Type-2 Diabetes Mellitus Individuals Carry Different Periodontal Bacteria

ABSTRACT Objective: To identify etiologic microbiota associated periodontal diseases among diabetes patients and the factors related to the most commonly identified bacteria species. Material and Methods: Periodontal plaque samples from 11 diabetic participants and 13 non-diabetic controls were collected to assess their aerobic and anaerobic bacterial growth. Different distinct colonies were identified by microscopic and 16srDNA sequencing. Pearson's chi-square tests were conducted to examine any association between categorical variables. Results: The diabetic subjects revealed a more intense plaque formation with a mean plaque index of 2.4 compared to 1.8 in non-diabetics. A total of 86 bacteria were isolated from 24 plaque samples, 44 were aerobic, and 42 were anaerobic. Only aerobic isolates, 22 from diabetic patients and 22 from non-diabetic patients, were evaluated in these analyses. Bacillus spp. (B. cereus mainly) and Klebsiella spp. (K. pneumoniae, K. aerogenes, K. oxytoca) were detected markedly higher in non-diabetic individuals than in diabetic subjects (p=0.026 and p=0.021, respectively). Some bacteria were only identified in the dental plaque of diabetic individuals, namely, Bacillus mojavensis, Enterobacter cloacae, Proteus mirabilis, Staphylococcus epidermidis, Staphylococcus hominis, Staphylococcus pasteuri, Streptococcus mutans, and Streptococcus pasteurianus. The presence of acid reflux and jaundice were significantly associated with the most common bacterial isolate, namely Bacillus spp., with the p-values of 0.007 and 0.001, respectively. Conclusion: Type-2 diabetes mellitus is associated with a higher amount of dental plaques. Periodontal plaque samples from diabetic and non-diabetic subjects possess differential microbial communities. Diabetic plaques contain more versatile microbes predominated by gram-positive streptococci and staphylococci.

Type 2 diabetes mellitus-related environmental factors and the gut microbiota: emerging evidence and challenges

The gut microbiota is a group of over 38 trillion bacterial cells in the human microbiota that plays an important role in the regulation of human metabolism through its symbiotic relationship with the host. Changes in the gut microbial ecosystem are associated with increased susceptibility to metabolic disease in humans. However, the composition of the gut microbiota in those with type 2 diabetes mellitus and in the pathogenesis of metabolic diseases is not well understood. This article reviews the relationship between environmental factors and the gut microbiota in individuals with type 2 diabetes mellitus. Finally, we discuss the goal of treating type 2 diabetes mellitus by modifying the gut microbiota and the challenges that remain in this area.

Microbiota intestinal y salud en humanos: obesidad y diabetes mellitus tipo 2 / Gut microbiota and healthy in human: obesity and type 2 diabetes mellitus

RESUMEN Introducción La cantidad y la diversidad bacteriana intestinal están relacionadas con las enfermedades metabólicas e inflamatorias. El objetivo de este trabajo fue caracterizar la composición de la microbiota intestinal en heces y su relación con variables bioquímicas y el patrón de consumo de alimentos en individuos sanos, obesos y pacientes con diabetes mellitus tipo 2, en Mallorca (España). Métodos Las bacterias en heces se caracterizaron por PCR tiempo real. El ADN se aisló a partir de sujetos sanos (23), obesos (no diabéticos) (24) y diabéticos tipo 2 (no obesos) y se amplificó con cebadores específicos para identificar Roseburia, Clostridium leptum, Lactobacillus y Clostridium coccoides-Eubacterium rectale (Firmicutes); Prevotella y Bacteroides (Bacteroidetes); Bifidobacterium (Actinobacteria) y el cebador Universal (para total de bacterias), para la amplificación de la región V4 del gen 16S rRNA. Los resultados se analizaron estadísticamente utilizando SPSS v.21. Resultados En una población rural y urbana de Baleares, se detectaron niveles de insulina significativamente superiores en obesos (12,2 + 1,3 md/dL). En diabéticos, los niveles de triglicéridos, glucosa en sangre, hemoglobina glucosilada y albúmina en orina fueron superiores que en controles y obesos (por encima del rango normal). La mayor dispersión de las variables bioquímicas en sangre se identificó con: Clostridium coccoide-Eubacterium rectale, Bacteroides y Bifidobacterium, como posibles marcadores en obesos y diabéticos y Prevotella y Lactobacillus, como marcadores de salud. El contenido total de bacterias es mayor en controles y la relación entre reinos bacterianos es menor en este grupo. Los patrones de consumo de alimentos fueron diferentes en los tres grupos lo cual está relacionado con la variación en los patrones bacterianos. Conclusión La variabilidad en el consumo de alimentos estuvo relacionada con cinco marcadores bacterianos principales que contribuyeron a la mayor variabilidad de marcadores bioquímicos entre grupos de sujetos: Clostridium coccoide-Eubacterium rectale, Bacteroides, Bifidobacterium, Prevotella y Lactobacillus, en una población de Mallorca (España). Gut microbiota and healthy in human: obesity and type 2 diabetes mellitus.

