Antimicrobial susceptibility surveillance of bacterial isolates recovered in Japan from odontogenic infections in 2013.

We report on the findings of the first antimicrobial susceptibility surveillance study in Japan of isolates recovered from odontogenic infections. Of the 38 facilities where patients representing the 4 groups of odontogenic infections were seen, 102 samples were collected from cases of periodontitis (group 1), 6 samples from pericoronitis (group 2), 84 samples from jaw inflammation (group 3) and 54 samples from phlegmon of the jaw bone area (group 4) for a total of 246 samples. The positivity rates of bacterial growth on culture were 85.3%, 100%, 84% and 88.9%, respectively, for groups 1, 2, 3 and 4. Streptococcus spp. isolation rates according to odontogenic infection group were 22% (group 1), 17.7% (group 3) and 20.7% (group 4). Anaerobic isolation rates were 66.9% (group 1), 71.8% (group 3) and 68.2% (group 4). Drug susceptibility tests were performed on 726 strains excluding 121 strains that were undergrown. The breakdown of the strains subjected to testing was 186 Streptococcus spp., 179 anaerobic gram-positive cocci, 246 Prevotella spp., 27 Porphyromonas spp., and 88 Fusobacterium spp. The isolates were tested against 30 antimicrobial agents. Sensitivities to penicillins and cephems were good except for Prevotella spp. The low sensitivities of Prevotella spp is due to ß-lactamase production. Prevotella strains resistant to macrolides, quinolones, and clindamycin were found. No strains resistant to carbapenems or penems were found among all strains tested. No anaerobic bacterial strain was resistant to metronidazole. Antimicrobial susceptibility testing performed on the S. anginosus group and anaerobic bacteria, which are the major pathogens associated with odontogenic infections, showed low MIC90 values to the penicillins which are the first-line antimicrobial agents for odontogenic infections; however, for Prevotella spp., penicillins combined with ß-lactamase inhibitor showed low MIC90 values.

Development of follicular lymphoma of the cervical lymph nodes in a postoperative patient with tongue cancer.

Patients with head and neck squamous cell carcinoma are at an increased risk of developing second malignancies. Most commonly, these second primary malignancies are squamous cell carcinoma of the head and neck region, but also noted are esophageal cancer or lung cancer. Hematologic malignancies are uncommon second malignancies. Diagnosis can be challenging, particularly when a patient suffers metastases of squamous cell carcinoma to the cervical lymph nodes in addition to synchronous or metachronous malignant lymphoma that originates in the cervical lymph nodes. This article describes a case of primary follicular lymphoma in the cervical region that was discovered during a postoperative follow-up after partial glossectomy and neck dissection for tongue cancer.

Identification of oral bacteria by 16S rRNA gene analysis in elderly persons requiring nursing care.

After incubation of saliva from 58 semi-bedridden elderly persons, the cultures were identified based on the 16S rRNA gene base sequence to compare the identification by the conventional culture method. As a result, the 16S rRNA gene base sequence of 198 strains identified by the culture method showed 98.5% or more homology in some of the Human Oral Microbiome database, and the identification of bacterial species and genus was possible. When an organism identified by the 16S rRNA gene sequencing method was compared with that by the culture method, the concordance rates were 54.5% at the genus level and 35.9% at the species level. Streptococcus mitis strains most frequently isolated from saliva that were identified by the culture method were identified as the same species by the 16S rRNA gene sequencing method (32/35), and all the 11 Streptococcus salivarius strains identified by the culture method were identified as the same species by the 16S rRNA gene sequencing method. All the strains identified as Streptococcus anginosus group by the culture method and 8 of the 9 strains identified as Prevotella species by the culture method were identified as the same group and genus by the 16S rRNA gene sequencing method. When an oral microbial flora test with saliva samples from elderly persons is performed, the 16S rRNA gene sequence identification enables us to identify major indigenous bacteria and pathogenic bacteria and is considered useful as a means of supplementing the conventional culture method.

High-level gentamicin-resistant isolates of oral streptococci and Aerococcus from blood specimens.

Seventy-nine isolates of oral streptococci and Aerococcus obtained from blood specimens between December 1997 and January 2000 were tested for high-level gentamicin resistance. Three isolates with minimum inhibitory concentrations (MICs) of > or =1024 microg/ml were selected as potential high-level gentamicin-resistant isolates. The DNA sequence of the structural gene encoding 6'-acetyltransferase-2"-phosphotransferase in the three high-level gentamicin-resistant isolates was investigated according to the method used for Enterococcus faecalis. The results of this gene analysis showed that all the DNA sequence of Aerococcus viridans no. 70, which had the highest MIC (2048 microg/ml), matched that of E. faecalis, whereas no polymerase chain reaction (PCR) products were obtained in the other two isolates that were tested. The mechanism of gentamicin resistance in these two isolates is unknown.