Identification of mutans and other oral streptococci by random amplified polymorphic DNA analysis

DNA finger printing of S. Mutans present in the saliva of caries active children and those associated with intellectual disability - An RAPD analysis

Aim

The aim of this study is, to evaluate and compare the diversity of S. Mutans genotypes with respect to caries activity among normal children and intellectually disabled children, which would enable the clinician to plan better strategies for early caries detection, management and prevention.

Materials and methods

Genotyping of S. Mutans was done by collecting the saliva samples from 40 caries active children (20 normal and 20 children associated with intellectual disability by Rapid amplified polymorphic DNA analysis using three arbitrarily primers (P1, P2, P3). Rapid amplified polymorphic DNA (RAPD) is preferred because of its reliability, reproducibility in generating genetic fingerprints of Streptococcus isolates.

Results

Number of bacterial counts in Group I showed a mean of 111.6500 followed by the Group II with a mean of 102.6500. Therefore, the difference in the number of bacterial counts was not significant between the two groups (p < 0.001). Genotype encoding Primer 1 was present in almost 82.5% of the total population of both groups. Genotype encoding Primer 2 was present in 95% of the total population. Whereas, Genotype encoding Primer 3 was present in 20% of children associated with intellectual disability and 95% of normal children.

Interpretation and conclusion

There was no significant difference in S. Mutans count of normal caries active children to that of caries active children with intellectual disability, but, there was a significance difference in the distribution of S. Mutans genotypes in both the groups.

Genotypic diversity and acidogenicity of Streptococcus mutans in Down syndrome children

AIMS

To evaluate the genotypic diversity and acidogenicity of Streptococcus mutans (S. mutans) and the potential association of these factors with dental caries experience in children with DS compared to non-DS children (controls).

METHODS AND RESULTS

Seventeen children (age 6-12 years) with high salivary S. mutans counts (> 2.5 × 10⁵ CFU/mL) were selected and divided into two groups: DS and non-DS. Five children in each group were caries-free, while the remainder had elevated caries experience. S. mutans isolates were obtained from each participant. The genotypic profile of the isolates was analyzed with the AP-PCR methodology. The acidogenicity of a representative strain from each genotype of S. mutans was also evaluated. DS children had 16 different S. mutans genotypes, while the control group had 21. Twelve genotypes were present in both groups and one of them was associated with caries-free status (P < .05). Although the acidogenicity of the genotypes found in DS children was significantly lower (P < .05) compared to controls, this fact was not associated with caries experience in both groups.

CONCLUSIONS

DS children have a lower S. mutans genotypic diversity and genotypes with lower acidogenicity than those of non-DS children. However these findings were not associated with their caries experience.

Raffinose Induces Biofilm Formation by Streptococcus mutans in Low Concentrations of Sucrose by Increasing Production of Extracellular DNA and Fructan

Streptococcus mutans is the primary etiological agent of dental caries and causes tooth decay by forming a firmly attached biofilm on tooth surfaces. Biofilm formation is induced by the presence of sucrose, which is a substrate for the synthesis of extracellular polysaccharides but not in the presence of oligosaccharides. Nonetheless, in this study, we found that raffinose, which is an oligosaccharide with an intestinal regulatory function and antiallergic effect, induced biofilm formation by S. mutans in a mixed culture with sucrose, which was at concentrations less than those required to induce biofilm formation directly. We analyzed the possible mechanism behind the small requirement for sucrose for biofilm formation in the presence of raffinose. Our results suggested that sucrose contributed to an increase in bacterial cell surface hydrophobicity and biofilm formation. Next, we examined how the effects of raffinose interacted with the effects of sucrose for biofilm formation. We showed that the presence of raffinose induced fructan synthesis by fructosyltransferase and aggregated extracellular DNA (eDNA, which is probably genomic DNA released from dead cells) into the biofilm. eDNA seemed to be important for biofilm formation, because the degradation of DNA by DNase I resulted in a significant reduction in biofilm formation. When assessing the role of fructan in biofilm formation, we found that fructan enhanced eDNA-dependent cell aggregation. Therefore, our results show that raffinose and sucrose have cooperative effects and that this induction of biofilm formation depends on supportive elements that mainly consist of eDNA and fructan.IMPORTANCE The sucrose-dependent mechanism of biofilm formation in Streptococcus mutans has been studied extensively. Nonetheless, the effects of carbohydrates other than sucrose are inadequately understood. Our findings concerning raffinose advance the understanding of the mechanism underlying the joint effects of sucrose and other carbohydrates on biofilm formation. Since raffinose has been reported to have positive effects on enterobacterial flora, research on the effects of raffinose on the oral flora are required prior to its use as a beneficial sugar for human health. Here, we showed that raffinose induced biofilm formation by S. mutans in low concentrations of sucrose. The induction of biofilm formation generally generates negative effects on the oral flora. Therefore, we believe that this finding will aid in the development of more effective oral care techniques to maintain oral flora health.

