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PubMed2000

The prevalence of pathogenic periodontal microflora in healthy young adult smokers.

BACKGROUND: Smoking is a major risk factor in periodontitis, although the mechanisms of its effects are not well understood. The overall goal of this clinical study was to determine if smoking enhances the colonization of the oral cavity by pathogenic bacteria in a periodontitis-free population. The prevalence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Campylobacter rectus, Eikenella corrodens, Bacteroides forsythus, and Treponema denticola was investigated in 25 smokers and 25 non-smokers by using DNA probes. METHODS: The subjects were 21 to 35 years of age with a healthy periodontium or slight gingivitis and were systemically healthy. The test group included subjects who had a minimum of a 1.5 pack-year history of smoking, while the control subjects never smoked. Subgingival plaque samples were taken by paper point following the assessment of multiple clinical parameters. RESULTS: This investigation showed: 1) no statistically significant differences were noted in any clinical parameter measured between the groups; 2) of the 8 subjects who were infected by at least 1 tested pathogen, seven were smokers (P= 0.02); 3) infected smokers had a 15.7+/-3.5 pack-year history and smoked a mean of 27+/-5 cigarettes/day versus 4.4+/-0.8 pack years and 15+/-1 cigarettes/day for the non-infected smokers (P = 0.0001 and P = 0.004); and 4) smokers were 18 times more likely to exhibit the presence of pathogens than non-smokers. CONCLUSIONS: These data indicate that the prevalence of colonization of the sulcus by pathogenic bacterial species in periodontitis-free individuals is related to the quantity and duration of cigarette smoking.

Adult↗
PubMed1994

Short-term microbiological and clinical effects of subgingival irrigation with an antimicrobial mouthrinse.

Fifty chronic adult periodontitis patients completed a 6-week controlled, double-blind, split mouth clinical study to determine the effects of subgingival irrigation with an antimicrobial mouthrinse on periodontal microflora, supragingival plaque, and gingivitis when used as an adjunct to normal oral hygiene. Qualifying subjects had at least four sites, two on each side of the mouth, with probing depths between 4 and 6 mm, which bled on gentle probing. Following baseline examinations, subjects received a half mouth scaling and prophylaxis and full mouth subgingival irrigation with either the antimicrobial mouthrinse or sterile colored water control professionally delivered. Subjects continued irrigation at home once daily for 42 days with their assigned rinse delivered via a subgingival delivery system. All sites in the mouth were scored at baseline and at day 42 for supragingival plaque, bleeding on probing, and redness. For the four selected periodontitis sites, probing depth and attachment level were measured at baseline and on day 42; additionally, supragingival plaque and gingival redness were scored on days 7 and 21. Subgingival plaque samples for microbiological analysis were harvested from the selected periodontal sites at baseline and on days 7, 21, and 42. Microbiologically, irrigation with the antimicrobial mouthrinse resulted in statistically significant reductions compared to control in putative periodontopathogens, including black pigmenting species, which persisted at 42 days. Clinically, subgingival irrigation with the antimicrobial mouthrinse produced a significant reduction in supragingival plaque (P < 0.001), bleeding on probing (P = 0.019), and redness (P = 0.017) compared to the control, whether or not the area irrigated received a prophylaxis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2000

Assessment and management of periodontal infections: a medical-surgical approach.

Over the last 30 years, significant advances have been achieved in elucidating the etiology, pathogenesis, and treatment of periodontal diseases. A new paradigm has emerged that includes the initiation of disease by specific bacteria within a biofilm that stimulate an immunoinflammatory host response, resulting in host tissue destruction. Disease modifiers, which may be of genetic, environmental, or acquired origin, have been recognized as major determinants of disease severity and progression. Current treatment protocols include an assessment of risk factors to identify an individual's degree of susceptibility and therapeutic responsiveness. Basic and clinical research has resulted in the development of several strategies to identify specific bacteria and host-derived markers associated with disease progression. Preventive and therapeutic antimicrobial therapies, which use various delivery systems, have been devised to target drug placement to the infection site. More recently, host modulatory therapies have been created that inhibit disease progression through the reduction of inflammatory mediators. Finally, biological mediators, including growth and differentiation factors, have been used to enhance an individual's healing potential to achieve periodontal and bone regeneration. A combined medical-surgical approach is indicated for these new methods of diagnosis, prevention, and treatment of periodontal diseases, which will allow for earlier treatment interventions and improved patient outcomes.

