Increased levels of Porphyromonas gingivalis are associated with ischemic and hemorrhagic cerebrovascular disease in humans: an in vivo study

OBJECTIVE: This study investigated the role of periodontal disease in the development of stroke or cerebral infarction in patients by evaluating the clinical periodontal conditions and the subgingival levels of periodontopathogens. MATERIAL AND METHODS: Twenty patients with ischemic (I-CVA) or hemorrhagic (H-CVA) cerebrovascular episodes (test group) and 60 systemically healthy patients (control group) were evaluated for: probing depth, clinical attachment level, bleeding on probing and plaque index. Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans were both identified and quantified in subgingival plaque samples by conventional and real-time PCR, respectively. RESULTS: The test group showed a significant increase in each of the following parameters: pocket depth, clinical attachment loss, bleeding on probing, plaque index and number of missing teeth when compared to control values (p<0.05, unpaired t-test). Likewise, the test group had increased numbers of sites that were contaminated with P. gingivalis (60 percentx10 percent; p<0.001; chi-squared test) and displayed greater prevalence of periodontal disease, with an odds ratio of 48.06 (95 percent CI: 5.96-387.72; p<0.001). Notably, a positive correlation between probing depth and the levels of P. gingivalis in ischemic stroke was found (r=0.60; p=0.03; Spearman's rank correlation coefficient test). A. actinomycetemcomitans DNA was not detected in any of the groups by conventional or real-time PCR. CONCLUSIONS: Stroke patients had deeper pockets, more severe attachment loss, increased bleeding on probing, increased plaque indexes, and in their pockets harbored increased levels of P. gingivalis. These findings suggest that periodontal disease is a risk factor for the development of cerebral hemorrhage or infarction. Early treatment of periodontitis may counteract the development of cerebrovascular episodes.

Infección por bacilos gram-negativos no fermentadores: Problemática en las unidades de cuidados intensivos / Infection caused by the nonfermentative gram-negative bacilli. Problematic in the intensive cares units

Las infecciones por bacilos gram-negativos no fermentadores han cobrado notoria importancia por su incidencia en las infecciones hospitalarias. Actualmente, se destaca el hallazgo de especies como la Pseudomonas aeruginosa y el Acinetobacter spp.; de este último, el Acinetobacter baumannii es la especie que con mayor frecuencia se asocia a infecciones graves y a la muerte. El aislamiento de estos patógenos se asocia a un incremento de la mortalidad y están entre los agentes que más frecuentemente causan infecciones en las Unidades de Terapia Intensiva, de ahí que constituyan desafíos terapéuticos. En el presente artículo, se realiza una revisión actualizada de la literatura y se hace énfasis en la problemática de la resistencia bacteriana y la terapéutica antibiótica(AU)

Infections caused by the nonfermentative gram-negative bacilli have charged notorious importance for their incidence in the hospital infections. At the moment it stands out the discovery of species like the Pseudomonas aeruginosa and the Acinetobacter spp.; Acinetobacter baumannii is the species that associates to severe infections and the death with more frequency. The isolation of these pathogens associates to an increment of the mortality. These pathogens are among the agents that more frequently cause infections in the Intensive Cares Units, they constitute therapeutic challenges. Presently article is made a modernized revision of the literature and emphasis is made in the problem of the bacterial resistance and the antibiotic therapy(AU)