Characterization of the facial microbiome in twins discordant for rosacea.

Previously, we determined that genetic and environmental factors contributed equally towards rosacea in twins. To assess an environmental factor, we characterized the malar cheek bacterial microbiome from twins discordant for rosacea. We found no significant difference in facial microbiome alpha and beta diversity between related twins discordant for rosacea. However, the relative percentage abundance of Gordonia and Geobacillus, low-abundant genera, was positively and negatively associated with rosacea severity, respectively. Our data demonstrate a significant correlation between facial microbiome and severity of rosacea in genetically matched twins and importantly that overall microbiome composition is largely unchanged.

Aggregation and Adhesion Activity of Lactobacilli Isolated from Fermented Products In Vitro and In Vivo: a Potential Probiotic Strain.

Approximately 25 strains of lactobacilli isolated from different dairy products and fermented vegetables were screened according to their possibility to show the high auto-aggregation and co-aggregation. The strains Lactobacillus helveticus INRA-2010-H11, Lactobacillus rhamnosus INA-5.1, and Lactobacillus acidophilus JM-2012 were determined to have the high auto-aggregation (approximately 73, 46, and 70.5% correspondingly). A high co-aggregation capacity (75.53%) for strains INRA-2010-H11 and JM-2012 was shown. The adhesion degree of INRA-2010-H11 on the surface of buccal epithelial cells was 88.23%. The study of INRA-2010-H11, JM-2012, and both strains' mixture (1:1) adhesion capacity on the surface of epithelial HeLa cells revealed the adhesion of 1.1 × 106, 6.3 × 104, and 2.3 × 105 CFU, respectively, from starter amount of CFU 107 and 108 for both strains. In vivo experiments of LAB adhesion in gastrointestinal tract of mouse revealed the presence of 2.5 × 109, 1.2 × 109, and 1.5 × 109 CFU of LAB in control and groups of mouse, fed by INRA-2010-H11 and mixture, respectively. Feeding by investigated lactobacilli was suggested to lead to microbiota biodiversity reduction in small intestine and colon and its augmentation in stomach. Thus, INRA-2010-H11 demonstrated a high aggregation and adhesion activity so it has the potential as a good probiotic strain.

Facial Actinomycosis Mimicking a Cutaneous Tumor.

Actinomycosis is a chronic granulomatous infection that commonly occurs in the cervicofacial region. Although Actinomcyes is an element of the normal oral flora, infections of the facial skin are very rare because of the entirely endogenous habitation of the organism. The authors report a case of facial actinomycosis, which mimicked a cutaneous tumor both clinically and surgically in a 44-year-old woman with chronic renal failure and Hepatitis C viral infection. The majority of cases can be treated with long-term antibiotics. However, a treatment-resistant abscess, a fistula, or postsurgical excision of the mass formation that are infected can be treated with antibiotics as soon as possible, and recurrence of infection is prevented. The treatment should consist of conservative surgery to obtain a firm histological diagnosis and to drain any collections.

Dirofilariasis Presenting as an Infiltrative Mass in the Right Buccal Space.

Dirofilariasis is caused by filarial nematodes (roundworms) of the genus Dirofilaria Dirofilariasis of the oral mucosa is very rare. Herein, we report a case of a 79-year-old man who had a slowly growing infiltrative mass in the right buccal space. Histopathologic examination showed an inflammatory infiltrate with eosinophilia, histiocytes, and small organisms (0.2-0.3 mm). Digital images were sent to the Centers for Disease Control and Prevention, which identified the parasite as a nematode in the genus Dirofilaria It appeared to be dead and degenerating, but external, fine longitudinal cuticular ridges and the presence of tall muscle cells were diagnostic. Thus, Dirofilaria, despite its rarity, should be considered in the differential diagnosis of tumor-like lesions in the buccal mucosa.

Development and characterization of a novel nystatin-loaded nanoemulsion for the buccal treatment of candidosis: ultrastructural effects and release studies.

Oral candidosis is a common opportunistic infection in patients suffering from mucositis (after chemotherapy and radiotherapy administration) and must be treated to prevent infecting other tissue. Nystatin (Nys) is one of the most prescribed drugs to treat this pathology, but because of its physicochemical properties, its pharmaceutical-technological requirements make it a challenge. The purpose of this work was the development and characterization of an optimal Nys delivery system for the potential treatment of oral candidosis avoiding undesirable side effects and toxicity of potential systemic absorption. A nanoemulsion was developed, evaluated, and characterized. It has been formulated successfully as a stable nanoemulsion with a droplet size of 138 nm. Release parameters were estimated using different mathematical approaches, and from the results of ex vivo permeation study of Nys through porcine buccal mucosa, it could be hypothesized that no systemic effects would happen. Microbiologic studies performed revealed an enhanced antifungal effect of the Nys-loaded nanoemulsion. Also, the evaluation of the treated buccal mucosa ultrastructure by transmission electron microscopy revealed a harmless effect. Thus, it could be inferred that the developed formulation could be potentially utilized for candidosis infection under mucositis conditions.

