Influence of sublethal antibiotic concentrations on bacterial adherence to saliva-treated hydroxyapatite

OxyR inactivation reduces the growth rate and oxidative stress defense in Capnocytophaga ochracea

OBJECTIVE

The human oral cavity harbors several bacteria. Among them, Capnocytophaga ochracea, a facultative anaerobe, is responsible for the early phase of dental plaque formation. In this phase, the tooth surface or tissue is exposed to various oxidative stresses. For colonization in the dental plaque phase, a response by hydrogen peroxide (H₂O₂)-sensing transcriptional regulators, such as OxyR, may be necessary. However, to date, no study has elucidated the role of OxyR protein in C. ochracea.

METHODS

Insertional mutagenesis was used to create an oxyR mutant, and gene expression was evaluated by reverse transcription-polymerase chain reaction and quantitative real-time reverse transcription-polymerase chain reaction. Bacterial growth curves were generated by turbidity measurement, and the sensitivity of the oxyR mutant to H₂O₂ was assessed using the disc diffusion assay. Finally, a two-compartment system was used to assess biofilm formation.

RESULTS

The oxyR mutant grew slower than the wild-type under anaerobic conditions. The agar diffusion assay revealed that the oxyR mutant had increased sensitivity to H₂O₂. The transcript levels of oxidative stress defense genes, sod, ahpC, and trx, were lower in the oxyR mutant than in the wild-type strain. The turbidity of C. ochracea, simultaneously co-cultured with Streptococcus gordonii, was lower than that observed under conditions of homotypic growth. Moreover, the percentage decrease in growth of the oxyR mutant was significantly higher than that of the wild-type.

CONCLUSIONS

These results show that OxyR in C. ochracea regulates adequate in vitro growth and escapes oxidative stress.

Capnocytophaga spp. involvement in bone infections: a review

Capnocytophaga are commensal gliding bacteria that are isolated from human and animal oral flora and are responsible for infections both in immunocompromised and immunocompetent hosts. Accumulation of microbial plaque, loss of collagen attachment, and alveolar bone resorption around the tooth can lead to local Capnocytophaga spp. bone infections. These capnophilic bacteria, from oral sources or following domestic animal bites, are also causative agents of bacteraemia and systemic infections as well as osteomyelitis, septic arthritis, and infections on implants and devices. The present literature review describes the main aetiologies of bone infections due to Capnocytophaga spp., the cellular mechanisms involved, methods used for diagnosis, antimicrobial susceptibility, and effective treatments.

Systemic anti-microbial agents used in periodontal therapy

Periodontitis is an infectious disease with marked inflammatory response, leading to destruction of underlying tissues. The aim of periodontal therapy is to eradicate the pathogens associated with the disease and attain periodontal health. This is achieved by non-surgical and surgical therapy; however, mechanical debridement and topical application of antiseptics may not be helpful in all cases. In such cases, adjunctive systemic antibiotic therapy remains the treatment of choice. It can reach micro-organisms at the base of the deep periodontal pockets and furcation areas via serum, and also affect organisms residing within gingival epithelium and connective tissue. Before advising any anti-microbial agent, it is necessary to have knowledge of that agent. The aim of this review article is to provide basic details of each systemic anti-microbial agent used in periodontal therapy. The points discussed are its mode of action, susceptible periodontal pathogens, dosage, its use in treatment of periodontal disease, and mechanism of bacterial resistance to each anti-microbial agent. It might be of some help while prescribing these drugs.

Direct evidence for the involvement of extracellular proteins in the adhesion of Azospirillum brasilense

Adhesion of Azospirillum brasilense to glass and polystyrene was investigated by bringing the cells into contact with the support by sedimentation. Adhesion depended on time and temperature: lower adhesion densities were observed when the contact time was only 2 h or 6 h, as compared to 24 h, or when the test was performed at 4 -C, as compared to 30 °. The influence of cell physiology was further demonstrated by the effect of tetracycline, which inhibited adhesion. Scanning electron microscopy showed that cells produced extracellular material when left in contact with a support for 24 h. The surface elemental composition of cells and of polystyrene supports after cell adhesion and subsequent detachment was determined by X-ray photoelectron spectroscopy; this provided information on the relative concentrations of proteins and polysaccharides at the surface. The protein concentration at the surface of a cell sediment increased as a function of time at 30 °, correlating with an increase of adhesion density. A similar correlation between protein concentration and adhesion density was found when comparing exponentialphase cells with stationary-phase cells. The surface composition of polystyrene supports examined after cell detachment was found to be rich in proteins, indicating that proteins are the major constituent at the support surface. Lowering the contact time, or performing adhesion under unfavourable metabolic conditions (4 °) or in the presence of tetracycline, resulted in a decrease in protein concentration at the support surface, which was correlated with a decrease in adhesion density. The correlation between protein concentration at the cell surface or at the support surface and adhesion density, under different experimental conditions, provides a direct demonstration of the involvement of extracellular proteins in the adhesion of A. brasilense to inert surfaces.

