Fatal thoracic empyema involving Campylobacter rectus: A case report.

We report the case of a 69-year-old man admitted for septic shock secondary to necrotic pneumoniae complicated by thoracic empyema of fatal issue. Microbiological examination of pleural liquid revealed a mixed anaerobic flora involving Campylobacter rectus and Actinomyces meyeri. Campylobacter rectus is an infrequent anaerobic pathogen of oral origin To our knowledge, this is the first case report of fatal C. rectus - associated thoracic empyema, and only the second reported case in which identification was successfully performed by MALDI-TOF MS.

Thoracic empyema caused by Campylobacter rectus.

We report a case of thoracic empyema caused by Campylobacter rectus, an organism considered as a periodontal pathogen but rarely recovered from extraoral specimens. The patient fully recovered through drainage of purulent pleural fluid and administration of antibiotics. The present case illustrates that C. rectus can be a cause of not only periodontal disease but also pulmonary infection.

Effect of a self-etching adhesive containing an antibacterial monomer on clinical periodontal parameters and subgingival microbiologic composition in orthodontic patients.

INTRODUCTION: The aims of this study were to evaluate the effect of a self-etching adhesive system containing an antibacterial monomer on periodontal health and subgingival microbiologic composition in orthodontic patients and to compare it with a conventional adhesive system. METHODS: A split-mouth design was chosen, and 15 patients were included in the study. Brackets in contralateral quadrants were bonded with either a conventional adhesive system (control) or a self-etching adhesive system that contained an antibacterial monomer. Clinical periodontal parameters including plaque index, gingival index, probing depths, and bleeding on probing were determined. Subgingival plaque samples were collected before bracket placement (T0) and at the 6-month follow-up (T1). The real-time TaqMan polymerase chain reaction assay was used to determine the subgingival counts of Porphyromonas gingivalis, Tannerella forsythensis, Prevotella intermedia, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Campylobacter rectus. For clinical periodontal parameters, analysis of covariance (ANCOVA) and, for bacterial counts, Wilcoxon tests were used for statistical comparisons at the P <0.05 level. RESULTS: Clinical periodontal parameters were not changed, and they were not different between the groups from T0 to T1. T forsythensis and F nucleatum increased during the treatment period in both groups (P <0.05). The majority of the bacteria were T nucleatum at T0 and T1 in both groups. Changes in bacterial load from T0 to T1 were not different between groups except for T forsythensis and F nucleatum (P <0.05). CONCLUSIONS: The use of an antibacterial monomer did not have an additional positive effect on clinical periodontal parameters. When used in bonding orthodontic brackets, the antibacterial monomer failed to reduce periodontopathogenic bacteria when compared with the conventional adhesive system during a 6-month treatment period.

The antimicrobial efficacy of commercial dentifrices.

This investigation compared the effects of a fluoride dentifrice and toothpastes formulated with antimicrobial ingredients (stannous fluoride and triclosan/copolymer) on oral micro-organisms, including those found in samples taken from the human oral cavity. Microbiological techniques determined the minimum inhibitory concentrations (MICs) of each dentifrice necessary to inhibit the growth of bacterial strains from the healthy oral cavity, as well as those found in dental caries, periodontal disease, and halitosis. Ex vivo studies utilized oral rinse samples and supragingival plaque from adults to determine antimicrobial effects on the entire microbial diversity of these samples, including biofilm-derived micro-organisms. The triclosan/copolymer dentifrice demonstrated the lowest MICs and significantly inhibited Gram-positive and Gram-negative bacteria (including the periodontal pathogens Aggregatibacter actinomycetemcomitans, Eikenella corrodens, and Fusobacterium nucleatum). In the ex vivo tests, the triclosan/copolymer dentifrice demonstrated substantial inhibition in the oral rinse samples over each treatment period (p > 0.0005) as compared to either the fluoride or stannous fluoride dentifrices. Similarly, the triclosan/copolymer dentifrice demonstrated the highest inhibition of micro-organisms in the supragingival plaque biofilm (p < 0.0005). No significant differences were observed between the fluoride and stannous fluoride dentifrices (p > 0.5).