ABSTRACT Introduction The amount and bacterial diversity in the bowel are associated to metabolic and inflammatory diseases. The aim was to characterize the gut microbiota composition in faeces and food consumption pattern in healthy, obese and Type 2 diabetes mellitus subjects from Majorca (Spain). Methods Bacteria in faeces were characterized by Real-time PCR. DNA was isolated from healthy subjects (23), obese patients (not diabetic) (24) and type 2 diabetic patients (12) and amplified with specific primers for the identification of Roseburia, Clostridium leptum, Lactobacillus and Clostridium coccoides-Eubacterium rectale (Firmicutes); Prevotella and Bacteroides (Bacteroidetes); Bifidobacterium (Actinobacteria); and Universal primer (for all bacteria), referred to amplification of 16S rRNA gene V4 region. Results were statistically analyzed by SPSS v.21. Results A rural and urban population from Balearic Islands was tested. The insulin levels were highest in obese group (12.2 + 1.3 md/dL) while the triglyceride, blood glucose, glycosylated haemoglobin and urine albumin levels were highest in diabetic group. The major dispersion of the blood variables was identified to a bacteria core: Clostridium coccoide-Eubacterium rectale, Bacteroides and Bifidobacterium as possible markers for obese and diabetic patients; and Prevotella and Lactobacillus levels as markers of health. The total amount of bacteria is the highest in control group, such as the ratio between phyla is the lowest. The food consumptiom patterns were different among which is related to the variation in the bacterial patterns. Conclusion The variability in the foods consumption among groups was related to five bacterial markers which contributed to the major variability in blood markers: Clostridium coccoide-Eubacterium rectale, Bacteroides, Bifidobacterium, Prevotella y Lactobacillus; in a population from Majorca, Spain.

Investigations of the prevalence and virulence of Candida albicans in periodontal and endodontic lesions in diabetic and normoglycemic patients

Abstract Pulpal and periodontal tissues have similar microbiota that allows cross-contamination between the pulp and periodontal tissues. Objective The aim of this study was to investigate the prevalence of isolated Candida albicans from periodontal endodontic lesions in diabetic and normoglycemic patients, and the fungi's virulence in different atmospheric conditions. Material and Methods A case-control study was conducted on 15 patients with type 2 diabetes mellitus (G1) and 15 non-diabetics (G2) with periodontal endodontic lesions. Samples of root canals and periodontal pockets were plated on CHROMagar for later identification by polymerase chain reaction (PCR) and virulence test. Results C. albicans was identified in 79.2% and 20.8% of the 60 samples collected from diabetic and normoglycemic patients, respectively. Of the 30 samples collected from periodontal pockets, 13 showed a positive culture for C. albicans, with 77% belonging to G1 and 23% to G2. Of the 11 positive samples from root canals, 82% were from G1 and 18% from G2. Production of proteinase presented a precipitation zone Pz<0.63 of 100% in G1 and 72% in G2, in redox and negative (Pz=1), under anaerobic conditions in both groups. Hydrophobicity of the strains from G1 indicated 16.4% with low, 19.3% with moderate, and 64.3% with high hydrophobicity in redox. In G2, 42.2% had low, 39.8% had moderate, 18% had high hydrophobicity in redox. In anaerobic conditions, G1 showed 15.2% with low, 12.8% with moderate, and 72% with high hydrophobicity; in G2, 33.6% had low, 28.8% had moderate, and 37.6% had high hydrophobicity. There was statistical difference in the number of positive cultures between G1 and G2 (p<0.05) with predominance in G1. There was statistical difference for all virulence factors, except hemolysis (p=0.001). Conclusions Candida albicans was isolated more frequently and had higher virulence in diabetic patients.