Colonization, safety, and tolerability study of the Streptococcus salivarius 24SMBc nasal spray for its application in upper respiratory tract infections

Streptococcus salivarius, a non-pathogenic species and the predominant colonizer of the oral microbiota, finds a wide application in the prevention of upper respiratory tract infections, also reducing the frequency of their main pathogens. In this pilot study, the primary objective was to evaluate the safety and tolerability of a nasal spray, S. salivarius 24SMBc, as a medical device in a clinical study involving 20 healthy adult subjects. The secondary aim was to determine the ability of colonization assessed by molecular fingerprinting. Twenty healthy adult subjects, aged between 30 and 54 years, without a medical history of recurrent otitis media, were enrolled. All patient characteristics fulfilled the inclusion criteria. All subjects were treated daily for 3 days with the nasal spray containing S. salivarius 24SMBc at a concentration of 5 × 10(9) colony-forming units (CFU)/ml. The persistence of S. salivarius in the nasopharynx was investigated by the antagonism test and random amplified polymorphic DNA polymerase chain reaction (RAPD-PCR). The tolerability and safety were clinically assessed by clinical examinations during treatment. Our results demonstrate the capability of S. salivarius 24SMBc to colonize the rhinopharynx tissues in 95% of subjects and persist in 55% of them after 6 days from the last dose of the formulation, maintaining a concentration of 10(5) CFU/ml. The treatment was well tolerated by all healthy patients and no adverse effects were found. The topical application of streptococcal probiotics is a relatively undeveloped field but is becoming an attractive approach for both prevention and therapy, especially for pediatric age patients. S. salivarius 24SMBc possess characteristics making this strain suitable for use in bacteriotherapy.

Enhancement of Lactobacillus reuteri KUB-AC5 survival in broiler gastrointestinal tract by microencapsulation with alginate-chitosan semi-interpenetrating polymer networks

AIMS

To evaluate an alginate-chitosan microcapsule for an intestinal probiotic delivery system for broilers.

METHODS AND RESULTS

Lactobacillus reuteri KUB-AC5 was successfully microencapsulated with alginate and chitosan mixtures using an emulsion cross-linking method with high microencapsulation efficiency. Scanning electron microscopy revealed a large number of the bacteria entrapped in the semi-interpenetrating network. The microcapsule effectively protected the cells against strong acids. The in vitro study showed that the 8 log CFU g(-1) was released at the jejunum and ileum. For the in vivo study, the number of probiotics was detected by a polymerase chain reaction-based random amplified polymorphic DNA technique. From provision of 10 log CFU, cell numbers of 5-8 log CFU were observed in the intestine.

CONCLUSIONS

The alginate-chitosan microcapsule can serve as a potential intestine-targeted probiotic delivery system.

SIGNIFICANCE AND IMPACTS OF THE STUDY

To the best of our knowledge, this is the first comparison study of the in vitro and in vivo gastrointestinal profiles of microencapsulated probiotics used as feed additives for broilers. This study reveals the similarities and differences of the in vitro and in vivo probiotic profiles and provides convincing evidence of the potential use of the alginate-chitosan microcapsule as a probiotic delivery system.

Phenotypic and genotypic characterization of invasive Streptococcus pneumoniae clinical isolates

BACKGROUND

The emergence of infection caused by invasive penicillinnonsusceptible (PNS) and multidrug-resistant strains of Streptococcus pneumoniae has become a worldwide concern, necessitating the epidemiologic surveillance of such strains.

OBJECTIVES

One aim of this study was to identify clones of invasive PNS S pneumoniae among isolates in Riyadh, Saudi Arabia. The second aim was to compare these clones with international clones to track their spread in Saudi Arabia.

METHODS

The phenotypes of invasive isolates characterized as S pneumoniae were determined using susceptibility testing and serotyping (capsular test and E-test). The genotypes of PNS isolates were determined using random amplified polymorphic DNA analysis. The genetic relatedness of these local strains to the international widespread clones was investigated.