Photodynamic therapy as an adjunct to non-surgical periodontal treatment: a randomized, controlled clinical trial.

BACKGROUND: Recent preclinical and clinical data have suggested a potential benefit of photodynamic therapy (PDT) in the treatment of periodontitis. However, there are very limited data from controlled clinical trials evaluating the effect of PDT in the treatment of periodontitis. The aim of this study was to evaluate the clinical and microbiologic effects of the adjunctive use of PDT to non-surgical periodontal treatment. METHODS: Twenty-four subjects with chronic periodontitis were randomly treated with scaling and root planing followed by a single episode of PDT (test) or scaling and root planing alone (control). Full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), probing depth (PD), gingival recession, and clinical attachment level (CAL) were measured at baseline and 3 and 6 months after therapy. Primary outcome variables were changes in PD and CAL. Microbiologic evaluation of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia (previously T. forsythensis), Treponema denticola, Parvimonas micra (previously Peptostreptococcus micros or Micromonas micros), Fusobacterium nucleatum, Campylobacter rectus, Eubacterium nodatum, Eikenella corrodens, and Capnocytophaga spp. was performed at baseline and 3 and 6 months following therapy by using a commercially available polymerase chain reaction test. RESULTS: At 3 and 6 months after treatment, there were no statistically significant differences between the groups with regard to CAL, PD, FMPS, or microbiologic changes. At 3 and 6 months, a statistically significantly greater improvement in FMBS was found in the test group. CONCLUSION: The additional application of a single episode of PDT to scaling and root planing failed to result in an additional improvement in terms of PD reduction and CAL gain, but it resulted in a significantly higher reduction in bleeding scores compared to scaling and root planing alone.

Impact of the use of Kampo medicine in patients with esophageal cancer during chemotherapy:a clinical trial for oral hygiene and oral condition.

OBJECTIVE: The aim of this study was to investigate the impact of the use of two Kampo medicines on oral mucositis, tongue coating bacteria, and gingiva condition in patients with esophageal cancer undergoing chemotherapy. METHODS: Twenty-three esophageal cancer patients who receive chemotherapy at Tokushima University Hospital, were included. The participants, who received professional oral healthcare, were randomly divided into three groups:7 subjects received Daiokanzoto sherbets, 7 subjects received Hangeshashinto sherbets, and 9 subjects received nothing (control). The numbers of total bacteria and specific periodontopathogenic bacteria in tongue coating were determined in addition to clinical parameters. RESULTS: No difference on the onset of oral mucositis was found among the three groups. However, tongue coating index, gingival index (GI), plaque index, the number of total bacteria, Fusobacterium nucleatum and Campylobacter rectus were decreased during chemotherapy. More specifically, GI as well as the number of F. nucleatum and C. rectus were decreased significantly in the Daiokanzoto group when compared to the control group (psize 8 < 0.05). No such differences were observed for the group receiving Hangeshashinto. CONCLUSION: This clinical trial showed that Daiokanzoto might be effective in attenuating gingival inflammation and reducing the levels of periodontopathogenic bacteria in patients with esophageal cancer. J. Med. Invest. 65:184-190, August, 2018.

In vivo evaluation of the effect of essential oil-containing oral strips on salivary bacteria using the checkerboard method.

