bactericidal concentration (MBC) two- to four-folds higher than MIC. There was significant inhibition in the biofilm formation by Streptococcus mutans on the saliva coated surface (P < 0.05), and confocal microscopy revealed that 4-epi-pimaric acid inhibited the clumping and attachment of S. mutans. At 8 × MIC concentration, it significantly prevented the pH drop and reduced S. mutans biofilms (P < 0.05). Increased propidium iodide staining and leakage of 260- and 280-nm absorbing material by 4-epi-pimaric acid treated cells of S. mutans suggested that it probably causes disruption of the cytoplasmic membrane structure. It also exhibited significant suppression of TNF-α expression in human neutrophils, suggestive of its anti-inflammatory activity. Furthermore, the compound was found to be significantly safe (IC(50) >100μg/ml) in the MTT assay on AML-12 cell lines. In conclusion, 4-epi-pimaric acid showed promising antibacterial, anti-biofilm and anti-inflammatory potency and this compound can be exploited for therapeutic application in oral microbial infections.