Dysbiosis of oral microbiota and its association with salivary immunological biomarkers in autoimmune liver disease

The gut microbiota has recently been recognized to play a role in the pathogenesis of autoimmune liver disease (AILD), mainly primary biliary cholangitis (PBC) and autoimmune hepatitis (AIH). This study aimed to analyze and compare the composition of the oral microbiota of 56 patients with AILD and 15 healthy controls (HCs) and to evaluate its association with salivary immunological biomarkers and gut microbiota. The subjects included 39 patients with PBC and 17 patients with AIH diagnosed at our hospital. The control population comprised 15 matched HCs. Salivary and fecal samples were collected for analysis of the microbiome by terminal restriction fragment length polymorphism of 16S rDNA. Correlations between immunological biomarkers measured by Bio-Plex assay (Bio-Rad) and the oral microbiomes of patients with PBC and AIH were assessed. Patients with AIH showed a significant increase in Veillonella with a concurrent decrease in Streptococcus in the oral microbiota compared with the HCs. Patients with PBC showed significant increases in Eubacterium and Veillonella and a significant decrease in Fusobacterium in the oral microbiota compared with the HCs. Immunological biomarker analysis showed elevated levels of inflammatory cytokines (IL-1β, IFN-γ, TNF-α, IL-8) and immunoglobulin A in the saliva of patients with AILD. The relative abundance of Veillonella was positively correlated with the levels of IL-1β, IL-8 and immunoglobulin A in saliva and the relative abundance of Lactobacillales in feces. Dysbiosis of the oral microbiota is associated with inflammatory responses and reflects changes in the gut microbiota of patients with AILD. Dysbiosis may play an important role in the pathogenesis of AILD.

Antimicrobial activity of a quaternary ammonium methacryloxy silicate-containing acrylic resin: a randomised clinical trial

Quaternary ammonium methacryloxy silicate (QAMS)-containing acrylic resin demonstrated contact-killing antimicrobial ability in vitro after three months of water storage. The objective of the present double-blind randomised clinical trial was to determine the in vivo antimicrobial efficacy of QAMS-containing orthodontic acrylic by using custom-made removable retainers that were worn intraorally by 32 human subjects to create 48-hour multi-species plaque biofilms, using a split-mouth study design. Two control QAMS-free acrylic disks were inserted into the wells on one side of an orthodontic retainer, and two experimental QAMS-containing acrylic disks were inserted into the wells on the other side of the same retainer. After 48 hours, the disks were retrieved and examined for microbial vitality using confocal laser scanning microscopy. No harm to the oral mucosa or systemic health occurred. In the absence of carry-across effect and allocation bias (disks inserted in the left or right side of retainer), significant difference was identified between the percentage kill in the biovolume of QAMS-free control disks (3.73 ± 2.11%) and QAMS-containing experimental disks (33.94 ± 23.88%) retrieved from the subjects (P ≤ 0.001). The results validated that the QAMS-containing acrylic exhibits favourable antimicrobial activity against plaque biofilms in vivo. The QAMS-containing acrylic may also be used for fabricating removable acrylic dentures.

Oxygen Affects Gut Bacterial Colonization and Metabolic Activities in a Gnotobiotic Cockroach Model

The gut microbiota of termites and cockroaches represents complex metabolic networks of many diverse microbial populations. The distinct microenvironmental conditions within the gut and possible interactions among the microorganisms make it essential to investigate how far the metabolic properties of pure cultures reflect their activities in their natural environment. We established the cockroach Shelfordella lateralis as a gnotobiotic model and inoculated germfree nymphs with two bacterial strains isolated from the guts of conventional cockroaches. Fluorescence microscopy revealed that both strains specifically colonized the germfree hindgut. In diassociated cockroaches, the facultatively anaerobic strain EbSL (a new species of Enterobacteriaceae) always outnumbered the obligately anaerobic strain FuSL (a close relative of Fusobacterium varium), irrespective of the sequence of inoculation, which showed that precolonization by facultatively anaerobic bacteria does not necessarily favor colonization by obligate anaerobes. Comparison of the fermentation products of the cultures formed in vitro with those accumulated in situ indicated that the gut environment strongly affected the metabolic activities of both strains. The pure cultures formed the typical products of mixed-acid or butyrate fermentation, whereas the guts of gnotobiotic cockroaches accumulated mostly lactate and acetate. Similar shifts toward more-oxidized products were observed when the pure cultures were exposed to oxygen, which corroborated the strong effects of oxygen on the metabolic fluxes previously observed in termite guts. Oxygen microsensor profiles of the guts of germfree, gnotobiotic, and conventional cockroaches indicated that both gut tissue and microbiota contribute to oxygen consumption and suggest that the oxygen status influences the colonization success.