OBJECTIVE: The aim of this study was to evaluate the antimicrobial effect of essential oil-containing oral strips on different species of the oral microbiota. METHODOLOGY: Saliva samples were collected from 20 subjects with good oral health, diluted and plated onto blood agar medium. The subjects were asked to place the strip (Listerine PocketPaks) on the tongue allowing it to dissolve. After 30 minutes, new saliva samples were collected again and the plates with the samples were incubated under anaerobic conditions at 37 degrees C for seven days. Colony counts (CFU/mL) were determined for each sample. The colonies on the plates were washed with 1 mL of TE buffer, and the bacterial suspensions were processed for the identification of 24 species by DNA probes and the Checkerboard DNA-DNA hybridization method. Differences in total counts, prevalence, and levels of the species evaluated before and after placement of the strips were determined by Wilcoxon sign rank and Chi-square tests. RESULTS: A modest increase in the total bacterial number in saliva from 1.4 x 10(8) to 1.7 x 10(8) bacterial cells was observed 30 minutes after the strip placement, although this change was not significant (p = 0.632). Most of the species reduced in frequency and/or levels, including the pathogens A. actinomycetemcomitans, C. rectus, E. corrodens, Fusobacterium spp., P. intermedia, and S. noxia, as well as the beneficial species A. meyeri, A. georgia, A. gerencseriae, A. odontolyticus, and P. acnes after strip placement. In contrast, A. viscosus, P. melaninogenica, P. gingivalis, P. micros, Streptococcus spp., T. forsythensis, and V. parvula presented an increase in prevalence and/or levels. These changes were not statistically significant after adjusting for multiple comparisons (p > 0.0022). CONCLUSION: The use of the essential oil-containing oral strips resulted in a short-term small increase in the total number of salivary microorganisms. In addition, a not significant decrease of certain periodontopathogens, and an increase in species compatible with oral health were observed.

Validation of antibiotic efficacy on in vitro subgingival biofilms.

BACKGROUND: Systemic antibiotics are often used as adjunctive treatment modalities for periodontal diseases. Testing of antimicrobial efficacy can be relevant only if the bacteria are in the form of biofilms rather than the planktonic state, and at concentrations of physiologic relevance, i.e., reachable in the periodontal pocket. The aim of the present study is to test the antimicrobial efficacy of five common antibiotic schemes at physiologically relevant concentrations on a multispecies in vitro biofilm model. METHODS: A 10-species in vitro subgingival biofilm model was exposed to metronidazole (15 µg/mL), amoxicillin (15 µg/mL), metronidazole and amoxicillin in combination, doxycycline (2 µg/mL), and azithromycin (10 µg/mL) over 24 hours. Species-specific bacterial numbers were determined by culture on selective agar media or by epifluorescence microscopy. RESULTS: Metronidazole alone did not affect biofilm composition. Total bacterial counts were significantly reduced by doxycycline, azithromycin, and amoxicillin alone or in combination with metronidazole, albeit by less than 1 log. On the species-specific level, these regimens significantly reduced the numbers of Streptococcus anginosus, Porphyromonas gingivalis, and Fusobacterium nucleatum, as well as Campylobacter rectus (except for amoxicillin alone). The strongest effects were displayed by the combination of amoxicillin and metronidazole. CONCLUSION: Antibiotics at concentrations detectable in gingival crevicular fluid do not dramatically reduce total bacterial loads in this in vitro biofilm model, but cause species-specific reductions, which may disrupt the biofilm unity.

Hyaluronic Acid as an adjunct after scaling and root planing: a prospective randomized clinical trial.

BACKGROUND: The study is designed to determine the effect on clinical variables, subgingival bacteria, and local immune response brought about by application of hyaluronan-containing gels in early wound healing after scaling and root planing (SRP). METHODS: In this randomized clinical study, data from 34 individuals with chronic periodontitis were evaluated after full-mouth SRP. In the test group (n = 17), hyaluronan gels in two molecular weights were additionally applied during the first 2 weeks after SRP. The control group (n = 17) was treated with SRP only. Probing depth (PD) and clinical attachment level (CAL) were recorded at baseline and after 3 and 6 months, and subgingival plaque and sulcus fluid samples were taken for microbiologic and biochemical analysis. RESULTS: In both groups, PD and CAL were significantly reduced (P <0.001). The changes in PD and the reduction of the number of pockets with PD ≥5 mm were significantly higher in the test group after 3 (P = 0.014 and 0.021) and 6 (P = 0.046 and 0.045) months. Six months after SRP, the counts of Treponema denticola were significantly reduced in both groups (both P = 0.043), as were those of Campylobacter rectus in the test group only (P = 0.028). Prevotella intermedia and Porphyromonas gingivalis increased in the control group. CONCLUSION: The adjunctive application of hyaluronan may have positive effects on PD reduction and may prevent recolonization by periodontopathogens.

