Dental caries and bacterial load in saliva and dental biofilm of type 1 diabetics on continuous subcutaneous insulin infusion

Abstract Objectives Since most of the studies evaluates diabetics on multiple daily injections therapy and continuous subcutaneous insulin infusion may help gain better metabolic control and prevent complications, the objective of this study was to evaluate the prevalence of dental caries, the unstimulated salivary flow rate and the total bacteria load, Streptococcus spp. levels and Lactobacillus spp. levels in saliva and supragingival dental biofilm of type 1 diabetics on insulin pump. Material and Methods Sixty patients with type 1 diabetes on insulin pump and 60 nondiabetic individuals were included. The dental caries evaluation was performed using ICDAS and the oral hygiene was assessed according to Greene and Vermillion Simplified Oral Hygiene Index. Unstimulated saliva and supragingival dental biofilm were collected. Total bacteria, Streptococcus spp. and Lactobacillus spp. was quantified by qPCR. Results Patients with type 1 diabetes had a higher prevalence of dental caries and filled and missing teeth when compared with the control group. These patients were associated with more risk factors for the development of dental caries, namely a lower unstimulated salivary flow rate and a higher bacterial load in saliva and dental biofilm. Conclusion Some risk factors related to dental caries were associated with type 1 diabetics. An early diagnosis combined with the evaluation of the risk profile of the diabetic patient is imperative, allowing the dental caries to be analyzed through a perspective of prevention and the patient to be integrated into an individualized oral health program.

Tipificación mediante electroforesis de campos pulsantes de cepas de Streptococcus beta hemolíticos presentes en un brote de faringitis en niños / Typing by pulsed field gel electrophoresis of beta hemolytic Streptococcus strains present in a pharyngitis outbreak in children

Introducción: en infecciones por Streptococcus beta hemolíticos los del grupo A de Lancefield son el principal causante de faringitis en niños, y entre los no A los del Grupo C ocupan un lugar importante. Objetivo: tipificar molecularmente las cepas que participaron en un brote de faringitis en niños y demostrar la utilidad de la técnica de electroforesis de campos pulsantes en la identificación de las cepas circulantes. Métodos: se caracterizaron mediante electroforesis de campos pulsantes 12 aislados de Streptococcusbeta hemolíticos pertenecientes a niños atendidos en el Hospital Juan Manuel Márquez durante un brote de faringitis aguda en los meses de enero a marzo de 2008. Resultados: mediante el test de seroagrupamiento se encontró que 6 de los aislados, correspondiente al primer periodo del brote, eran Streptococcus del grupo C y los otros 6 aislados clasificaron como Streptococcuspyogenes, con una mayor presencia en la segunda etapa del brote. La subtipificación mediante la macrorrestriccion con SmaI y electroforesis de campos pulsantes mostró la existencia de dos poblaciones clonales consecutivas durante el brote. Conclusiones: los resultados obtenidos demuestran la utilidad que pudiera tener la subtipificación de aislados mediante electroforesis de campos pulsantes durante un brote o una reemergencia facilitando el control epidemiológico, la localización de la fuente y la toma de decisiones cuando esta fuera necesaria(AU)

Introduction: in the context of infection by beta hemolytic Streptococci, Lancefield group A is the main cause of pharyngitis in children, whereas Streptococci C play an important role in the non group A. Aims: the purpose of the study was to molecularly typify the strains involved in a pharyngitis outbreak in children, and show the usefulness of pulsed field gel electrophoresis technique for identification of circulating strains. Methods: twelve beta hemolytic Streptococcus isolates from children cared for at Juan Manual Márquez hospital were characterized by pulsed field gel electrophoresis during an acute pharyngitis outbreak from January to March 2008. Results: the serogrouping test found that six of the isolates, corresponding to the first stage of the outbreak, were group C Streptococci, whereas the other six classified as Streptococcus pyogenes, with a greater presence in the second stage. Subtyping by Sma I macrorestriction and pulsed field gel electrophoresis revealed the presence of two consecutive clonal populations during the outbreak. Conclusions: results show the potential usefulness of subtyping isolates with pulsed field gel electrophoresis during an outbreak or an instance of re-emergence, thus facilitating epidemiological control, location of the source, and decision making when required(AU)