In vitro susceptibility of Streptococcus mutans to chlorhexidine and six other antimicrobial agents

The susceptibility of Streptococcus mutans to chlorhexidine and to six commonly used, systemic antibacterial agents (amoxicillin, cefuroxime, penicillin, sulfamethoxazole-trimethoprim, tetracycline, and erythromycin) was studied for 424 clinical isolates from 116 children and students. The MIC of chlorhexidine for all isolates was < or = 1 micrograms/ml. No resistance to the other antimicrobial agents was detected. Although widely exposed to various antimicrobial agents, S. mutans has remained susceptible to common antimicrobial agents, most importantly to chlorhexidine.

Prevention of infective endocarditis: a review of the medical and dental literature

This paper is a review of what is presently known about the cause and prevention of infective endocarditis. Systemic antibiotics alone are not always enough for an effective prevention of infective endocarditis. Non-streptococcus bacteria frequently found in the periodontal pocket are now reported as causing infective endocarditis; these bacteria are not uniformly susceptible to the antibiotics recommended for prophylaxis. Animal studies indicate that periodontal disease does increase the incidence of infective endocarditis and that the number of microbes entering the blood stream may not be as important in the production of infective endocarditis as other qualities, such as the microbe's ability to adhere. Antibiotics may affect the ability of a microorganism to adhere to tissues of the heart, but this association is yet unclear and may vary with the antibiotic and species of bacteria. Reduction of inflammation of the periodontal tissues is of the utmost importance in the prevention of infective endocarditis; however, mouthrinses have a very limited effect in a periodontal pocket of more than 3 mm in depth and irrigation of a periodontal pocket may create a dangerous bacteremia. Nevertheless, in addition to systemic antibiotics, local antimicrobial agents followed by routine dental treatment and maintenance show promise as an effective means for the prevention of infective endocarditis. Future research in the prevention of infective endocarditis should include placement of antimicrobials in the periodontal pocket and systemic agents that reduce platelet adhesion. The suggestions presented in this review are only recommendations for further research and are not to be construed as a substitute for the current guidelines.

A review of the experimental use of antimicrobial agents in the treatment of periodontitis and gingivitis in the dog

Tetracycline, metronidazole, and chlorhexidine have been tested for their effectiveness in the treatment of periodontitis in dogs under experimental conditions. Tetracycline has been effective in reducing bone resorption in dogs with periodontitis when used in the long-term. When used for short times, it can result in reduction of the numbers of microorganisms that are associated with disease. Tetracycline can inhibit the activity of mammalian collagenase thought responsible for the destruction of alveolar bone and it may be capable of inhibiting the adherence of microorganisms and thus preventing infection. In some experiments, metronidazole was more effective than tetracycline in eliminating spirochetes from the periodontal flora, and it has been found effective in preventing the inflammation and the development of the bacterial flora usually associated with the natural accumulation of plaque. Chlorhexidine (0.2% aqueous solution) has been found effective in preventing the normal progression of periodontal disease when used as a spray for the long-term treatment of dogs. It could prove to be as effective as brushing for the long-term control of periodontitis in the dog. Limited information is available on the use of clindamycin, spiramycin, and vancomycin.

Subinhibitory concentrations of tetracycline alter fibrinogen binding by Bacteroides intermedius

Previous studies from our laboratory have shown that a strain of Bacteroides intermedius, VPI 8944, an organism isolated originally from a patient with acute necrotizing ulcerative gingivitis, binds human fibrinogen rapidly, reversibly, specifically, saturably, and with high affinity (M.S. Lantz, L.M. Switalski, K.S. Kornman, and M. Höök, J. Bacteriol. 163:623-628, 1985). We examined the effect of growth in subinhibitory levels (sub-MICs) of tetracycline on fibrinogen binding by these bacteria and found concentration-dependent inhibition of fibrinogen binding by bacteria grown in the presence of tetracycline over the range of tetracycline concentrations from 1/64 to 1/8 the MIC. Analysis of the binding data suggests that bacteria grown in the presence of sub-MICs of tetracycline bind fewer fibrinogen molecules per cell than do bacteria grown in the absence of the drug. If fibrinogen-mediated adherence is important in the establishment B. intermedius in periodontal lesions and lesions of acute necrotizing ulcerative gingivitis, then tetracycline may be effective in disrupting establishment of these organisms at concentrations well below those required to achieve a bacteriostatic effect.

