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Critical Reviews in Microbiology May 2024Systemic antibiotics are an effective adjunct in the treatment of periodontitis, but their judicious use is necessary as antimicrobial resistance is a growing global... (Review)
Review
Systemic antibiotics are an effective adjunct in the treatment of periodontitis, but their judicious use is necessary as antimicrobial resistance is a growing global concern. This review aims to explore the current understanding and insight related to antibiotic resistance in the subgingival microbiota of periodontitis patients. A search of MEDLINE (PubMed) was carried out from 1 January 2012 to 25 November 2021 for studies related to antibiotic resistance in periodontitis patients. Of the 90 articles identified, 12 studies were selected for inclusion. A significant incidence of antibiotic resistant isolates was reported for , , , , , , , , , and but resistance to specific antibiotics did not reach above 10% of isolates in most studies except for amoxicillin resistance in . The highest frequency of resistance across all bacterial species was for amoxicillin, clindamycin, and metronidazole. However, resistance patterns were widely variable across geographical locations, and the high heterogeneity between antibiotic-resistant isolates across studies precludes any clinical recommendations from this study. Although antibiotic resistance has yet to reach critical levels in periodontitis patients, an emphasis on antibiotic stewardship interventions such as point-of-care diagnostics and education for key stakeholders is needed to curb a growing problem.
Topics: Humans; Periodontitis; Anti-Bacterial Agents; Microbiota; Drug Resistance, Bacterial; Bacteria
PubMed: 37140235
DOI: 10.1080/1040841X.2023.2197481 -
European Journal of Clinical... Jul 2023Parvimonas micra isolations are usually part of polymicrobial infections and the pathogenic role of this microrganism is still debated. We describe here a large series...
Parvimonas micra isolations are usually part of polymicrobial infections and the pathogenic role of this microrganism is still debated. We describe here a large series of hospitalized patients diagnosed with Parvimonas micra infections and discuss the clinical and therapeutic management and the outcome of these infections.
Topics: Humans; Firmicutes; Gram-Positive Bacterial Infections
PubMed: 37133638
DOI: 10.1007/s10096-023-04617-6 -
The Journal of Contemporary Dental... Dec 2022This study compared two molecular iodine mouthrinses for their bactericidal effects against subgingival biofilm bacteria from severe periodontitis patients.
AIM
This study compared two molecular iodine mouthrinses for their bactericidal effects against subgingival biofilm bacteria from severe periodontitis patients.
MATERIALS AND METHODS
In a subgingival biofilm eradication assay, dilution aliquots of subgingival microbial specimens from 32 adults with severe periodontitis were mixed with either a mouthrinse containing 100 parts per million (ppm) molecular iodine (Iorinse®) or one containing 150 ppm molecular iodine (iClean®), followed by mouthrinse neutralization after 60 seconds with 3% sodium thiosulfate. The mixtures, along with unexposed subgingival biofilm aliquots, were inoculated onto enriched Brucella blood agar and incubated anaerobically for 7 days to quantitate total viable bacterial counts and selected red/orange complex periodontal pathogens ( and ).
RESULTS
Both molecular iodine mouthrinses significantly reduced total viable bacterial counts in the subgingival biofilm samples, with iClean® providing significantly greater suppression than Iorinse®. Both molecular iodine mouthrinses also significantly reduced total red/orange complex periodontal pathogens, with significantly greater suppression also exhibited by iClean®.
CONCLUSION
The molecular iodine mouthrinses exerted marked bactericidal activity against human subgingival biofilm microbial species, including red/orange complex periodontal pathogens associated with severe periodontitis, with iClean® providing significantly better antimicrobial activity than Iorinse®.
CLINICAL SIGNIFICANCE
These findings suggest potential value of molecular iodine mouthrinses in the treatment and prevention of periodontal diseases.
Topics: Adult; Humans; Mouthwashes; Periodontitis; Porphyromonas gingivalis; Periodontal Diseases; Anti-Bacterial Agents; Aggregatibacter actinomycetemcomitans; Prevotella intermedia
PubMed: 37125513
DOI: 10.5005/jp-journals-10024-3447 -
Cureus Mar 2023Endocarditis is a life-threatening, relatively rare disease caused by an infection of the endocardial epithelium of the heart. Its clinical presentation is highly...
