Improvisation and Evaluation of Laterosporulin Coated Titanium Surfaces for dental Applications: An In Vitro Investigation.

Despite recent improvement in implant survival rates, there remains a significant demand for enhancing the long-term clinical efficacy of titanium (Ti) implants, particularly for the prevention of peri-implantitis. Bioactive substances such as antimicrobial peptides are emerging as effective alternatives for contemporary antimicrobial agents used in dental health care. Current research work was focused to use laterosporulins that are non-haemolytic cationic antimicrobial peptides from Brevibacillus spp. for coating commercially available Ti discs. The coated Ti surfaces were evaluated in vitro for biofilm formation by two dental plaque isolates Streptococcus gordonii strain DIGK25 and S. mutans strain DIGK119 as representatives of commensal and pathogenic streptococci respectively. The biofilm inhibition was ascertained with replicated experiments on hydroxyapatite discs and confirmed by florescence microscopy. The laterosporulin coated Ti discs showed significantly reduced biofilm formation by oral streptococci and displayed promising potential to enhance the antibacterial surface properties. Such improvised Ti surfaces may curb the menace of oral streptococcal biofilm formation on dental implants and the associated implant failures.

Comparative evaluation of the antibacterial activity of curcumin-coated gutta-percha versus nanocurcumin-coated gutta-percha against Escherichia coli: An in vitro study.

Introduction: Due to its biological and antibacterial qualities, many plants, including curcumin, are used as phytomedicines in dentistry. They are primarily used as intracanal medication in endodontics to prevent probable chemical side effects and also to address antimicrobial resistance. Curcumin nanoformulations have improved antibacterial activity and improved dispersion, making them the superior form of curcumin. The purpose of this study was to assess curcumin and nanocurcumin's antibacterial properties. As a gutta-percha coating, they are to be tested against Escherichia coli. Materials and Methods: The study employs the standard strain of E. coli, ATCC 25922. The antibacterial activity of gutta-percha cones against E. coli is assessed after coating them with suspensions of curcumin and nanocurcumin. Scanning electron microscopy is utilized to evaluate the coatings' continuity. Results: The gutta-percha cones that are untreated, coated with curcumin, and coated with nanocurcumin exhibit significantly different levels of antibacterial activity. There is statistically significant variation in their antibacterial activity. Conclusion: (1) Compared to curcumin-coated and untreated gutta-percha cones, those coated with nanocurcumin exhibit a stronger antibacterial activity. (2) Compared to uncoated gutta-percha cones, gutta-percha cones coated with curcumin exhibit more antibacterial action.

Evaluation of antimicrobial efficacy of nanocurcumin-coated gutta-percha against Enterococcus faecalis: An in vitro study.

Background: Nanocurcumin has antimicrobial properties and it is to be tested as a coating on gutta-percha against Enterococcusi faecalis. Aim: To evaluate the antimicrobial efficacy of nanocurcumin-coated gutta-percha against E. faecalis in comparison with conventional gutta-percha. Materials and Methods: The broth dilution method and colony-forming unit count assay were chosen for the evaluation of the minimum inhibitory concentration (MIC) and minimum bactericidal concentration of nanocurcumin against E. faecalis. ISO size 30, 4% taper gutta-percha cones were manually coated with nanocurcumin. All the coated and noncoated gutta-percha cones were examined under a scanning electron microscope to study the exterior surface. Antibacterial efficacy of nanocurcumin-coated gutta-percha and conventional gutta-percha was seen by agar diffusion method against E. faecalis. Results: MIC of nanocurcumin was observed at 50 mg/ml for E. faecalis. Nanocurcumin-coated gutta-percha showed a larger zone of inhibition when compared to conventional gutta-percha which showed a smaller zone of inhibition (P < 0.0001). Nanocurcumin-coated gutta-percha showed moderate antimicrobial activity, while conventional gutta-percha showed weak activity. Conclusion: The results of the study reveal that nanocurcumin has an antimicrobial activity against E. faecalis. The use of herbal alternatives in endodontics might prove to be advantageous.

An in vitro evaluation of antibacterial effect of curcumin-loaded chitosan nanoparticle-coated gutta-percha against Staphylococcus aureus.