RESULTS

Of 296 S pneumoniae isolates identified using biochemical and culture characteristics, 89 (30.1%) were invasive. Susceptibility testing using the E-test revealed that 17 of the 89 invasive isolates (19.1%) were PNS. Most of the 89 isolates (89.9%) were resistant to sulfamethoxazole-trimethoprim; 32.6% and 23.6% of isolates were resistant to chloramphenicol and tetracycline, respectively. All of the isolates (100.0%) were fully susceptible to ceftriaxone and vancomycin. Capsular serotyping of the 89 isolates showed that 19A (18.0%), 613 (14.6%), 23F (13.5%), 9V (11.2%), 14 (6.7%), 19F (5.6%), and 18C (4.5%) were the most predominant serogroups/serotypes. The 17 PNS strains were confirmed on polymerase chain reaction to have penicillin resistance genes. Of these 17 strains, international clone 19A-a was the most predominant (41.2%), followed by 6B-a (17.6%), and 23F-a and 9V-a (each, 11.8%).

CONCLUSIONS

The present study identified the spread of the 4 most commonPNS S pneumoniae isolates (clones)-19A, 613, 23F, and 9V-to Riyadh, but identified no new clones among patients having invasive infection with S pneumoniae in Riyadh. This study emphasizes that international PNS clones have contributed to the prevalence and spread of PNS pneumococci among the clinical isolates in Saudi Arabia.

Microbial analysis of bite marks by sequence comparison of streptococcal DNA

Bite mark injuries often feature in violent crimes. Conventional morphometric methods for the forensic analysis of bite marks involve elements of subjective interpretation that threaten the credibility of this field. Human DNA recovered from bite marks has the highest evidentiary value, however recovery can be compromised by salivary components. This study assessed the feasibility of matching bacterial DNA sequences amplified from experimental bite marks to those obtained from the teeth responsible, with the aim of evaluating the capability of three genomic regions of streptococcal DNA to discriminate between participant samples. Bite mark and teeth swabs were collected from 16 participants. Bacterial DNA was extracted to provide the template for PCR primers specific for streptococcal 16S ribosomal RNA (16S rRNA) gene, 16S–23S intergenic spacer (ITS) and RNA polymerase beta subunit (rpoB). High throughput sequencing (GS FLX 454), followed by stringent quality filtering, generated reads from bite marks for comparison to those generated from teeth samples. For all three regions, the greatest overlaps of identical reads were between bite mark samples and the corresponding teeth samples. The average proportions of reads identical between bite mark and corresponding teeth samples were 0.31, 0.41 and 0.31, and for non-corresponding samples were 0.11, 0.20 and 0.016, for 16S rRNA, ITS and rpoB, respectively. The probabilities of correctly distinguishing matching and non-matching teeth samples were 0.92 for ITS, 0.99 for 16S rRNA and 1.0 for rpoB. These findings strongly support the tenet that bacterial DNA amplified from bite marks and teeth can provide corroborating information in the identification of assailants.

Point-of-care salivary microbial tests for detection of cariogenic species--clinical relevance thereof--review

Dental caries is a highly prevalent multifactorial disease that can result in serious health impairment. It was shown that oral bacteria play a significant role in caries development. Point-of-care (POC) salivary microbial tests for detection of cariogenic species have been investigated as a potential tool for caries risk assessment. This review aims to evaluate clinical relevance of these tests in the light of recent scientific evidence. Methodology involved PubMed search using key words salivary microbial tests, cariogenic bacteria and caries risk prediction. Articles obtained by the search were cross-referenced to obtain further sources. Specificity and negative-predictive value of these tests are higher than their sensitivity and positive value. Predictive power of the POC salivary microbial tests as a single predictor is generally weak, although it increases when included in multifactorial models for caries prediction. Literature findings support the use of these tests for screening of at-risk individuals in a population of young preschool children without visible caries and for motivation of subjects on individual level. POC salivary microbial tests are simple and inexpensive and, therefore, may be advantageous from public health perspective.