Anti-Infective Agents, Local↗
PubMed1994

Dermatologic and systemic manifestations of syphilis.

The incidence of syphilis is increasing, predominantly among urban heterosexuals. Early recognition is important in preventing progression of the disease and transmission of Treponema pallidum to the fetus. Untreated primary syphilis is characterized by intervals of active disease punctuated by periods of latency. Not all patients progress through each phase, and the physician must be alert to varying presentations. Cutaneous lesions are the hallmark of syphilis. However, diagnosis can be difficult, because the lesions can be asymptomatic or transient. The course of syphilis is accelerated in patients infected with the human immunodeficiency virus, and these patients frequently exhibit atypical lesions. The incidence of congenital syphilis is increasing, and efforts to control fetal morbidity depend on prompt recognition and treatment of infection during pregnancy. The definitive diagnosis of any stage of syphilis is based on historical and clinical findings supported by serologic testing.

Chancre↗
PubMed2000

Molecular epidemiology and association of putative pathogens in root canal infection.

The purpose of this study was to investigate the epidemiology of putative pathogens in root canals with apical periodontitis and to determine the associations among the putative pathogens. Eighteen symptomatic and 20 asymptomatic teeth from 36 subjects were studied. This research was performed with polymerase chain reaction and hybridization using rRNA-based oligonucleotide probes. The most frequently found species was Fusobacterium sp. (68.4%), followed by Peptostreptococcus micros (44.7%) and Porphyromonas gingivalis (26.3%). Sixteen teeth (42.1%) contained one or more species of the selected black-pigmented bacteria. Bacteroides forsythus and Treponema sp. were detected in 8 teeth and 6 teeth, respectively. Among the analyzed bacteria, significant relationships were shown in the combination of B. forsythus/P. gingivalis and Treponema sp./P. gingivalis. There was no significant association between any bacteria and any symptoms.

Adolescent↗
PubMed1980

Detection of circulating immune complexes in the sera of rabbits with experimental syphilis: possible role in immunoregulation.

The in vivo and in vitro immunoglobulin G plaque-forming cell responses to sheep erythrocytes (SRBC) are nearly obliterated during disseminated syphilitic infection (3 to 8 weeks post-intravenous injection) in rabbits. Splenic and lymph node cells obtained from infected rabbits during this time period were capable of suppressing the normal in vitro responses of uninfected, SRBC-primed cells. Cell-free washings of cells from infected animals were also suppressive. This finding coupled with the fact that treatment of infected cells with proteolytic enzymes abrogated the suppressive effect constitute arguments against involvement of a specific suppressor cell population. The incidence of elevated levels of circulating immune complexes in the sera of rabbits with disseminated disease was also significantly different from that of uninfected controls or infected rabbits before the onset or after the regression of lesions. When added to cultures of lymphocytes from uninfected, SRBC-sensitized rabbits, sera containing complexes caused dose-related suppression of the in vitro immunoglobulin responses. Unlike immune complexes, no correlation was found between the presence of mucopolysaccharide materials and the stage of infection or the ability of serum to suppress the immunoglobulin responses to SRBC.

Animals↗
PubMed1983

[Diagnosis and therapy of newborn infants of mothers with so-called "positive Wassermann"].

With modern immunological methods of syphilis diagnosis--TPHA, FTA-ABS., cardiolipin complement-fixation reaction, separation of specific IgM-antibodies, paired sample analysis--it is possible to distinguish between antibodies, which are stimulated by prenatal treponemal infection and those transmitted through the placenta. Investigation of maternal blood during pregnancy facilitates an early diagnosis and therapy as well as it saves an unnecessary prophylaxis of the newborn. If the investigation of the maternal blood has not been possible, it has to be done in the newborn blood, optimally in the cordblood. Fourteen cases during the last five years illustrate the possibilities and limitations of serodiagnosis. In three cases a recent syphilis infection during pregnancy was diagnosed, only in one of these newborns there was detectable an infection of the fetus. With regard to the remaining eleven cases a connatal infection could be excluded by calculating also the halftime of the treponemal antibodies of IgG and IgM class.

Antibodies, Bacterial↗
PubMed2000

Seropositivity to multiple sexually transmitted infections is not common.