Influence of glycemic control on the levels of subgingival periodontal pathogens in patients with generalized chronic periodontitis and type 2 diabetes

Abstract Objective This study evaluated the influence of glycemic control on the levels and frequency of subgingival periodontal pathogens in patients with type 2 diabetes mellitus (DM) and generalized chronic periodontitis (ChP). Material and Methods Fifty-six patients with generalized ChP and type 2 DM were assigned according to the levels of glycated hemoglobin (HbA1c) into one of the following groups: HbA1c<8% (n=28) or HbA1c≥8% (n=28). Three subgingival biofilm samples from sites with probing depth (PD)<5 mm and three samples from sites with PD≥5 mm were analyzed by quantitative Polymerase Chain Reaction (PCR) for the presence and levels of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Eubacterium nodatum, Parvimona micra, Fusobacterium nucleatum ssp. and Prevotella intermedia. Results The mean counts of F. nucleatum ssp. were statistically significantly higher in the sites with PD≥5 mm of the HbA1c≥8% group (p<0.05). Frequencies of detection of T. forsythia, E. nodatum, P. micra and F. nucleatum ssp. were all higher in the sites with PD≥5 mm of the patients with HbA1c≥8%, compared with those of patients with HbA1c<8% (p<0.05). Frequency of detection of P. intermedia was higher in the sites with PD<5 mm of the patients with HbA1c≥8% than those of the patients with HbA1c<8% (p<0.05). Conclusions Poor glycemic control, as indicated by HbA1c≥8%, is associated with increased levels and frequencies of periodontal pathogens in the subgingival biofilm of subjects with type 2 DM and ChP.

Comparison of independent and dependent culture methods for the detection of transient bacteremia in diabetic subjects with chronic periodontitis / Comparación entre métodos de cultivo independientes y dependientes para la detección de bacteriemia transitoria en individuos diabéticos con periodontitis crónica

Introduction: Oral-derived bacteremia may occur after several dental procedures and routine daily activities. Some conditions of the oral cavity may favor episodes of bacteremia. This would be the case of patients with diabetes mellitus and periodontitis, who exhibit exacerbated gingival inflammation and may be more prone to developing oral-derived bacteremia. Objective: To compare the effectiveness of an independent culture method (quantitative real-time PCR- qCR) and the most commonly used method (BacT-ALERT 3D ® ) for the diagnosis of bacteremia. Materials and methods: Blood samples were drawn from subjects with type 2 diabetes mellitus and chronic periodontitis before and after apple chewing. Samples were processed by an automated blood culture system (BacT-ALERT 3D ® ) monitored for 15 days with suitable subculture of positive cultures. In parallel, whole DNA from blood samples was purified using a commercial kit and screened by qPCR using a universal primer set of 16S rDNA for bacteria detection. Results: Blood cultures taken before apple chewing were shown to be negative by the two diagnostic methods. After chewing, two samples (11%) showed bacterial growth by BacT-ALERT 3D ® whereas qPCR did not detect the presence of bacteria in any sample. Conclusions: qPCR did not show greater effectiveness than the BacT-ALERT 3D ® in the detection of bacteremia of oral origin.