Generation of diversity in Streptococcus mutans genes demonstrated by MLST

Streptococcus mutans, consisting of serotypes c, e, f and k, is an oral aciduric organism associated with the initiation and progression of dental caries. A total of 135 independent Streptococcus mutans strains from caries-free and caries-active subjects isolated from various geographical locations were examined in two versions of an MLST scheme consisting of either 6 housekeeping genes [accC (acetyl-CoA carboxylase biotin carboxylase subunit), gki (glucokinase), lepA (GTP-binding protein), recP (transketolase), sodA (superoxide dismutase), and tyrS (tyrosyl-tRNA synthetase)] or the housekeeping genes supplemented with 2 extracellular putative virulence genes [gtfB (glucosyltransferase B) and spaP (surface protein antigen I/II)] to increase sequence type diversity. The number of alleles found varied between 20 (lepA) and 37 (spaP). Overall, 121 sequence types (STs) were defined using the housekeeping genes alone and 122 with all genes. However pi, nucleotide diversity per site, was low for all loci being in the range 0.019-0.007. The virulence genes exhibited the greatest nucleotide diversity and the recombination/mutation ratio was 0.67 [95% confidence interval 0.3-1.15] compared to 8.3 [95% confidence interval 5.0-14.5] for the 6 concatenated housekeeping genes alone. The ML trees generated for individual MLST loci were significantly incongruent and not significantly different from random trees. Analysis using ClonalFrame indicated that the majority of isolates were singletons and no evidence for a clonal structure or evidence to support serotype c strains as the ancestral S. mutans strain was apparent. There was also no evidence of a geographical distribution of individual isolates or that particular isolate clusters were associated with caries. The overall low sequence diversity suggests that S. mutans is a newly emerged species which has not accumulated large numbers of mutations but those that have occurred have been shuffled as a consequence of intra-species recombination generating genotypes which can be readily distinguished by sequence analysis.

Evaluation of genotypic diversity of Streptococcus mutans using distinct arbitrary primers

Streptococcus mutans has been considered one of the main etiological agents of dental caries and the genotypic diversity rather than its salivary counts may be considered as a virulence factor of this bacterium. For genotyping with polymerase chain reaction (PCR) with arbitrary primers, several primers have been used in order to improve complexity and specificity of amplicon patterns. Thus, the aim of this study was to evaluate the degree of agreement of genotypic identification among AP-PCR reactions performed with 5 distinct arbitrary primers of S. mutans isolated from saliva. Stimulated saliva was collected from 11 adult volunteers for isolation of S. mutans, and a total of 88 isolates were genotyped with arbitrary primers OPA 02, 03, 05, 13 and 18. Fourteen distinct genotypes were identified in the saliva samples. Most volunteers (9 out of 11) presented only one genotype. The results of the present study suggest that primers OPA 02, 03, 05 and 13 were suitable for genotypic identification of S. mutans isolates of saliva from adult volunteers.

Principles and applications of polymerase chain reaction in medical diagnostic fields: a review

Recent developments in molecular methods have revolutionized the detection and characterization of microorganisms in a broad range of medical diagnostic fields, including virology, mycology, parasitology, microbiology and dentistry. Among these methods, Polymerase Chain Reaction (PCR) has generated great benefits and allowed scientific advancements. PCR is an excellent technique for the rapid detection of pathogens, including those difficult to culture. Along with conventional PCR techniques, Real-Time PCR has emerged as a technological innovation and is playing an ever-increasing role in clinical diagnostics and research laboratories. Due to its capacity to generate both qualitative and quantitative results, Real-Time PCR is considered a fast and accurate platform. The aim of the present literature review is to explore the clinical usefulness and potential of both conventional PCR and Real-Time PCR assays in diverse medical fields, addressing its main uses and advances.

Species identification of mutans streptococci by groESL gene sequence

The near full-length sequences of the groESL genes were determined and analysed among eight reference strains (serotypes a to h) representing five species of mutans group streptococci. The groES sequences from these reference strains revealed that there are two lengths (285 and 288 bp) in the five species. The intergenic spacer between groES and groEL appears to be a unique marker for species, with a variable size (ranging from 111 to 310 bp) and sequence. Phylogenetic analysis of groES and groEL separated the eight serotypes into two major clusters. Strains of serotypes b, c, e and f were highly related and had groES gene sequences of the same length, 288 bp, while strains of serotypes a, d, g and h were also closely related and their groES gene sequence lengths were 285 bp. The groESL sequences in clinical isolates of three serotypes of S. mutans were analysed for intraspecies polymorphism. The results showed that the groESL sequences could provide information for differentiation among species, but were unable to distinguish serotypes of the same species. Based on the determined sequences, a PCR assay was developed that could differentiate members of the mutans streptococci by amplicon size and provide an alternative way for distinguishing mutans streptococci from other viridans streptococci.

Oral care in intensive care units: A literature review

Patients in an intensive care unit (ICU) may have significant oral health needs. This article offers a review of the available literature regarding oral care for patients in the ICU. Based on this review, the author describes signs and symptoms reported as common among patients in the ICU and makes recommendations concerning their oral care. The implications of these findings are also discussed.