Endocarditis is a life-threatening, relatively rare disease caused by an infection of the endocardial epithelium of the heart. Its clinical presentation is highly variable, depending on whether it presents acutely, subacutely, or chronically. Also, the wide array of causal etiologies and pathogens makes its diagnosis and treatment complex and challenging. The main etiological agents are S and S, while fastidious microorganisms are infrequent agents of this pathology. Advancements in the identification of microorganisms with novel molecular techniques have revealed new previously unidentified pathogens. Despite their low frequency, these fastidious pathogens are highly relevant, as they have been associated with a higher rate of complications and mortality. Therefore, it is necessary to be aware of the wide array of clinical presentations and important considerations for the management of patients with subacute endocarditis with atypical microorganisms. In this article, we present a case series involving three different clinical presentations of subacute endocarditis with fastidious microorganisms, which required extensive medical management and surgical valve repair with favorable and unfavorable outcomes. We also engage in a review of the literature on their microbiology, diagnosis, and treatment.
PubMed: 37041916
DOI: 10.7759/cureus.35997 -
Journal of Cardiothoracic Surgery Apr 2023Tension pyopneumothorax is a rare and life-threatening complication of pneumonia, lung abscess, and empyema, and immediate thoracic drainage or surgery is required. A...
Tension pyopneumothorax is a rare and life-threatening complication of pneumonia, lung abscess, and empyema, and immediate thoracic drainage or surgery is required. A 70-year-old man presented to another hospital 2 weeks after exacerbation of dyspnea and anorexia. Chest X-ray imaging revealed leftward deviation of the mediastinum, pleural effusion, and collapse of the right lung. The patient was referred to our hospital for surgical treatment. He underwent chest drainage immediately after the transfer. The patient's blood pressure was elevated after drainage. Chest X-ray imaging showed improvement in the mediastinal deviation, but expansion failure of the lung occurred. Debridement and parietal and visceral decortications were performed under thoracotomy. The thoracic cavity was irrigated using a pulse lavage irrigation system with 12,000 mL of saline. The patient underwent fibrinolytic therapy with intrathoracic urokinase postoperatively because of persistent high inflammatory marker levels and multilocular pleural effusion. Parvimonas micra was detected in the preoperative pleural fluid culture. He was discharged on postoperative day 22 and followed up as an outpatient afterwards. Two years have passed since the surgery, and there has been no recurrence of empyema. Decortication of the parietal and visceral pleura and irrigation using a pulse lavage irrigation system were effective.
Topics: Male; Humans; Aged; Empyema, Pleural; Pleura; Pleural Effusion; Pneumothorax; Drainage
PubMed: 37038174
DOI: 10.1186/s13019-023-02239-9 -
Journal of Infection and Chemotherapy :... Jul 2023Filifactor alocis, an anaerobic Gram-positive rod, has garnered interest from its association with periodontal disease. Extraoral infections by F. alocis are rare; only...
Filifactor alocis, an anaerobic Gram-positive rod, has garnered interest from its association with periodontal disease. Extraoral infections by F. alocis are rare; only seven cases have been reported. We report the first case in which we identified F. alocis as one of the causative organisms of a deep neck abscess. A 71-year-old male on hemodialysis came to our hospital with a fever and left buccal pain. The patient's left neck was swollen, and contrast-enhanced computed tomography showed an abscess with gas extending from the left cheek to the deep neck. We diagnosed the patient with a deep neck abscess and performed an urgent neck drainage. We isolated F. alocis, Eggerthia catenaformis, Parvimonas micra, and Streptococcus constellatus in the abscess and identified them using matrix-assisted laser desorption ionization-time of flight mass spectrometry. Blood cultures were negative. We initiated treatment with piperacillin-tazobactam and vancomycin. The patient improved but developed a hemorrhagic duodenal ulcer on the third day of admission. We attempted endoscopic hemostasis, but the patient's bleeding continued. Ultimately, he died of the duodenal ulcer hemorrhage on the sixth day of admission. This is the first case of F. alocis detected in a deep neck abscess.