Comparison of oral Streptococci biofilm in caries-free and caries-affected preschool Mexican children / Comparación de la composición de la biopelícula de estreptococos orales en niños preescolares mexicanos con presencia y libres de caries dental

La interacción de los estreptococos orales en la biopelícula es el principal factor etiológico de la caries dental, por lo que objetivo del estudio fue comparar la distribución de los estreptococosorales en la biopelícula de niños preescolares con dentición temporal, afectados por caries y libres de esta enfermedad. Este estudio transversal incluyó 40 niños con caries y 40 niños libres de caries con dentición primaria. Cada sujeto fue examinado usando el índice ceo, y se tomó una muestra desaliva, de la cual se extrajo el DNA y se determinó la presencia de los estreptococos orales por medio de PCR. Comparando los dos grupos no se mostraron diferencias significativas encuanto a edad y género (P>0.05). La presencia de Streptococcus mutans (Smut), Streptococcus sobrinus (Ssob) y su combinación mostraron diferencias estadísticas entre grupos (P<0.05). La presencia de Smut, Streptococcus sanguinis y Streptococcus gordonii mostró una relación inversa con elíndice ceo, en contraste Ssob así como la combinación Smut- Ssob observaron una relación directa. Smut-Ssob combinados con otros estreptococos orales, mostraron diferencias estadísticas entre grupos (P<0.05). En el grupo libre de caries Streptococcusgordonii se identificó con mayor frecuencia que Smut. La proporción Smut/Streptococcus sanguinis podría representar un alto riesgo de desarrollo de caries dental, esta proporción fue mayor en los sujetos afectados por caries dental (1.18) en comparación con el grupo libre de caries (0.32). En conclusión, los estreptococos orales juegan un importante papel en el riesgo de caries dental así como en su severidad, no solo la presencia de Smut y Ssob, sino también la complejidad y distribución de los estreptococos orales en la biopelícula

Hydrophobicity test in mutans Streptococci

Kinetic hydrophobic measurements were performed by confronting 40 mutans streptococci from thirty 10- to 20-year-old patients with 200 ml hexadecane (Sigma). Fourteen patients had high dental caries risk (Group A), dmft + DMFT >5 with 3 or more active caries, and 16 had low dental caries risk (Group B), dmft + DMFT <3 without active caries. Twenty bacteria from Group A and 20 bacteria from Group B were typed using De La Higuera's procedure and confirmed by API strip (bio- Merieux). From the 14 patients in Group A we obtained 12 S. mutans (8 hydrophobic/ 4 non-hydrophobic), 5 S. sobrinus (4 hydrophobic/ 1 non-hydrophobic) and 3 S. rattus (hydrophobic). From the 16 patients in Group B we obtained 11 Streptococcus mutans (10 non-hydrophobic/ 1 hydrophobic), 7 Streptococcus sobrinus (6 non-hydrophobic/ 1 hydrophobic) and 2 Streptococcus rattus (hydrophobic). Patients with high dental caries risk have a higher prevalence of hydrophobic bacteria than patients with low dental caries risk (p=0.0003). All typed S. rattus were hydrophobic.