Mechanistic analysis of PLGA/HPMC-based in-situ forming implants for periodontitis treatment

In-situ forming implant formulations based on poly(lactic-co-glycolic acid) (PLGA), acetyltributyl citrate (ATBC), minocycline HCl, N-methyl pyrrolidone (NMP) and optionally hydroxypropyl methylcellulose (HPMC) were prepared and thoroughly characterized in vitro. This includes electron paramagnetic resonance (EPR), nuclear magnetic resonance ((1)H NMR), mass change and drug release measurements under different conditions, optical microscopy, size exclusion chromatography (SEC) as well as antibacterial activity tests using gingival crevicular fluid samples from periodontal pockets of periodontitis patients. Based on these results, deeper insight into the physico-chemical phenomena involved in implant formation and the control of drug release could be gained. For instance, the effects of adding HPMC to the formulations, resulting in improved implant adherence and reduced swelling, could be explained. Importantly, the in-situ formed implants effectively hindered the growth of bacteria present in the patients' periodontal pockets. Interestingly, the systems were more effectively hindering the growth of pathogenic bacterial strains (e.g., Fusobacterium nucleatum) than that of strains with a lower pathogenic potential (e.g., Streptococcus salivarius). In vivo, such a preferential action against the pathogenic bacteria can be expected to give a chance to the healthy flora to re-colonize the periodontal pockets.

In vitro activity of linezolid against clinical isolates of Fusobacterium spp

OBJECTIVES

Although most susceptibility studies for linezolid have investigated aerobic bacteria, only a few have investigated anaerobe isolates. The aim of the present study was to determine the antibacterial activity of linezolid against a larger sample of clinical isolates of Fusobacterium spp. and to report on the detailed susceptibility, stratified by species.

METHODS

The in vitro susceptibility of 80 clinical isolates of Fusobacterium (Fusobacterium necrophorum, n = 34; Fusobacterium nucleatum, n = 20; Fusobacterium varium, n = 18; Fusobacterium mortiferum; n = 8) was tested and compared with the activity of the older compounds amoxicillin and amoxicillin/clavulanic acid.

RESULTS

The MIC of linezolid ranged from 0.016 to 1.0 mg/L, with the MIC(90) being 0.5 mg/L. The highest MIC obtained for linezolid (1.0 mg/L) was measured for an F. varium isolate. The MIC(90) for both, amoxicillin (range: 0.016-0.75 mg/L) and amoxicillin/clavulanic acid (range: 0.047-0.75 mg/L), was 0.5 mg/L. Overall, no resistant strains were found in the study.

CONCLUSIONS

Compared with amoxicillin and amoxicillin/clavulanic acid, linezolid was less active against F. necrophorum (MIC(90) 0.25 mg/L) and F. nucleatum (MIC(90) 0.25 mg/L), equally active against F. varium (MIC(90) 0.75 mg/L) and slightly more active against F. mortiferum (MIC(90) 0.19 mg/L).

Clinical evaluation of postpartum vaginal mucus reflects uterine bacterial infection and the immune response in cattle

Bacteria contaminate the uterus of most dairy cattle after parturition and endometritis causes infertility. An endometritis score can be ascribed based on the vaginal mucus character and odour but it is not clear if the clinical score reflects the number of uterine bacteria or the inflammatory response. The present study tested the hypothesis that clinical evaluation of endometritis reflects the number of bacteria present in the uterus, and the acute phase protein response. Swabs (n = 328) were collected from the uterine lumen of dairy cattle, 21 and 28 days postpartum, vaginal mucus was scored for character and odour, and blood samples collected for acute phase protein measurement. Bacteria were identified following aerobic and anaerobic culture, and the bacterial growth density was scored semi-quantitatively. When bacteria were categorised by their expected pathogenic potential in the uterus, purulent or fetid odour vaginal mucus was associated with the growth density of pathogenic bacteria but not opportunist contaminants. When bacteria were analysed independently, Arcanobacterium pyogenes, Proteus and Fusobacterium necrophorum growth densities were associated with mucopurulent or purulent vaginal mucus. The bacterial growth densities for A. pyogenes, Escherichia coli, non-hemolytic Streptococci, and Mannheimia haemolytica were associated with a fetid mucus odour. Peripheral plasma concentrations of alpha(1)-acid glycoprotein were higher if there was a fetid compared with a normal vaginal mucus odour (1.50 +/- 0.09 mg/mL versus 1.05 +/- 0.02 mg/mL, P < 0.001), but did not differ significantly between vaginal mucus character scores. The evaluation of the character and odour of vaginal mucus reflects the number of bacteria in the uterus, and the acute phase protein response.