Detection of selected bacterial species in intraoral sites of patients with chronic periodontitis using multiplex polymerase chain reaction

OBJECTIVE: The aim of this study was to detect the prevalence of selected bacterial species in intraoral sites of patients with chronic periodontitis (CP) using multiplex polymerase chain reaction (PCR). METHODOLOGY: Samples were collected from the tongue dorsum, buccal mucosa, supragingival and subgingival plaque and saliva of 30 patients with untreated CP. Multiplex PCR was used to determine prevalence rates, which were then compared using a chi-square test. Significance level was set at p<0.05. Mean and standard deviation values were used to evaluate variations in prevalence according to site. RESULTS: The prevalence of S. mutans was 70 percent in saliva; 60 percent in samples collected from the tongue dorsum; 50 percent in samples collected from the buccal mucosa; 56.5 percent in the supragingival plaque; and 53.5 percent in the subgingival plaque. The prevalence of E. faecalis ranged from 3.5 percent to 13.5 percent in all intraoral microenvironment. The highest prevalence of P. gingivalis was found in subgingival plaque (53.5 percent), and of P. intermedia in supragingival plaque (33.5 percent), subgingival plaque (30 percent) and tongue dorsum (33.5 percent). The prevalence of bacteria did not vary significantly among the intraoral sites. CONCLUSIONS: All studied bacteria were identified in intraoral sites. S. mutans, P. gingivalis and P. intermedia had high prevalence rates, but the prevalence of E. faecalis was low. Multiplex PCR proved to be an adequate method for epidemiological studies.

[Inhibitory effect of baicalin on germ tube formation and adhesion of Candida albicans].

OBJECTIVE: To investigate the effects of baicalin against Candida albicans germ tube formation, and adherence to buccal epitherial and vaginal epitherial cells. METHOD: Various concentrations of baicalin (100, 50, 10 mg x L(-1)) were incubated with C. albicans suspension, the mixed suspension of C. albicans and human buccal epitherial cells, the mixed suspension of C. albicans and vaginal epitherial cells, respectively. The effects of baicalin on C. albicans germ tube formation, and adherence to buccal epitherial and vaginal epitherial cells were then assessed microscopically. RESULT: All concentrations of baicalin could inhibit C. albicans germ tube formation, and adherent to buccal epitherial and vaginal epitherial cells,while there was no significant difference between standard and clinical strains. CONCLUSION: Baicalin could inhibit C. albicans germ tube formation, and adherence to buccal epitherial and vaginal epitherial cells.

Characterisation of potential virulence markers in Pseudomonas aeruginosa isolated from drinking water.

Pseudomonas aeruginosa isolates from tap water, mineral water, and artesian well water were investigated for their ability to produce different potential virulence factors or markers such as hemolysins, hemaglutinins, cytotoxins and their ability to adhere to epithelial cells and to abiotic surfaces. The susceptibility to antibiotics, human serum sensitivity and the survival of P. aeruginosa isolates in a chlorinated environment were also examined. Of the 30 isolates tested, 16 possessed the capacity to adhere to abiotic surfaces, and 28 to adhere to epithelial cells; 30 were capable of producing hemolysins, 27 produced cytotoxins, 9 hemagglutinins, and 18 were classified as serum-resistant. For the lowest concentration of chlorine (0.2 mg/l) tested, no killing of biofilm bacteria could be discerned, even after prolonged exposure to the agent. Although all the drinking water isolates were susceptible to aztreonam, cefepime, ceftazidime, ciprofloxacin, imipenem, meropenem, piperacillin-tazobactam, and polymyxin, the P. aeruginosa isolates were resistant to one or more antibiotics. The increasing prevalence of resistance in the isolates from environmental sources may have important therapeutic implications. A notable proportion of the P. aeruginosa isolates from drinking water were able to develop virulence factors, and the incidence of virulence properties was not statistically different among the three sources. A more extensive study of the virulence properties of this bacterium by toxic assays on animals should be explored. Still more interesting would be toxicity assays on immuno-deficient animals with isolates from drinking water in order to better understand the health risk these bacteria may present.

An association between the DAT1 polymorphism and smoking behavior in young adults from the National Longitudinal Study of Adolescent Health.