Background: The persistence of microorganisms in root canal system is pivotal factor pertinent to endodontic failure. Even if you meet the highest technical and asepsis standards and also minimize the procedural errors, failures result. The rapidly increasing antibiotic resistance among these bacteria and the adverse effects of these antibiotics along with their toxicity are the main situations indicating the utmost urgent requirement of a safe, effective, natural phytochemical like curcumin with tremendous medicinal potential. Nanoformulations of curcumin are their improved version with enhanced antibacterial activity. Materials and Methods: A thin layer of nanocurcumin was coated on the surface of gutta-percha cones. To observe the uniformity and adherence of nanocurcumin coating on the exterior surface of gutta-percha, scanning electron microscopy (SEM) was done. Further agar gel diffusion technique was used to assess the antimicrobial activity of nanocurcumin-coated gutta-percha cones and conventional gutta-percha cones and their results were compared statistically. Results: The results of SEM study showed a layer of nanocurcumin adhering uniformly to the surface of gutta-percha cones. Furthermore, the nanocurcumin-coated gutta-percha cones demonstrated higher antibacterial activity as compared to the conventional cones. Conclusions: Our study results reveal that the coating of nanocurcumin on gutta-percha cones has augmented their antibacterial activity.

Acquisition of potential reservoirs of nosocomial infection on gadgets and clothing in the dental hospital setting: An epidemiological study.

Introduction: During dental procedures, dental professionals as well as patients are exposed to pathogens and toxic substances, which may be transmitted through direct or indirect contact. Their clothing is visibly soiled during the procedures. Their hands can serve as vectors for the transmission of pathogens. Use of mobiles, laptop, and other gadgets tend to increase the chances of microbial colonization on these surfaces. The objective of the study is to screen for the presence of microorganism the most common items pertaining to our daily personal utility which are being used in the hospital settings, to access the microbial load and their potential hazards. Materials and Methods: In this study, 80 samples were collected from different personal utility items such as white coats, mobiles, hand towels, and laptops. These samples were evaluated for the presence of any microbial colonization on them. Results: All the sampled surfaces showed the presence of microorganisms and all showed polymicrobial growth. Conclusion: These identified surfaces should be cleaned and decontaminated on regular basis to prevent the transmission of pathogens in the dental hospital environment.

Effectiveness of subgingival irrigation and powered toothbrush as home care maintenance protocol in type 2 diabetic patients with active periodontal disease: A 4-month randomized controlled trial.

Background: There is a bidirectional link between diabetes and periodontal disease. Control of active periodontal infection is an essential requisite to maintain optimal oral and systemic health in diabetic patients. The purpose of this study was to evaluate the efficacy of subgingival irrigation and powered toothbrush as home care maintenance protocol in type 2 diabetic patients with active periodontal disease compared to routine oral hygiene. Materials and Methods: Forty (n = 40) diabetic (HbA1c >7%) patients were enrolled in this parallel, examiner-blind, interventional clinical trial. Patients were randomized into two groups: Group A (sonic toothbrush and irrigation with water twice daily) or Group B (manual toothbrush and mouth rinsing with 0.12% Chlorhexidine gluconate (CHX) twice daily)). All patients received Phase I therapybefore the start of the study. Clinical parameters (plaque index [PI], gingival index [GI], oral hygiene index [OHI], pocket depth [PD], clinical attachment level [CAL], and bleeding index [BI]) were assessed at baseline, 1, 2, and 4 months. Levels of C-reactive protein (CRP), HbA1c, and interleukin (IL)-1 ß were assessed at baseline and 4 months only. Verbal and written instructions were provided to each subject specific to their intervention allocation. Descriptive, parametric, and nonparametric analyses were used where appropriate. Results: Sixteen (n = 16) patients in Group A and fifteen (n = 15) patients in Group B completed the 4-month study. Both groups showed a significant difference in BI, PD, CAL, and HbA1c from baseline to 4 months. There were no differences within groups for OHI, GI, or PI and CRP, IL-1 ß. The results are based on an underpowered study due to the drop out of 9 patients reducing the number below the needed 19 patients per group based on the power analysis. Conclusion: Results from this study provide information for future studies on self-care regimens for individuals living with Type 2 diabetes.