Introducción. Las bacteriemias de origen oral pueden ocurrir después de procedimientos odontológicos y de otros actos cotidianos. Algunas condiciones de la cavidad oral favorecen las bacteriemias como en el caso de pacientes con diabetes mellitus y periodontitis que presentan inflamación gingival exacerbada. Objetivo. Comparar la eficacia de un método independiente de cultivo (PCR cuantitativa) y otro dependiente (BacT-ALERT 3D ® ) en la detección de la bacteriemia. Materiales y métodos. Se tomaron muestras de sangre de individuos con diabetes mellitus de tipo II y periodontitis, antes y después de la masticación de manzana. Una alícuota se procesó por el sistema automatizado de hemocultivo (BacT-ALERT 3D ® ) y se monitorizó durante 15 días; la otra alícuota fue tratada para la extracción del ADN y procesada por RT-PCR usando un conjunto de cebadores de 16S rDNA exclusivos para bacterias. Resultados. En las muestras tomadas antes de masticar se confirmó la ausencia de bacterias mediante los dos métodos. En las muestras tomadas después de masticar la presencia de bacterias se evidenció únicamente en dos hemocultivos y en ninguna de las muestras se detectó la presencia de bacterias con el método de RT-PCR. Conclusiones. La PCR cuantitativa no mostró mayor eficacia que el BacT-ALERT 3D ® en la detección de la bacteriemia de origen oral.

Detection and sampling methods for isolation of Candidaspp. from oral cavities in diabetics and non-diabetics

The purpose of this study was to detect Candida spp. on the tongue and in the subgingival sites in healthy and type 2 diabetes (T2D) patients with chronic periodontitis (CP), and to compare the accuracy of sampling methods. This study included 131 patients divided into four groups: healthy control (group A), nondiabetics + CP (Group B), diabetics with good metabolic control + CP (group C) and diabetics with poor glycoregulation + CP (Group D). Cotton swab samples from tongue and subgingival samples were obtained from each patient with help of sterile paper points and a sterile curette. Swab cultures were made on Sabouraud dextrose agar. The number of CFUs was counted. The sampling methods for subgingival plaque were compared by Receiving Operator Curve (ROC). The presence of Candida spp. on the tongue was statistically significant among groups (group D vs. others three groups: χ2: p < 0.005 for each group). Positive findings of subgingival Candida spp. did not differ among the groups. There were no significant differences in the quantification ofCandida spp., neither on the tongue, nor in the subgingival samples. 17.2% of diabetic patients revealed the presence ofCandida spp. in the subgingival samples, with negative finding on tongue. There was a significant difference in the sampling methods for subgingival plaque (p = 0.000). Candidaspp. is more prevalent on the tongue of diabetics. The sampling of subgingival plaque by a sterile curette is more accurate than with paper points. Subgingival plaque may represent a reservoir of commensals. It is necessary to standardize the sampling of subgingival plaque.

Determinants of periodontopathogens in microbiological monitoring of diabetic patients with periodontitis

To determine and analyze the frequency of periodontopathogens in microbiological monitoring of diabetic patients with periodontitis. This cross-sectional study included 352 diabetic patients with periodontitis who were registered at Riyadh Armed Forces Hospital, King Faisal Specialist Hospital and Research Centre, King Abdul Aziz Medical City, Naval Base Hospital, and Sultan Bin Adulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia from July 2004 to August 2008. Microbiological analysis comprised the detection of Bacteroides forsythus [Bf], Aggregatibacter actinomycetemcomitans [Aa], Porphyromonas gingivalis [Pg], and Prevotella intermedia [Pi] by polymerase chain reaction method. The mean age of patients was 54.4 +/- 0.67 [range: 21-80 years]. There were 214 [61%] males and 138 [39%] females. Among the study population, 36 [10%] had type 1, and 316 [90%] patients had type 2 diabetes. The results showed that 55.6% of patients had Bf, 51.7% had Az, 63.7% had Pg, and 6.1% had Pi. The frequencies of periodontopathogens were higher in males than females in all age groups. The risk of periodontopathogens Bf were found higher level in 41-50 age group, Aa in 51-60, Pg in 51-60, and Pi in 31-40 age groups. This study found that the frequencies of periodontal pathogens Bf, Aa, and Pg were higher than Pi in diabetic patients with periodontitis