Direct Detection of Bacterial Pathogens in Brain Abscesses by Polymerase Chain Reaction Amplification and Sequencing of Partial 16S Ribosomal Deoxyribonucleic Acid Fragments

OBJECTIVE

To evaluate the feasibility of detecting bacterial pathogens directly from the clinical brain abscess specimens by polymerase chain reaction (PCR) amplification and sequencing of bacterial 16S ribosomal deoxyribonucleic acid (rDNA).

METHODS

A total of 14 specimens were tested by both culture and PCR amplification, targeting the full-length or a partial region of 16S rDNA. 16S rDNA is known to be conserved in bacteria. Sequencing of partial-length and full-length 16S rDNA was performed. The sequence data were compared with known sequences of 16S rDNA in the National Center for Biotechnology Information GenBank by using the Basic Local Alignment Search Tool (BLAST) algorithm. The species with the best match of similarity were regarded as the pathogenic species in the samples. We also developed a Streptococcus-specific multiplex PCR analysis for identifying members of the Streptococcus species, the most common pathogen of brain abscesses.

RESULTS

The 10 culture-positive specimens were all PCR-positive for partial 16S rDNA, but only seven were positive for full-length 16S rDNA amplification. Bacterial DNA was not detected in the remaining four specimens with a negative culture. Species identification by phenotypes from culture was in agreement with that by sequencing results of partial-length (or full-length) 16S rDNA. The Streptococcus-specific PCR analysis could detect Streptococcus species correctly in one step.

CONCLUSION

Bacterial 16S rDNA sequences provide reliable clues to the identification of unknown pathogens. PCR analysis of 16S rDNA and sequencing may identify pathogens to the species level directly from brain abscesses. This approach is rapid and is useful especially in the identification of slow-growing and fastidious organisms.

Growth requirements and fermentation products of Fusobacterium prausnitzii, and a proposal to reclassify it as Faecalibacterium prausnitzii gen. nov., comb. nov

Two newly isolated strains of obligately anaerobic bacteria from human faeces are shown here to be related to Fusobacterium prausnitzii, which is regarded as one of the most abundant colonizers of the human colon. These strains, along with Fusobacterium prausnitzii ATCC 27768(T) and 27766, are non-motile and produce butyrate, formate and lactate, but not hydrogen as fermentation products. A new finding is that all four strains produce D-lactate, but not L-lactate. The strains have a requirement for acetate in the growth medium and this may account for the previously reported requirement for rumen fluid. The DNA G+C content of the four strains is 47-57 mol%. Together with phylogenetic analysis based on 16S rRNA sequencing, this establishes that Fusobacterium prausnitzii strains are only distantly related to Fusobacterium sensu stricto and are more closely related to members of Clostridium cluster IV (the Clostridium leptum group). It is proposed that a new genus, Faecalibacterium gen. nov. be created; this genus should include Faecalibacterium prausnitzii gen. nov., comb. nov. ATCC 27768(T) (= NCIMB 13872(T)) (formerly Fusobacterium prausnitzii) as the type species together with ATCC 27766 and the newly isolated strains A2-165 and L2-6.

Local antimicrobial therapy after initial periodontal treatment

AIM

The aim of this single-blind, randomized, parallel-designed clinical trial (RCT) was to evaluate the clinical and microbiological effects of three sustained-release biodegradable polymers delivered into periodontal pockets following initial periodontal therapy.