Determination of mutacin activity and detection of mutA genes in Streptococcus mutans genotypes from caries-free and caries-active children

Relationships between genetic diversity, mutacin production and sensitivity to mutacins in Streptococcus mutans were evaluated in 19 clinical isolates from caries-free and caries-active children. Mutacin production was tested against 30 indicator strains; results showed significant variations in the inhibitory spectra of the clinical isolates. There was no association between the inhibitory spectrum of the infecting strain and the caries experience or the level of mutans streptococci infection of the host. Homology to the mutA gene coding for mutacin II was detected in one clinical isolate; none of the clinical isolates showed homology to the mutA genes coding for mutacins I or III. Genotyping by random amplified polymorphic DNA (RAPD) reactions grouped the isolates into three clusters, but no correlation was found between any of the clusters and mutacin activity, caries experience or level of mutans streptococci in the host.

Tracing genotypes of mutans streptococci on tooth sites by random amplified polymorphic DNA (RAPD) analysis

The aim of this study was to clarify the distribution and persistence of mutans streptococci on different tooth sites in the same oral cavity. Thirteen subjects, aged 20-40 years, were examined. Salivary levels of mutans streptococci, caries prevalence, oral hygiene habits and status of tooth surfaces sampled were recorded. Plaque samples were obtained from four sites, the mesial and buccal surfaces of the first permanent molar on the right side of the lower jaw (46m and 46b), the distal surface of the first permanent premolar (24d) and the mesial surface of the second permanent premolar (25m) on the left side of the upper jaw, using sterile toothpicks on two occasions at 4-7-month intervals. The samples were cultivated on site-specific Strip mutans. Up to 10 colonies/site were isolated when present and genotyped by random amplified polymorphic DNA (RAPD) analysis, after species identification with PCR. Genotyping was also performed by restriction endonuclease analysis (REA) on 148 isolates, and results were consistent with the RAPD results. Most mutans streptococcus-positive samples were obtained from 46m. Within each individual, the same genotype occurred on at least two sites on all but one sampling occasion. A maximum of seven different genotypes were found in an individual. For a particular tooth site, four genotypes occurred simultaneously and taking both sampling occasions together the maximum was six different types. The same genotypes/types were found again after 4-7 months on 25 sites in 12 subjects. Fifteen sites were mutans streptococcus-positive on only one sampling occasion. The results indicate that several different genotypes of mutans streptococci colonize a tooth site, and that the same genotype colonizes several sites in the same oral cavity. Persistence of genotypes on a site for several months and interindividual differences in the occurrence of genotypes were also found.

Typing and subtyping of 83 clinical isolates purified from surgically implanted silicone feeding tubes by random amplified polymorphic DNA amplification

In this study, 83 clinical isolates purified from biofilms colonizing 18 silicone gastrostomy devices (12 "buttons" and six tubes converted to skin level devices) were selected for subtype characterization utilizing genetic analysis. The tubes, previously used for feeding, remained in place for 3 to 47 months (mean, 20.0 months) in children ranging in age from 6 months to 17 years. Classification of specific microbes using random amplified polymorphic DNA (RAPD) analysis revealed genetic similarities and differences among isolates belonging to the same genus. Both gram-positive and -negative bacteria were investigated, including 2 isolates of Bacillus brevis, 4 isolates of Bacillus licheniformis, 2 isolates of Bacillus pumilus, 3 isolates of Enterococcus durans, 19 isolates of Enterococcus faecalis, 8 isolates of Enterococcus faecium, 2 isolates of Enterococcus hirae, 7 isolates of Escherichia coli, 8 isolates of Lactobacillus plantarum, 19 isolates of Staphylococcus aureus, 2 isolates of Staphylococcus epidermidis, and 7 isolates of Staphylococcus saprophyticus. Amplified DNA fragments (amplicons) provided species-specific fingerprints for comparison by agarose gel electrophoresis. A total of 62 distinct RAPD types were categorized from the five genera studied. Typing analysis suggested cross acquisition of E. coli, E. faecalis, and S. aureus in three patient pairs. Genomic polymorphism detection proved efficient and reliable for classifying bacterial subtypes isolated from biofilms adhering to various portions of commonly employed enteral access tubes.

A rapid procedure for isolating chromosomal DNA from Lactobacillus species and other Gram-positive bacteria

This study describes a rapid procedure for the isolation of genomic DNA from various Gram-positive bacteria. Species tested included Lactobacillus delbrueckii subsp. lactis ATCC 4797, Lact. acidophilus N2, Staphylococcus aureus, Staph. epidermidis, Propionibacterium jensenii P126, Bacillus pumilus and Enterococcus faecalis. Our technique for chromosomal DNA isolation circumvents the need for phenol-chloroform extractions and caesium chloride gradients. Isolated DNA is consistently greater than 25 kb in size and can be used directly for subcloning, polymerase chain reaction amplification, restriction digestions and library construction.