Associations between smoking behavior and polymorphisms in the dopaminergic genes (DAT1 and DRD2) were tested by using within- and between-family measures of allelic transmission in 2,448 young adults from the National Longitudinal Study of Adolescent Health. The 9-repeat allele of the dopamine transporter gene polymorphism (DAT1) was inversely associated with smoking in samples that included all subjects and only those who had initiated smoking, accounting for approximately 1% of the variance. Never smokers and current nonsmokers had an excess transmission of the 9-repeat allele compared with regular smokers, suggesting a protective effect of the 9-repeat allele, which is hypothesized to alter synaptic dopamine levels.

Reduction in the adherence of Pseudomonas aeruginosa to human buccal epithelial cells with neuraminidase inhibition.

The aim of this study was to evaluate the reduction in the adherence of 33 strains of Pseudomonas aeruginosa isolated from humans and different animals to human buccal epithelial cells with neuraminidase inhibition. Buccal epithelial cells were incubated with strains of Pseudomonas aeruginosa in the presence or absence of the neuraminidase inhibitors, 2,3-dehydro-2-deoxy-N-acetyl-neuraminic acid (DANA) or N-acetyl-neuraminic acid (NANA). Incubation of cells with bacteria in the presence of either DANA or NANA reduced bacterial adherence significantly by 35.24 +/- 23.90%, and 68.00 +/- 22.51 %, respectively. We suggest that the in vivo effects of such interventions should be explored as potential mechanisms reducing Pseudomonas aeruginosa in the binding to buccal cells.

Facial reconstruction after mucormycosis in an immunocompetent host.

Cutaneous mucormycosis in the immunocompetent patient is exceedingly rare. However, if the infection is not rapidly identified and aggressively treated, its progression is fast, fulminate, and characteristically fatal. This case report describes the treatment and surgical reconstruction of a previously healthy, immunocompetent girl after pervasive mucormycosis of the right face. The patient's diagnosis was established by tissue biopsy. She was promptly started on 1.5 mg/kg per day intravenous amphotericin B and underwent numerous surgical debridements resulting in a large defect of the right face. After 2 xenograft procedures the defect was covered with an autologous split thickness skin graft. During this procedure a submandibular 4 x 7-cm tissue expander with a remote occipital port was placed superficial to the platysma. Serial tissue expansion took place over 8 weeks without complication. The tissue expander was removed and the expanded flap was advanced over the freshly de-epithelialized defect. Revisional surgeries may yet be performed; notwithstanding, the patient and her parents are pleased with the current results. Although the management of cutaneous mucormycosis often involves disfiguring tissue resection, the current wealth of reconstructive modalities can greatly improve the aesthetic and functional outcomes of requisite therapy.

[An oral infection not to be underestimated: actinomycosis. A study of 4 cases with extensive bone necrosis]. / Une infection buccale à ne pas sous-estimer: l'actinomycose. Etude de 4 observations avec nécrose osseuse extensive.

We report 4 cases of osteitis with extensive necrosis of the maxillofacial bone due to actinomycosis. Histological study showed soft tissue necrosis with bone involvement, suppuration and granulomatous inflammation. At contact with bone destruction, numerous Gram and PAS positive bacteria with branched filaments, inconsistently associated with granules, were noted. Cultures were negative. Ultrastructural study showed in two cases, some elongated bacteria, variable in size, less to one micron in diameter, associated with ossein destruction. Actinomycetes usually represented in the normal oral flora, may become pathogenic in debilited host. Histologic study is necessary for the diagnosis allowing to confirm the tissue invasion by the bacteria.

Adherence of Pseudomonas aeruginosa to human buccal epithelial cells.

The aim of this study was to evaluate adherence of 83 strains of Pseudomonas aeruginosa isolated from humans and different animals to trypsin-treated buccal cells. We have demonstrated that Pseudomonas aeruginosa attached to trypsin-treated buccal cells in far greater numbers than to cells from controls (normal buccal epithelial cells). The mean number of bacteria adhering to trypsin-treated cells amounted 107.05 +/- 102.16 and to normal cells - 6.97 +/- 3.53. We conclude that exposure of cells to proteolytic enzymes increases Pseudomonas aeruginosa binding to buccal cells.

Candida-associated denture stomatitis.

Candida-associated denture stomatitis was demonstrated by its cultivation in 171 out of 240 patients examined with partial or total dentures. After taking smears from lesions of the oral mucosa (tongue, cheeks, palate) and the contiguous denture surface by cotton wool swabs and inoculating them onto Sabouraud glucose agar and CHROMagar Candida, individual yeast species were identified by a germ tube, filamentous, and assimilation tests employing the commercial kit AuxaColor. Seven Candida species were identified in smears from the oral mucosa lesions and the contiguous denture surface: C. albicans (95 patients), C. tropicalis (26), C. parapsilosis (20), C. krusei (14), C. guilliermondii (12), C. lusitaniae (1) and C. freyschusii (1). Diabetes mellitus, neoplastic diseases, chemotherapy, radiotherapy, and broad-spectrum antibiotic therapy were identified as some of the large number of factors predisposing patients to stomatitis prothetica.