BACKGROUND: Seropositivity for several sexually transmitted infections (STIs) is often used as a surrogate measure of sexual behavior. The authors assessed the concomitant seropositivity for STIs in women. GOAL: To estimate the excess of concomitant seropositivity for four STIs among fertile-aged women assuming no coinfections above what would be expected at random. STUDY DESIGN: Antibodies to herpes simplex virus type 2, human papillomavirus type 16, HIV, Chlamydia trachomatis, and Treponema pallidum were determined from a random sample of 1110 pregnant women in Tallinn, Estonia. RESULTS: A total of 310 combinations of the concomitant seropositivity were observed, whereas only 193 were expected by chance. Among persons seropositive for two STIs, 78 extra combinations were observed, whereas for three STIs, 35 extra combinations were observed. For four STIs, 3.8 extra combinations were found. CONCLUSIONS: Seropositivity to multiple STIs is not common. This fits the concept of different transmission probabilities and the spread of the STIs, and suggests that seropositivity alone should be used with caution as a surrogate to sexual behavior in women.

Adolescent↗
PubMed1999

Studies on the binding of Treponema pectinovorum to HEp-2 epithelial cells.

We developed a radioassay to assess the adherence of the oral treponemes Treponema denticola and Treponema pectinovorum to live HEp-2 epithelial cells. T. pectinovorum bound firmly to the epithelial cell monolayer in a concentration-dependent manner. The results indicated that a subpopulation of T. pectinovorum appeared to bind and that the binding could be influenced by environmental factors. Increasing concentrations of fetal bovine serum inhibited binding, whereas T. pectinovorum membrane vesicles and co-incubation with T. denticola ATCC 35404 increased the number of cells bound to the monolayer. Treatment of T. pectinovorum with periodic acid, but not trypsin or proteinase K, decreased the binding suggesting that a cell surface carbohydrate, such as the O-antigenic component of the lipopolysaccharide, mediates attachment of the bacteria to the epithelial cells. Co-infection of the HEp-2 cells with both T. denticola and T. pectinovorum did not interfere with each other in attachment to the epithelial cell suggesting that they do not compete for the same cellular receptor on the host cell surface. This study demonstrates that T. pectinovorum is capable, in vitro, of forming a tight association with host cells and that this binding could represent an initial step in the pathogenesis of T. pectinovorum.

Adhesins, Bacterial↗
PubMed1994

The antimicrobial activity of essential oils and essential oil components towards oral bacteria.

A method for reproducibly determining minimal inhibitory concentrations and minimal bactericidal concentrations of plant extracts towards fastidiously and facultatively anaerobic oral bacteria, predicated upon measurements of optical densities in microtitre plate wells, was devised. The antimicrobial properties of some botanical oils were surveyed; of these, Australian tea tree oil, peppermint oil, and sage oil proved to be the most potent essential oils, whereas thymol and eugenol were potent essential oil components.

Actinomyces viscosus↗
PubMed1987

Natural antibodies to treponemal antigens in four strains of guinea-pigs.

A total of 185 serum samples obtained from healthy male and female guinea-pigs of inbred strains 2 and 13 and outbred strains C4D and Hartley A were examined for natural antibodies to treponemal antigens by ELISA using Treponema pallidum (TP), T. phagedenis biotype Reiter (TR) and T. vincentii (TV) antigens and by the FTA test. The prevalence and titres of natural antibodies depended on the age and strain of guinea-pig and the treponemal antigen used. One- and 7-day-old guinea-pigs contained significantly (P less than 0.001) higher levels of natural antibodies than did animals 1 or 3-6 months old. The similar high levels of natural antibodies in newborn guinea-pigs and their mothers (12-30 months old) and the sharp drop observed at the age of 1 month suggested maternal transfer as the mechanism of acquisition. In young adults 3-6 months old, the age group most susceptible to TP infection, antibodies to TP and TR were at their lowest levels, but antibodies reacting to TV had already begun to rise. Natural antibodies were of the IgG1 and IgG2 but not of the IgM class. The highest levels of natural antibodies were in the C4D guinea-pigs; the lowest were in the Hartley A strain. Natural antibody activity was inhibited or adsorbed by TR antigens.