Proximal subungual onychomycosis of digitus minimus due to Aspergillus brasiliensis.

Onychomycosis is a common nail infection caused by dermatophytes, non-dermatophytic molds (NDMs) and yeast. Aspergillus spp. are emerging etiological agents of non-dermatophyte mold onychomycosis (NDMO). Though this is usually of cosmetic concern, it may also cause pain and discomfort to the patient. The toenail is more commonly involved as compared to fingernail. The nails are discoloured and disfigured. Onychomycosis may expose the patient to cellulitis of lower extremities. The clinical presentation of dermatophytic and NDM onychomycosis is more or less similar, which creates problem in the diagnosis. Fingernail infection may cause social and psychological problem to the patient if fingernail is involved. Incidence of onychomycosis has been seen more in immunosuppressed individuals, where it is of more serious medical concern. In the present study we are reporting a case of proximal subungual onychomycosis (PSO) due to Aspergillus brasiliensis.

Enterococci in the oral cavity of periodontitis patients from different urban socioeconomic groups.

BACKGROUND: Enterococci are the transient constituents of the oral microbiome and have been now increasingly related to oral and systemic diseases. They have now become the most notable nosocomial pathogens and also been linked to etiology of periodontitis. This study evaluates the prevalence of Enterococci in the chronic periodontitis and healthy Indian cohort in different urban socioeconomic groups. MATERIALS AND METHODS: In this retrospective study, individuals in the age range of 18.75 years were included. Seventy individuals had mild-to-moderate periodontitis and 30 healthy persons were taken as controls. A questionnaire was administered. Paper point samples of gingival crevicular fluid were obtained, pooled, and sent to microbiology laboratory in a transport media. Forty-six isolates were identified as enterococci for statical analyzes Pearson's Chi-square test used and. P < 0.001 was considered to be significant. RESULTS: The prevalence of enterococci was seen mostly in the individuals from lower socioeconomic class, having poor oral hygiene, and smokers. This was significantly different from those of upper class (P < 0.001). The predominant species isolated was Enterococcus faecalis. CONCLUSION: Enterococci particularly E. faecalis followed by Enterococcus faecium could play a crucial role in the severity or progression of periodontitis particularly in a favorable oral environment.

Isolation of a Novel Phage and Targeting Biofilms of Drug-Resistant Oral Enterococci.

INTRODUCTION: Enterococci are now recognized as the second most cause of nosocomial infections worldwide. The emergence of multidrug-resistant strains in the organism has given rise to alternative strategies such as phage therapy. In this study, an Enterococcus faecalis infecting phage was isolated and its efficiency against biofilms formed by drug-resistant enterococci obtained from chronic periodontitis was evaluated. MATERIALS AND METHODS: Bacteriophage against E. faecalis was isolated from sewage sample. The phage was propagated and identified using transmission electron microscope (TEM). In vitro biofilm formation was assessed. RESULTS: TEM microscopy showed that the phage belonged to Siphoviridae family. In the presence of the novel phage, the metabolic activity of enterococci biofilm was reduced at 48 h of contact. A difference of at least 5 log CFU/ml was seen in the live cells of the control biofilm, and the phage treated biofilm of enterococci isolates. CONCLUSION: The study shows that the novel phage inhibits biofilm production in oral enterococci isolates from periodontitis patients but has a narrow host range. The role of bacteriophages as strong biotechnological and natural therapeutic agents for E. faecalis in chronic periodontitis can be considered.

Epidemiology & antibiograms of Vibrio cholerae isolates from a tertiary care hospital in Chandigarh, north India.