Cell surface hydrophobicity of Actinobacillus actinomycetemcomitans Y4

Oral bacteria colonize the dento-gingival tissues in a selective manner. Hydrophobic reactions have been suggested as one of the major mechanisms of adhesion. Hydrophobicity of Actinobacillus actinomycetemcomitans Y4 (Aa) cells was studied in vitro using adherence to the liquid hydrocarbon, octane. Adherence of Aa cells to octane varied from 60-90%, depending on the medium in which they were grown, age of the culture and the buffer in which the assay was carried out. These data suggest that Aa is a hydrophobic bacterium, the hydrophobicity of which is expressed to a varying degree, and may have a rôle in its adherence to oral tissues.

Tetracycline-impregnated enamel and dentin: duration of antimicrobial capacity

The present study was done in order to examine the durability of the tetracycline-induced antimicrobial capacity, and also to assess the reproducibility of the bacterial growth-inhibitory assay used. Standardized enamel and dentin specimens were impregnated in aqueous solutions of tetracycline HCl, oxytetracycline HCl or doxycycline HCl, rinsed in water, and stored dry for 200 days. Another series of specimens was impregnated in solutions of doxycycline HCl and then rinsed in tap water for varying periods up to 35 days. In addition, drug-impregnated specimens were used for reproducibility tests without storage or prolonged rinsing. Impregnated specimens were tested for antimicrobial capacity on agar plates seeded with S. sanguis. After 24 h aerobic incubation in 10% CO2 atmosphere, the plates were inspected and the diameter of the bacterial growth inhibition zones measured. The drug-impregnated enamel and dentin specimens consistently demonstrated growth-inhibitory capacity. The results of the reproducibility tests showed moderate intrasample and day-to-day variation. Two hundred days of dry storage or 35 days soaking in water reduced, but did not eliminate, the bacterial growth-inhibitory capacity of the impregnated dental specimens. The results show that a short-term exposure of dental hard tissues to tetracyclines may result in a long-lasting antibacterial capacity.

Adherent interactions which may affect microbial ecology in the mouth

Bacteria attach to teeth and oral mucosal surfaces in a surprisingly selective manner, and attachment appears to be the first step in the colonization process. Attachment is thought to involve lectin-like and/or hydrophobic ligands, called adhesins, often present in bacterial surface appendages which interact with receptors on oral tissues. A variety of factors can influence bacterial attachment, and therefore have the potential to affect host-parasite interactions in the mouth. Factors discussed include salivary components, dietary lectins, and sublethal concentrations of antibiotics.

A rationale for the management of periodontal diseases: effects of tetracycline on subgingival bacteria

Microbiologic criteria obtained with phase-contrast microscopy were used in a short-term, double-blind study to measure the effects of systemic tetracycline HCl on subgingival bacterial populations in advanced periodontal pockets refractory to local therapy (repeated scaling, root planing, and the subgingival administration of chemotherapeutic agents [H2O2, NaHCO3, NaCl, MgSO4]). Twenty-one subjects, selected for study, had at least one of the following conditions present after local therapy: spirochetes, motile rods, or crevicular leukocytes greater than or equal to 125 per phase-contrast microscopic field. Tetracycline HCl (1 gm/day for 14 days) was randomly distributed to 11 subjects and a placebo to ten subjects, so that neither the subjects nor investigators were aware of the prescription contents. Evaluations after two weeks disclosed that tetracycline HCl significantly reduced elevated levels of spirochetes, motile rods, and crevicular leukocytes to low or undetectable levels, whereas levels in the placebo subjects remained generally unchanged. The results clearly demonstrate the value of tetracycline HCl as an adjunct to periodontal therapy in reducing remaining suspected periodontopathic bacterial populations in advanced lesions after local therapy of scaling, root planing, and topically applied chemotherapy.

Bacteriology of experimental gingivitis in young adult humans

From replicate trials of experimental gingivitis in four periodontally healthy subjects, 166 bacterial species and subspecies were detected among 3,034 randomly selected isolates from 96 samples. Of these bacteria, Actinomyces naeslundii (serotype III and phenotypically similar strains that were unreactive with available antisera), Actinomyces odontolyticus (serotype I and phenotypically similar strains that were unreactive with available antisera), Fusobacterium nucleatum, Lactobacillus species D-2, Streptococcus anginosus, Veillonella parvula, and Treponema species A appeared to be the most likely etiological agents of gingivitis. Statistical interpretations indicated that the greatest source of microbiological variation of the total flora observed was person-to-person differences in the floras. The next greatest source of variation was the inflammatory status of the sample sites. Person-to-person differences were smallest at experimental day 4. The floras became more diverse with time and as gingivitis developed and progressed. Analyses indicated that sequential colonization by certain species was repeatable and therefore probably predictable. Variation was relatively small between replicate trials, between two sites on the same teeth sampled on the same day, and between the same sites sampled at the same relative time in a replicate trial.