Oral carriage rate of Candida species in diabetic patients

It is well known that diabetes is one of the predisposing factors, which affect the oral carriage rate of Candida species, in this paper we try to study the size of this problem. A total of 340 oral swabs from diabetic patients [type l and 2], 67% females and 33% males taken, results show that 37.9% of those had isolates of Candida species older patients had higher carriage rate but is not significant statistically [P>0.05]. Females had higher carriage raw [P<0.0l] possibly due to hormonal difference no difference found between type 1 and 2 of diabetes [P>0.05]. Those with poor control had higher carriage rate than those with good control [P<0.01]. In this study we see that being diabetic, female, with poor control had high chance to had oral carriage of Candida especially of albicans type

Adesão ao tratamento em portadores de diabetes: efeitos de um treino em análise de contingência sobre comportamento de autocuidado / Adoption to the treatment in diabetes patients: effects of a trainning in contingency analysis about self-management cares

Este trabalho teve como objetivo estudar o processo de aquisição e manutenção de comportamentos de autocuidado correspondentes à adesão ao tratamento em adultos portadores de diabetes Tipo 2...

Prevalancia y agentes patógenos de la onicomicosis en el diabético tipo II / Prevalance and pathogenic agents causing onychomycosis in class II diabetic foot

Se estudiaron a pacientes diabéticos y no diabéticos con la sospecha clínica de onicomicosis, a los cuales se les realizó un interrogatorio dirigido y se les tomó una muestra biológica de una uña afectada la cual se llevó al alboratorio para su estudio por diferentes métodos para su análisis morfológico y bioquímico de posibles microorganismos existentes, con el objeto de describir los tipos de microorganismos más frecuentes que se encuentran afectados al pie diabético para su tratamiento específico. Se concluyó que no todo paciente diabético con manifestaciones clínicas de onicomicosis la presenta, lo cual indica que muchas veces se dan tratamientos innecesarios e inespecíficos

Itraconazol como tratamiento de vulvovaginitis por candida en pacientes con diabetes mellitus tipo II (no insulino-dependiente) / Intraconazol in vulvovagitis by candida in patients with diabetes mellitus type II (non-insulin dependent)

El objetivo de la presente investigación fue determinar la utilidad de la administración tradicional de itraconazol para el manejo de la vulvovaginitis por Candida albicans en las pacientes con diabetes mellitus tipo II (no insulino-dependiente). Se realizó un ensayo clínico, al azar, ciego simple, controlado, en 32 pacientes con diabetes mellitus tipo II y diagnóstico de vulvovaginitis por Candida albicans corroborado por examen micológico. La mitad de ellas formó el grupo de estudio que recibió itraconazol a razón de 200 mg/día con el desayuno por tres días y el resto de pacientes quedó como grupo testigo. Una buena respuesta clínica fue observada en 87.50 por ciento de las pacientes (p = 0.001). La erradicación de la Candida sólo se logró en 56.25 por ciento de los casos. La respuesta general mostró fracaso del medicamento en 43.75 por ciento de las ocaciones. Se concluye que el manejo tradicional con itraconazol de las vulvovaginitis por Candida albicans en las mujeres con diabetes mellitus tipo II es una buena alternativa para el control de los signos y síntomas, más no así para la erradicación del hongo

Estado de portador de Staphylococcus aureus en pacientes diabéticos

Estudio bacteriológico realizado en pacientes diabéticos insulino dependientes y no insulino dependientes que asisten al Patronato contra la Diabetes, en el período comprendido de Junio a Julio de 1987. Las infecciones causadas por Staphylococcus aureus han constitutido una muy seria preocupación para médicos y epidemiologos, por la gravedad que representan especialmente para diabéticos; en quiens se ha demostrado que el estado del portador es fuente de infección frecuente representado riesgo de diseminación para ellos y otros pacientes. (1) En este trabajo se investigaron 120 pacientes diabéticos, pudiéndose establecer que la frecuencia del estado portador varía significativamente en relación a los datos que se tienen de la población en general, que la presencia de Staphylococcus a nivel nasal es mayor en frecuencia los pacientes diabéticos insulinos dependientes (Tipo I) que en no dependientes, además que el patrón de susceptibilidad a los antimicrobianos varió notablemente entre un grupo y otro, la resistencia a las penicilinas G y a la oxacilina es dos veces mayor en cepas aisladas en pacientes insulino dependientes