Aging↗
PubMed1992

Comparison of various detection methods for periodontopathic bacteria: can culture be considered the primary reference standard?

The development of diagnostic tests for a periodontal infection raises the issue as to what the appropriate reference standard, or "gold standard," should be for the evaluation of a new test. The present research was initiated to compare the ability of several detection methods, i.e., a serial dilution anaerobic culture and/or microscopic procedure, a DNA probe procedure, and immunological reagents using both an enzyme-linked immunosorbent assay and an indirect immunofluorescence assay to detect Treponema denticola, Porphyromonas gingivalis, Bacteroides forsythus, and Actinobacillus actinomycetemcomitans in subgingival plaque samples taken from 204 periodontally diseased tooth sites. The prevalence of the four monitored species varied as a function of both the species and the detection method. Spirochetes were present in 99% of the plaques, whereas A. actinomycetemcomitans was detected at the lowest frequency. The culture method yielded the lowest prevalence values for the three cultivable species. This raised the question as to which results, those obtained by culture or those obtained by the DNA probes and the immunological reagents, were the most reliable. This issue was addressed by looking at the prevalence profile of the monitored organisms, as determined by all the detection methods. If the species was detected by three or four of the detection methods, then it was considered present, whereas if it was absent by three or four of the detection methods, then it was considered absent. This approach showed the DNA probes and immunological reagents to be significantly superior (P less than 0.05) to the culture approach for the detection of P. gingivalis, A. actinomycetemcomitans, and B. forsythus and to be comparable to the microscopic approach in the detection of T. denticola.

Aggregatibacter actinomycetemcomitans↗
PubMed1989

Roxithromycin--a new macrolide derivative.

This ether oxim derivative of erythromycin A is an easy to absorb oral antimicrobial somewhat less effective in vitro than erythromycin. At relatively low MIC's it is active against staphylococci, streptococci, pneumococci, branhnamella and chlamydiae, higher concentrations are needed against enterococci and some strains of H. influenzae. Roxithromycin is also reported to have a very good effect on campylobacters, many anaerobic bacteria, Toxoplasma gondii, Treponema pallidum, Mycoplasma pneumoniae and Legionella pneumophilla. Its half-life in the serum of healthy individuals ranges from 9 to 16 hours. Maximum serum concentrations at 2 oral doses of 150 mg a day are reached at 3 to 4 days and vary from 5.5 to 11.1 mg/l. The distribution of roxithromycin in body tissues is excellent. In a group of 57 patients treated for various infections of clear etiology the positive therapeutic effects resulting in the state of bacteriological negativity was reached in 86% of cases. Roxithromycin can be recommended as a drug of choice in mild or less severe cases of infection caused by agents sensitive to this antimicrobial. Its excellent tolerance makes it especially well suited for use in pediatric practice.

Adult↗
PubMed1975

A study of yaws among pygmies in Cameroon and Zaire.

In a survey of 333 pygmies in the Cameroon 4.5 percent. were found to have clinical evidence of yaws. This was also found in 10 per cent. of the inhabitants of camps in Zaire. The results of VDRL and FTA-ABS tests on a sample of the population are presented. These provide evidence of a very high incidence of treponemal disease, 80 to 90 percent. of the population showing serological evidence of infection. Active transmission is taking place in both areas but more frequently in Zaire.

Adolescent↗
PubMed1978

Ribosomal ribonucleic acid synthesis by virulent Treponema pallidum.

Ribosomal ribonucleic acid (rRNA) synthesis by virulent Treponema pallidum was monitored by incorporation of [(3)H]uridine into trichloroacetic acid-precipitable counts and examination of radiolabeled rRNA on polyacrylamide gels. Verification that rRNA synthesis originated with T. pallidum was based upon co-electrophoresis with Escherichia coli rRNA, proportionate reductions in the amount of rRNA synthesized when numbers of treponemes were decreased, and inclusion of appropriate animal cell controls. The rate of treponemal rRNA synthesis was greater at temperatures of 37 and 39 degrees C than at 33 degrees C; rRNA synthesis was inhibited at 4 and 42 degrees C and was effectively inhibited by actinomycin D. Kinetic experiments indicated that the majority of rRNA synthesis occurred early after extraction of treponemes from infected rabbit testicular tissue. Polyacrylamide gel profiles demonstrated the capacity of virulent T. pallidum to synthesize and process RNA to 23s, 16s, and 4 to 5s classes. Although motility of T. pallidum appeared unaffected during longer periods of incubation, pulselabeling experiments confirmed significant reductions in the rate of rRNA synthesis. When the effect of various environmental conditions upon rRNA synthesis was investigated, optimal synthesis was found to occur in an atmosphere of 20% oxygen whereas virtually no synthesis was observed under anaerobic or low-oxygen conditions.