Con el objeto de evaluar una posible relacion entre hidrofobicidad y caries dental, se estudiaron 40 cepas de Streptococcus grupo mutans provenientes de 30 pacientes de entre 10 y 20 anos, 14 pacientes con tres o mas caries activas e indice ceod mas CPOD > 5 (Grupo A) y 16 pacientes sin caries activas, con ceod mas CPOD < 3 (Grupo B). Las cepas fueron aisladas a partir de muestras de saliva en AMS-BT y tipificadas por pruebas bioquimicas y API-strep realizandose la medicion cinetica de hidrofobicidad, enfrentandolas con 200 ml de hexadecano (Sigma). En el grupo A se caracterizaron 12 cepas Streptococcus mutans: 8 hidrofobicas y 4 no hidrofobicas, 5 cepas de Streptococcus sobrinus: 4 hidrofobicas y 1 no hidrofobica y 3 cepas Streptococcus rattus hidrofobicas. En el grupo B, se caracterizaron 11 cepas de S. mutans, 10 no hidrofobicas y 1 hidrofobica, 7 cepas de S. sobrinus: 6 no hidrofobicas y 1 hidrofobica y 2 cepas de S. rattus hidrofobicas. Todos los pacientes del grupo A presentaron al menos 1 cepa hidrofobica. En las cepas aisladas de estos pacientes se demostro la existencia de una alta prevalencia de Streptococcus grupo mutans con caracteristicas hidrofobicas p=0,0003. Estos resultados indicarian la relacion entre la capacidad de adherencia a hexadecano y caries activa. Todas las cepas tipificadas como S. rattus fueron hidrofobicas independientemente del grupo de origen.

Bacterial biofilm formation, pathogenicity, diagnostics and control: An overview.

Bacterial biofilms are complex, mono- or poly-microbialn communities adhering to biotic or abiotic surfaces. This adaptation has been implicated as a survival strategy. The formation of biofilms is mediated by mechanical, biochemical and genetical factors. The biofilms enhance the virulence of the pathogen and have their potential role in various infections, such as dental caries, cystic fibrosis, osteonecrosis, urinary tract infection and eye infections. A number of diagnostic techniques, viz., bright-field microscopy, epifluorescence microscopy, scanning electron microscopy, confocal laser scanning microscopy and amplicon length heterogeneity polymerase chain reaction, have been employed for detection of these communities. Researchers have worked on applications of catheter lock solutions, a fish protein coating, acid shock treatment, susceptibility to bacteriophages, etc., for biofilm control. However, we need to rearrange our strategies to have thorough insight and concentrate on priority basis to develop new accurate, precise and rapid diagnostic protocols for detection and evaluation of biofilm. Above all, the strict compliance to these techniques is required for accurate diagnosis and control.

The effect of subminimal inhibitory concentrations of penicillin on growth rate and haemolysin activity of group G Streptococcus

The influence of the subminimal inhibitory concentrations (1/3 and 1/4 of the MIC) of penicillin on growth rate and on haemolysin production of a strain of group G Streptococcus was studied. It was shown that 1/3 of the MIC almost completely inhibited the bacterial growth, but it was not able to inhibit haemolysin activity in the culture supernate. The generation time of bacteria grown in 1/4 of the MIC was approximately twice longer than that of the control culture. In all cultures, the haemolysin, after being produced (or liberated), reached a peak and decreased to low levels, which could suggest that group G Streptococcus produces some end products of metabolism that are able to inhibit haemolysin activity

Bacterial Adherence to Human Buccal Epitheliald Cells and Its Possible Role in Bacterial Colonization in Human Oral Cavity

The ability of several species of streptococcus and staphylococcus to adhere to human buccal epithelial cells was studied in vitro by using bacteria and epithelial cells isolated from human buccal cavity. Viridans streptococci were found adhering in highest numbers(65 +/- 8 bacteria per epithelial cell) to epithelial cells. Streptococcus pyogenes adhered in great numbers (44 +/- 4), whereas Streptococcus pneumoniae (26 +/- 2), Staphylococcus aureus (21 +/- 2), Staphylococcus epidermidis (14 +/- 2) adhered poorly. These data showed that bacteria differed in their ability to adhere to human buccal epithelial cells. This difference in adhesive ability between bacterial species may correlate with the ability of the bacteria to colonize oral surface of human.