Inoculation of Lacazia loboi into the subcutaneous tissue of the hamster cheek pouch.

The subcutaneous tissue of the hamster cheek pouch, a site of immunologic privilege, has been used to investigate the potential infectivity of different types of parasites. It has been demonstrated that the implantation of fragments of lesions induced by the fungus Lacazia loboi, the etiologic agent of Jorge Lobo's disease, into the subcutaneous tissue of the hamster cheek pouch resulted in parasite multiplication and dissemination to satellite lymph nodes16. Here we describe the evolution of lesions induced by the inoculation of the isolated fungus into this immunologically privileged site. The morphology of the inflammatory response and fungal viability and proliferation were evaluated. Inoculation of the fungus into the cheek pouch induced histiocytic granulomas with rare lymphocytes. Although fungal cells were detected for a period of up to 180 days in these lesions, the fungi lost viability after the first day of inoculation. In contrast, when the parasite was inoculated into the footpad, non-organized histiocytic lesions were observed. Langhan's giant cells, lymphocytes and fungal particles were observed in these lesions. Fungal viability was observed up to 60 days after inoculation and non-viable parasites were present in the persistent lesions up to 180 days post-inoculation. These data indicate that the subcutaneous tissue of the hamster cheek pouch is not a suitable site for the proliferation of Lacazia loboi when the fungus isolated from human tissues is tested.

Inoculation of Lacazia loboi into the subcutaneous tissue of the hamster cheek pouch

The subcutaneous tissue of the hamster cheek pouch, a site of immunologic privilege, has been used to investigate the potential infectivity of different types of parasites. It has been demonstrated that the implantation of fragments of lesions induced by the fungus Lacazia loboi, the etiologic agent of Jorge Lobo's disease, into the subcutaneous tissue of the hamster cheek pouch resulted in parasite multiplication and dissemination to satellite lymph nodes16. Here we describe the evolution of lesions induced by the inoculation of the isolated fungus into this immunologically privileged site. The morphology of the inflammatory response and fungal viability and proliferation were evaluated. Inoculation of the fungus into the cheek pouch induced histiocytic granulomas with rare lymphocytes. Although fungal cells were detected for a period of up to 180 days in these lesions, the fungi lost viability after the first day of inoculation. In contrast, when the parasite was inoculated into the footpad, non-organized histiocytic lesions were observed. Langhan's giant cells, lymphocytes and fungal particles were observed in these lesions. Fungal viability was observed up to 60 days after inoculation and non-viable parasites were present in the persistent lesions up to 180 days post-inoculation. These data indicate that the subcutaneous tissue of the hamster cheek pouch is not a suitable site for the proliferation of Lacazia loboi when the fungus isolated from human tissues is tested.

The relationship between the acid and alkaline phosphatase activity and the adherence of clinical isolates of Candida parapsilosis to human buccal epithelial cells.

Candida parapsilosis is an emerging fungal pathogen implicated in many diseases, especially in compromised hosts. Candidal colonization and infection depends on the initial ability to adhere to host surfaces, which in turn depends upon the cell wall components and the allied structures of both the host and the fungus. Examination of a miscellaneous collection of 24 C. parapsilosis isolates, from both superficial and deep infections, for their potential pathogenic traits displayed a relationship between the phosphatase activity measured with p-nitrophenol phosphate and adhesion of the yeasts to human buccal epithelial cells (BECs). Significant intraspecies differences were seen in both the alkaline and acid phosphatase activity as well as in their adhesion to BECs (p<0.0001). The acid phosphatase activity of the superficial isolates was significantly greater (152%) than that of the systemic isolates (p = 0.0352). A highly significant positive correlation was also established between the yeast adhesion to BECs and both the acid (r = 0.88, p<0.0001) and alkaline (r = 0.9, p<0.0001) phosphatase activity. These relationships, described here for the first time, imply that phosphatases of Candida species may play a crucial role in potentiating their virulence.

The lom gene of bacteriophage lambda is involved in Escherichia coli K12 adhesion to human buccal epithelial cells.

The role of the lom gene of bacteriophage lambda in adhesion of Escherichia coli to human buccal epithelial cells (HBC) was studied testing the adherence of lamda lom+ and lambda lom::TnphoA E. coli lysogens. lambda lom+ prophage increased 50% E. coli adhesion. This effect was not observed with lambda lom::TnphoA. These results suggest that the normal Lom protein participates directly in adhesion or regulates the synthesis of other protein(s), which may be involved in adhesion.