Animals↗
PubMed2006

Seroprevalence of sexually transmitted infections among accepted and deferred blood donors in Jamaica.

Critical donor selection and testing increases the safety of blood transfusion by excluding donors at risk of transmitting infections. This study investigated the seroprevalence of and risk factors for sexually transmitted infections (STIs) among accepted and deferred blood donors in Jamaica. A total of 1015 blood donors consisting of 794 (78%) accepted donors and 221 (22%) deferred donors presenting at the Central Blood Bank, Jamaica, over a six-month period, were recruited for this study. A standardized questionnaire was administered to each participant and a sample of blood obtained for detection of hepatitis B surface antigen, antibodies to Treponema pallidum, human immunodeficiency virus (HIV) and human T-cell lymphotrophic virus type-1 (HTLV-1). Deferred donors were three times more likely to be seropositive for STI than accepted donors (16.3% vs 5.2%, OR 3.57, 95% CI 2.16 - 5.90, p < 0.0001). Males had significant association between STI seropositivity and having fathered children with two or more women (p = 0.0085), unprotected sexual intercourse with several persons (p = 0.0326), and history of genital herpes (p = 0.0121). Significant risk factors identified among females were unprotected sex with several partners (p = 0.0385); having more than ten lifetime partners (p = 0.0105); and use of depoprovera (p = 0.0028). This study confirms higher rates of STI among deferred blood donors and supports the donor deferral system in Jamaica.

Adolescent↗
PubMedDate not supplied

[Evaluation of the risks of sexually transmitted diseases and HIV infection in a rural region of Senegal in 1991].

This study was performed in the Sereer region 150 km to the east of Dakar, the capital of Senegal. The population of the region is characterised by large seasonal migration, a high divorce rate (41% of marriages end in divorce) and frequent polygamy (1.8 married women per married man). We organised the medical centres in the region to monitor actively the epidemiology of HIV infection. Three populations were targeted: pregnant women presenting for their first prenatal consultation; patients presenting with STD; and people with chronic (more than three weeks) cough. The patients consulting for STD were recruited two ways: those presenting spontaneously and those identified during home interviews by the team performing a parallel sociological study of behaviour. Overall, the prevalence of HIV seropositivity was 0.2% of the women and 1.3% of the men (the difference is not significant). The seropositive individuals identified were 2 pregnant women and 5 patients (3 of 409 women and 2 of 84 men) with STD. There was no significant difference between the sex, age, marital status, or type of recruitment (spontaneous or identified by the sociological survey) of the HIV seropositive and seronegative individuals. The prevalence of treponema antibodies was 1.8% among pregnant women, 2% among STD patients and 2.4% among patients with chronic cough. There was no significant difference according to age, sex, marital status or motivation for consultation. More than half the patients consulting for STD presented biomedical disease. The majority of the STD patients were women: 70% of those spontaneous consulting; 90% of those identified by the survey; and 92% of those with biomedical disease were women.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Morphological heterogeneity among spirochetes isolated from cases of swine dysentery.

Pathogenic and non-pathogenic spirochetes isolated from the intestines of pigs were examined by electron microscopy using the negative staining and ultrathin sectioning techniques. Morphological differences were observed among cells of different strains. The cells differed in length as well as in width and in the number of flagella inserted at each end. In addition, the cells from different strains also varied in their resistance to the action of the detergents, Teepol and sodium deoxycholate. Three of the strains studied contained weakly haemolytic spirochetes, two of which differed markedly in their morphology from the cells of the other strains. These spirochetes had fewer flagella inserted at each end than those from other isolates and showed a distinct lattice-like substructure covering the ends of the cells. The spirochetes examined were found to be morphologically more similar to those of the genus Borrelia than to those of the genus Treponema but were clearly different from the cells of both of these genera. The taxonomic implications of the observations are discussed in brief.

Animals↗