BACKGROUND & OBJECTIVE: Cholera is endemic in Chandigarh and its surrounding areas. This retrospective study was undertaken over a period of nine years (January 1999-December 2007) from a tertiary care hospital in north India to understand the changing epidemiology aspects and antibiotic resistance patterns in Vibrio cholerae isolates. METHODS: A total of 277 isolates of V. cholerae were included in the study. V. cholerae was identified by standard microbiological procedures. Antibiotic sensitivity testing was performed by disc diffusion method and isolates phage typed. RESULTS: All the isolates were identified as V. cholerae O1 biotype El Tor serotype Ogawa; phage 27 was the predominant type. Men were more commonly affected with maximum number in the age group 0-5 yr. Majority of the isolates were resistant to furazolidone but sensitive to gentamicin and cefotaxime. Resistance pattern to amoxycillin was variable. Three isolates were found to be resistant to ciprofloxacin. All the patients presented during June-October coinciding with the monsoon season and a majority were from suburbs. INTERPRETATION & CONCLUSION: The emergence of resistance amongst V. cholerae especially towards ciprofloxacin may significantly influence the control strategies in future outbreaks. Phage 27 remained the predominant type in all the years. Continuous surveillance with regard to drug resistance, early detection and a strong regional commitment may help contain the disease.

Biofilm Formation by Drug Resistant Enterococci Isolates Obtained from Chronic Periodontitis Patients.

INTRODUCTION: Enterococci are an important cause of opportunistic nosocomial infections and several multidrug resistant strains have emerged. The severity of periodontal diseases is managed by reduction in the pathogenic bacteria. There is a need to assess the prevalence and antibiotic susceptibility of enterococci colonizing the periodontal pocket and correlate its biofilm formation ability because oral biofilms provide a protective environment and are a reservoir of bacterial colonization of the gingival crevice. AIM: To investigate possible association between antibiotic susceptibility and biofilm formation in enterococci isolates from chronic periodontitis patients. MATERIALS AND METHODS: This retrospective study was conducted at Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Punjab University, Chandigarh from January 2015 to October 2015. Sterile paper points were inserted in the periodontal pocket of 100 subjects and put in a transport media. Forty -six isolates were identified as enterococci. The isolates were further examined for their ability to form biofilm by microtitre plate assay and antimicrobial susceptibility testing was done by disc diffusion method for clinically relevant antibiotics. RESULTS: Significant relationship (p<0.001) was found between biofilm production with antibiotic resistance to Vancomycin, Erythromycin, Ciprofloxacin, Tiecoplanin, Amoxycillin and Gentamycin. CONCLUSION: The study demonstrates a high propensity among the isolates of Enterococci to form biofilm and a significant association of biofilm with multiple drug resistance.

Susceptibility of Urinary Tract Bacteria to Newer Antimicrobial Drugs.

Urinary tract infections (UTIs) are among the commonest types of bacterial infections. The antibiotic treatment for UTIs is associated with important medical and economic implications. Many different microorganisms can cause UTIs though the most common pathogens are E. coli and members of family Enterobacteriaceae. The knowledge of etiology and antibiotic resistance pattern of the organisms causing urinary tract infection is essential. The present study was undertaken to evaluate trends of antibiotic susceptibility of commonly isolated uropathogens using newer antimicrobial agents, prulifloxacin, fosfomycin (FOM) and doripenem. We conclude that maintaining a record of culture results and the antibiogram may help clinicians to determine the empirical and/or specific treatment based on the antibiogram of the isolate for better therapeutic outcome.

Outbreak of cholera in & around Chandigarh during two successive years (2002, 2003).

BACKGROUND & OBJECTIVE: Outbreaks of cholera caused by Vibrio cholerae O1 Ogawa occurred in and around Chandigarh during two successive year 2002 and 2003. This study highlights the antibiotic sensitivity and phage typing pattern of V. cholerae isolates during 2002 and 2003. METHODS: Faecal specimens from acute gastroenteritis cases from July to September, 2002 and in the same month in 2003 were collected. Isolation and identification of pathogen was done according to standard methodology. Simultaneously water samples from the areas reporting the maximum number of cholera cases were also processed. Antibiotic susceptibility pattern of the isolates was studied and isolates were sent to National Institute of Cholera and Enteric Diseases (NICED), Kolkata for confirmation and phage typing. RESULTS: Of the 156 patients in 2002 and 125 in 2003, 59 and 40 isolates respectively were found to be positive for V. cholerae O1 serotype Ogawa biotype El tor. Of the 45 water samples tested in 2002, eight were found to be positive for V. cholerae O1 serotype Ogawa biotype El tor. None of the 52 water samples tested in 2003 was found to be positive for V. cholerae. Phage type 27 was found to be the predominant type for both the years. Majority of the clinical isolates were found to be resistant to more than two drugs. INTERPRETATION & CONCLUSION: The drug resistance in V. cholerae was on the rise during the subsequent outbreak. Phage 27 remained the predominant type in both the years. The major reason for the outbreak was traced to be contaminated water of the hand pumps in the affected area. Continuous surveillance of the outbreak is necessary to contain the spread of transmission.