Topics: Male; Humans; Aged; Abscess; Duodenal Ulcer; Lactobacillus
PubMed: 37003537
DOI: 10.1016/j.jiac.2023.03.017 -
Clinical Oral Investigations May 2023The objective of this study was to evaluate the microbiological profile of root canals indicated for endodontic retreatment due to secondary endodontic infections...
OBJECTIVE
The objective of this study was to evaluate the microbiological profile of root canals indicated for endodontic retreatment due to secondary endodontic infections evidenced by the presence of chronic apical periodontitis (G1) or for prosthetic reasons, without clinical and radiographic signs of endodontic reinfection (G2).
METHODS
Microbiological samples were collected from thirty teeth (N=30) out of which 15 were indicated for retreatment due to the presence of chronic apical periodontitis (G1) and 15 were indicated exclusively for prosthetic reasons (G2). Samples were collected from root canals before (S1), after chemomechanical preparation (S2), and after 30 days of intracanal medication composed of calcium hydroxide and 2% chlorhexidine gel (S3). The molecular analysis was performed using Nested-PCR for the detection of 17 bacterial species. The efficacy of each stage of the retreatment in reducing the microbial load was verified by counting colony-forming units (CFU). The statistical analysis considered a significance level of 5%.
RESULTS
The results showed that bacteria were detected in 100% of the cases in S1, in both groups, by Nested PCR. The most frequently found species in S1 in both groups were Enterococcus faecalis, Fusobacterium nucleatum, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Parvimonas micra. The microbial load of G1 was higher than G2 in the initial samples (S1). Endodontic retreatment was effective in reducing the microbial load in G1 and G2. Statistically significant associations were found between specific bacteria and clinical signs and symptoms.
CONCLUSION
It was concluded that the microbial community present in the root canal of teeth indicated for endodontic retreatment is mixed and heterogeneous. G1 and G2 differ in the number of species per case and microbial load.
CLINICAL RELEVANCE
Endodontic retreatment was effective in reducing the microbial load. Statistically significant associations were found between specific bacteria and clinical signs and symptoms.
Topics: Humans; Dental Pulp Cavity; Periapical Periodontitis; Chlorhexidine; Porphyromonas gingivalis; Retreatment; Root Canal Irrigants; Calcium Hydroxide
PubMed: 37002440
DOI: 10.1007/s00784-023-04947-x -
Environmental Microbiology Reports Aug 2023Recent advances in our understanding of microbiome composition at sites of inflammatory dysbiosis have triggered a substantial interest in a variety of historically... (Review)
Review
Recent advances in our understanding of microbiome composition at sites of inflammatory dysbiosis have triggered a substantial interest in a variety of historically understudied bacteria, especially among fastidious obligate anaerobes. A plethora of new evidence suggests that these microbes play outsized roles in establishing synergistic polymicrobial infections at many different sites in the human body. Parvimonas micra is a prime example of such an organism. Despite being almost completely uncharacterized at the genetic level, it is one of the few species commonly detected in abundance at multiple mucosal sites experiencing either chronic or acute inflammatory diseases, and more recently, it has been proposed as a discriminating biomarker for multiple types of malignancies. In the absence of disease, P. micra is commonly found in low abundance, typically residing within the oral cavity and gastrointestinal tract. P. micra exhibits the typical features of an inflammophilic organism, meaning its growth actually benefits from active inflammation and inflammatory tissue destruction. In this mini-review, we will describe our current understanding of this underappreciated but ubiquitous pathobiont, specifically focusing upon the role of P. micra in polymicrobial inflammatory dysbiosis and cancer as well as the key emerging questions regarding its pathobiology. Through this timely work, we highlight Parvimonas micra as a significant driver of disease and discuss its unique position at the crossroads of dysbiosis and cancer.
Topics: Humans; Dysbiosis; Firmicutes; Neoplasms; Gastrointestinal Tract
PubMed: 36999244
DOI: 10.1111/1758-2229.13153 -
Canadian Journal of Dental Hygiene :... Feb 2023Supragingival air polishing of teeth effectively removes dental plaque and extrinsic stain on coronal tooth surfaces, but its impact on specific periodontal pathogens in...