A comparative evaluation of the antibacterial efficacy of honey in vitro and antiplaque efficacy in a 4-day plaque regrowth model in vivo: preliminary results.

BACKGROUND: Honey has a potent broad-spectrum antibacterial action that may make it suitable for "anti-infective" treatment of periodontal disease. The aims of this study are as follows: 1) to evaluate the antibacterial efficacy of honey against oral bacteria and compare the same with 0.2% chlorhexidine; and 2) to compare antiplaque efficacy in vivo with chlorhexidine. METHODS: The study was conducted in two parts. In the in vitro part, the inhibitory effects of three test agents, 0.2% chlorhexidine gluconate, honey mouthwash, and saline, against six oral bacteria at concentrations of 1, 2, 4, 8, 16, 32, 64, 128, 256, and 512 µg/mL were tested in duplicate. The minimum inhibitory concentration (MIC) was set as the lowest concentration of the agent that completely inhibited the growth of the test species. The in vivo part consisted of a double-masked parallel clinical trial based on a 4-day plaque regrowth model. Sixty-six volunteers, 20 to 24 years of age, participated in the study, and the plaque scores were compared at baseline and at the end of 4 days. The Kruskal-Wallis test was used for significance, and the Mann-Whitney U test was used for pairwise comparison of the groups. The mean plaque scores were 1.77 ± 0.86, 1.64 ± 0.90, and 3.27 ± 0.83 for groups 1, 2, and 3, respectively. RESULTS: The honey mouthrinse effectively inhibited the six tested microorganisms. The chlorhexidine gluconate rinse had the lowest MICs compared with honey and saline rinses for all test species examined. The in vivo results revealed that plaque formation was inhibited/reduced by chlorhexidine and honey rinses. CONCLUSION: Honey has antibacterial action against tested oral microorganisms and also has antiplaque action.

Effect of female sex hormones on Campylobacter rectus and human gingival fibroblasts.

Recent studies have suggested a relationship between maternal Campylobacter rectus infections and preterm low birth weight. The purpose of this study was to investigate the effect of female sex hormones, estradiol and progesterone, on C. rectus and human gingival fibroblasts (HGF). The growth of C. rectus was significantly enhanced by incorporating either estradiol or progesterone in the culture medium. The production of vascular endothelial growth factor (VEGF), interleukin (IL)-6 and IL-8 by HGF increased following stimulation with estradiol or progesterone, at concentrations comparable to those present in the plasma of pregnant women. In addition, a significantly higher secretion of VEGF by HGF treated with the combination of C. rectus and estradiol was observed in comparison with a treatment with C. rectus alone. Stimulation of HGF with VEGF resulted in production of IL-6 and IL-8 in a dose-dependent manner. The capacity of female sex hormones to enhance both C. rectus growth and VEGF, IL-6, and IL-8 production by HGF has the potential to contribute to periodontal disease progression during pregnancy.

Periodontal diseases: microbiological considerations.

The location of plaque-associated gingivitis at the gingival portion of the tooth plays an essential role in its genesis. However, at times local and other host response modifying factors also have an influence. The pathogeny of periodontitis is more complex. The microorganisms that comprise subgingival plaque are capable of acting directly on periodontal tissues or of modifying the host response, whereas the participation of the plaque per se (normal, decreased, or increased) is as decisive as the action of the bacteria themselves in the emergence of the disease. Different types of periodontitis are associated with specific microorganisms. The most periodontopathogenic are A. actinomycetemcomitans, P. gingivalis, and T. forsythensis. Periodontitis as a whole, represent the source of complications such as root caries, endoperiodontal processes and periodontal abscesses. They are associated with various illnesses such as atherosclerosis, diabetes, and respiratory infections, amongst others, as well as pathological oral halitosis. The different modalities of PCR are particularly important in the microbiological diagnosis of periodontitis, although on the negative side of things, it must be pointed out that in vitro sensitivity studies cannot be performed using this technique. First line antibiotic treatment of periodontitis includes amoxicillin/ clavulanic acid, metronidazole (associated or not with amoxicillin) and clindamycin.