Antimicrobial susceptibility pattern of blood isolates from a teaching hospital in north India.

Bloodstream infections are associated with significant patient morbidity and mortality worldwide. In this study, we examined antimicrobial susceptibility patterns by reviewing the data on 5,704 blood samples that were collected from patients with fever/sepsis admitted to Government Medical College and Hospital, Chandigarh, India, over a period of 1 year from August 2003 to July 2004. Among the 567 qualifying samples, Pseudomonas aeruginosa (19.75%), Escherichia coli (15.17%), Klebsiella pneumoniae (14.99%), and Salmonella enterica serovar Typhi (12.87%) were the most frequently isolated Gram-negative bacteria other than Citrobacter, Acinetobacter, Proteus, and Enterobacter spp. collectively accounting for 80.96% of the isolates. Staphylococus aureus (13.86%) and Enterococcus feacalis (2.35%) were most frequently isolated Gram-positive bacteria other than other Streptococcus and Staphylococcus spp. collectively accounting for 18% of the isolates. Among the antibiotics used for susceptibility testing of Gram-negative isolates, amikacin showed higher activity (76.61%) against Enterobacteriaceae and ciprofloxacin (65.17%) against non-fermenters. However, cefoperazone + sulbactum showed the highest activity (82.66%) among all Gram-negative isolates. For Gram-positive isolates, vancomycin (100%), ciprofloxacin (89.74%) showed the highest activity against Staphylococcus spp. Combinations of antibiotics are often prescribed as emperic therapy for bacteremia, especially for Gram-negative pathogens. Hence the antibiotic susceptibility patterns of blood isolates reported here may be a useful guide for physicians initiating emperic therapy with antibiotics.

Nanotechnology: role in dental biofilms.

Biofilms are surface-adherent populations of microorganisms consisting of cells, water and extracellular matrix material Nanotechnology is promising field of science which can guide our understanding of the role of interspecies interaction in the development of biofilm. Streptococcus mutans with other species of bacteria has been known to form dental biofilm. The correlation between genetically modified bacteria Streptococcus mutans and nanoscale morphology has been assessed using AFMi.e atomic force microscopy. Nanotechnology application includes 16O/18O reverse proteolytic labeling,use of quantum dots for labeling of bacterial cells, selective removal of cariogenic bacteria while preserving the normal oral flora and silver antimicrobial nanotechnology against pathogens associated with biofilms. The future comprises a mouthwash full of smart nanomachines which can allow the harmless flora of mouth to flourish in a healthy ecosystem.

Neonatal septicemia isolates and resistance patterns in a tertiary care hospital of North India.

BACKGROUND: Septicemia continues to be a major cause of neonatal mortality and morbidity worldwide. METHODOLOGY: To know the rate of neonatal septicemia in our tertiary care centre, a retrospective analysis of 2,247 blood samples was done over a period of four years and three months (July 2003 to October 2007). RESULTS: During that period, a total of 296 (13.17%) blood samples were found to be positive for bacterial isolates. Gram-negative septicemia (80.40%) was identified in more cases than Gram-positive septicemia (20.60%) with Klebsiella species 84 (28.3%) being the most common isolate. Maximum resistance among Gram-negative organisms was seen in amoxycillin/ampicillin and third-generation cephalosporins. Amikacin, cefoperazone/sulbactam and imipenem were found to be good alternative drugs. Among Gram-positive organisms, all strains were sensitive to Vancomycin. CONCLUSION: Continued surveillance for various pathogens and their susceptibility profile should be done to effectively and timely treat the patients of neonatal septicaemia.