BACKGROUND
Supragingival air polishing of teeth effectively removes dental plaque and extrinsic stain on coronal tooth surfaces, but its impact on specific periodontal pathogens in adjacent subgingival biofilms is not known. This study assessed the microbiological effect of supragingival air polishing on the subgingival microbiota of individuals with severe periodontitis.
METHODS
Supragingival air polishing with a sodium bicarbonatebased powder was performed on 15 adult test subjects, with the nozzle of the air polishing device aimed apically at a 45° angle onto tooth surfaces immediately coronal to the entrance of periodontal pockets. Supragingival prophylaxis paste polishing, using a slow-speed handpiece, was carried out on 13 adult control subjects. Subgingival specimens were collected from a single 5 mm to 7 mm periodontal pocket with bleeding on probing in each of the study participants before and immediately after supragingival polishing procedures. Viable bacterial counts and selected putative periodontal pathogens ( species) were quantified by microbial culture, and motile morphotypes (spirochetes and motile rods) by phase-contrast microscopy.
RESULTS
Statistically significant decreases were detected after supragingival air polishing in total viable counts (84.9% decrease), in species, total proportions of red/orange complex periodontal pathogens (82.3% decrease), and in motile morphotypes (85.3% decrease). No statistically significant subgingival microbiological changes occurred with supragingival prophylaxis paste polishing.
CONCLUSION
Supragingival air polishing of teeth, but not supragingival prophylaxis paste polishing, may serve as a useful therapeutic adjunct to disrupt and help remove pathogenic biofilms in deep periodontal pockets.
Topics: Adult; Humans; Periodontal Pocket; Dental Polishing; Dental Plaque; Periodontitis; Campylobacter; Microbiota
PubMed: 36968802
DOI: No ID Found -
International Endodontic Journal Jul 2024To evaluate the root canal microbiome composition and bacterial functional capability in cases of primary and secondary apical periodontitis utilizing whole-metagenome...
AIM
To evaluate the root canal microbiome composition and bacterial functional capability in cases of primary and secondary apical periodontitis utilizing whole-metagenome shotgun sequencing.
METHODOLOGY
Twenty-two samples from patients with primary root canal infections, and 18 samples obtained from previously treated teeth currently diagnosed with apical periodontitis were analysed with whole-metagenome shotgun sequencing at a depth of 20 M reads. Taxonomic and functional gene annotations were made using MetaPhlAn3 and HUMAnN3 software. The Shannon and Chao1 indices were utilized to measure alpha diversity. Differences in community composition were evaluated utilizing analysis of similarity (ANOSIM) using Bray-Curtis dissimilarities. The Wilcoxon rank sum test was used to compare differences in taxa and functional genes.
RESULTS
Microbial community variations within a community were significantly lower in secondary relative to primary infections (alpha diversity p = .001). Community composition was significantly different in primary versus secondary infection (R = .11, p = .005). The predominant taxa observed among samples (>2.5%) were Pseudopropionibacterium propionicum, Prevotella oris, Eubacterium infirmum, Tannerella forsythia, Atopobium rimae, Peptostreptococcus stomatis, Bacteroidetes bacterium oral taxon 272, Parvimonas micra, Olsenella profusa, Streptococcus anginosus, Lactobacillus rhamnosus, Porphyromonas endodontalis, Pseudoramibacter alactolyticus, Fusobacterium nucleatum, Eubacterium brachy and Solobacterium moorei. The Wilcoxon rank test revealed no significant differences in relative abundances of functional genes in both groups. Genes with greater relative abundances (top 25) were associated with genetic, signalling and cellular processes including the iron and peptide/nickel transport system. Numerous genes encoding toxins were identified: exfoliative toxin, haemolysins, thiol-activated cytolysin, phospholipase C, cAMP factor, sialidase, and hyaluronic glucosaminidase.
CONCLUSIONS
Despite taxonomic differences between primary and secondary apical periodontitis, the functional capability of the microbiomes was similar.
Topics: Humans; Microbiota; Dental Pulp Cavity; Periapical Periodontitis; Metagenome; Adult; Female; Male; Middle Aged; Bacteria
PubMed: 36861850
DOI: 10.1111/iej.13911