Survival of gram positive anaerobic cocci on swabs and their isolation from the mouth and vagina.

The survival of Gram positive anaerobic cocci on plain cotton wool and albumin coated swabs held in various transport media was investigated. Results suggested that in most cases Amies', Stuart's and VMGII media do not offer any more protection to the bacteria than storing swabs dry in their containers. A technique was developed for the isolation and identification of Gram positive anaerobic cocci from the mouth and vagina, incorporating bicozamycin in the medium as a selective agent. Few strains were recovered from the oral cavity, but larger numbers were isolated from the vagina. Using a minimum number of antibiotic sensitivity and biochemical tests, including analysis of end products by gas-liquid chromatography, most isolates were identified to species level.

The prevalence of hepatitis B serological markers in dental personnel.

There is a need to assess the risk to members of the dental profession in the U.K. of acquiring hepatitis B from patients. Towards this end a study was performed in order to determine the degree of carriage of serological markers of hepatitis B in a sample of dental workers in and around Edinburgh. Of a total of 88 persons tested only one, a dental assistant, was positive. She had evidence of past infection but did not give a history of previous jaundice. We conclude that in the Edinburgh area the risk of dental personnel acquiring hepatitis B from patients is very small and that routine active immunisation is not necessary. Those who volunteer to treat known hepatitis B virus (HBV) carriers should be offered immunisation and the recommendations of the expert group of the Health Departments of Great Britain on the treatment of HBV carriers should be implemented.

Relationship of oral disease to the presence of cytomegalovirus DNA in the saliva of AIDS patients.

Cytomegalovirus is an important pathogen in persons infected with human immunodeficiency virus. In this study a thorough oral examination was done and blood and urine cultures for cytomegalovirus were obtained from a group of 31 patients with acquired immunodeficiency syndrome with CD4 lymphocyte counts less than 150 cells/mm3. Whole saliva was also collected for detection of cytomegalovirus deoxyribonucleic acid (DNA) via the polymerase chain reaction. The presence of cytomegalovirus DNA in the saliva specimens was not related to the presence of cytomegalovirus in the urine, which suggests a local source of cytomegalovirus from salivary gland and kidney parenchyma. There was also a strong statistical relationship between salivary cytomegalovirus DNA and xerostomia (p = 0.0004), which suggests that cytomegalovirus may be a cause of salivary gland dysfunction in patients with acquired immunodeficiency syndrome with low CD4 counts.

Alteration of humoral responses to Candida in HIV infection.

The objectives of this preliminary study were to determine the prevalence of oral candidal carriage and infection in a group of HIV-positive individuals and compare the humoral immune responses in serum and saliva in this group with a control group of HIV-negative subjects. Patients were examined clinically with particular reference to the presence of candidal lesions and oral swabs taken to identify carriers. Venous blood and whole saliva were obtained for estimation of total and anti-Candida antibody levels. Pseudomembranous candidiasis was the commonest clinical variant in HIV-positive individuals. Candida albicans was the commonest species isolated in both groups. Increased levels of anti-Candida IgG were found in both serum and saliva of HIV-negative individuals who were either carriers of Candida species or had clinical candidiasis. This was associated with a reciprocal fall in anti-Candida IgA. Similar trends were seen in HIV-positive individuals in association with candidal carriage and infection, although the changes were more marked.

Isolation of Bordetella pertussis from swabs.

Four varieties of swabs held in plastic containers and three swab transport media kits, all obtainable in the United Kingdom, were tested to assess their effectiveness in the isolation of Bordetella pertussis. The highest isolation rates up to 48 hours were obtained with Dacron swabs held in plastic containers. Swab-transport media kits proved unsatisfactory. B pertussis may have a stronger affinity to Dacron than to cotton-wool, and pernasal swabs should be made of Dacron to improve the recovery of B pertussis.

Denture stomatitis in the elderly.

A study was carried out of 121 elderly edentulous individuals living in institutionalised homes in the Lothian Region, Scotland to determine the prevalence of yeasts and associated oral disease. Clinical examinations found that 65(54%) of the individuals suffered from denture stomatitis, and yeasts were recovered from 51(78%) of these individuals. The main yeasts isolated were Torulopsis glabrata and Candida albicans. Culture of saliva samples produced a slightly higher recovery rate of yeasts compared with swabbing of the floor of mouth and palate. The number of cigarettes smoked per day had a significant positive effect on the presence of denture stomatitis. No difference in disease state was shown between secretors and non-secretors of blood group antigens in saliva. This study demonstrates a significant level of oral mucosal infection in an institutionalised elderly population.

Chronic atrophic oral candidiasis among patients with diabetes mellitus--role of secretor status.

Non-diabetic individuals who are non-secretors of blood group antigens are prone to superficial infections by Candida albicans. In this study, 216 patients with diabetes mellitus who were denture wearers were examined for the presence or absence of denture stomatitis. There was an overall trend for non-secretors to be prone to denture stomatitis compared with secretors. Stepwise linear discriminant analysis was used to dissect the contribution of secretor status and other variables to the development of the disease. Secretor status was found to be a contributory factor among patients with non-insulin dependent diabetes but not among those with insulin-dependent diabetes. The possible reasons for this are discussed.