METHODS

Forty-seven patients (28 females and 19 males) with a mean age of 51 years (range 29-71) underwent a periodontal examination at baseline (i.e. Week 0) and after 18 weeks. This included the assessment of the Plaque Index (PlI), Bleeding on Probing (BOP), Pocket Probing Depths (PPD) and Probing Attachment Levels (PAL) at six sites per tooth. Two to 4 months prior to baseline, all subjects had received initial periodontal therapy including motivation, instruction in oral hygiene practices and full-mouth scaling and root planing. At the treatment appointment (i.e. Week 2), the patients were randomly assigned to receive either Atridox trade mark, Elyzol Dental Gel or PerioChip at all residual periodontal pockets with a probing depth >/= 5 mm and concomitant BOP. In accordance with the manufacturer's recommendations, Elyzol Dental Gel was applied for a second time 7 days later. In addition to the clinical evaluation, subgingival microbiological samples were collected prior to treatment (i.e. Week 2) and at Weeks 4 and 18. Analysis of variance/covariance was used to evaluate changes from baseline to Week 18 for the clinical parameters.

RESULTS

Between the baseline and 18-week examinations, subjects treated with Atridox showed a significantly greater gain in mean PAL of 0.33 mm +/- 0.09 (SD) than subjects treated with Elyzol Dental Gel [0.03 mm +/- 0.09 (SD)](p = 0.03). However, the gain in PAL of 0.16 mm +/- 0.10 (SD) found after PerioChip application did not differ significantly from that obtained following the application of Atridox(p = 0.27). Of the sites treated with Atridox, 42% gained >/= 1 mm PAL and 9% >/= 2 mm PAL as opposed to the sites treated with Elyzol Dental Gel, in which 34% gained >/= 1 mm PAL and 8% gained >/= 2 mm PAL. Of the sites treated with PerioChip, 36% gained >/= 1 mm and 6% gained >/= 2 mm PAL following a completed initial periodontal therapy.

CONCLUSIONS

The application of the three biodegradable sustained release devices tested following initial periodontal therapy resulted in a statistically significant gain in mean PAL for AtridoxTM and a significant reduction in PPD for all three devices during the study period. Furthermore, when sites treated with Atridox were compared with sites treated with Elyzol, a significant difference in mean PAL gain (0.3 mm) was observed.

Metabolism of sucrose and its five isomers by Fusobacterium mortiferum

Fusobacterium mortiferum utilizes sucrose [glucose-fructose in alpha(1-->2) linkage] and its five isomeric alpha-D-glucosyl-D-fructoses as energy sources for growth. Sucrose-grown cells are induced for both sucrose-6-phosphate hydrolase (S6PH) and fructokinase (FK), but the two enzymes are not expressed above constitutive levels during growth on the isomeric compounds. Extracts of cells grown previously on the sucrose isomers trehalulose alpha(1-->1), turanose alpha(1-->3), maltulose alpha(1-->4), leucrose alpha(1-->5) and palatinose alpha(1-->6) contained high levels of an NAD+ plus metal-dependent phospho-alpha-glucosidase (MalH). The latter enzyme was not induced during growth on sucrose. MalH catalysed the hydrolysis of the 6'-phosphorylated derivatives of the five isomers to yield glucose 6-phosphate and fructose, but sucrose 6-phosphate itself was not a substrate. Unexpectedly, MalH hydrolysed both alpha- and beta-linked stereomers of the chromogenic analogue p-nitrophenyl glucoside 6-phosphate. The gene malH is adjacent to malB and malR, which encode an EII(CB) component of the phosphoenolpyruvate-dependent sugar:phosphotransferase system and a putative regulatory protein, respectively. The authors suggest that for F. mortiferum, the products of malB and malH catalyse the phosphorylative translocation and intracellular hydrolysis of the five isomers of sucrose and of related alpha-linked glucosides. Genes homologous to malB and malH are present in both Klebsiella pneumoniae and the enterohaemorrhagic strain Escherichia coli O157:H7. Both these organisms grew well on sucrose, but only K. pneumoniae exhibited growth on the isomeric compounds.

Spatial arrangements and associative behavior of species in an in vitro oral biofilm model

The spatial arrangements and associative behavior of Actinomyces naeslundii, Veillonella dispar, Fusobacterium nucleatum, Streptococcus sobrinus, and Streptococcus oralis strains in an in vitro model of supragingival plaque were determined. Using species-specific fluorescence-labeled antibodies in conjunction with confocal laser scanning microscopy, the volumes and distribution of the five strains were assessed during biofilm formation. The volume-derived cell numbers of each strain correlated well with respective culture data. Between 15 min and 64 h, populations of each strain increased in a manner reminiscent of batch growth. The microcolony morphologies of all members of the consortium and their distributions within the biofilm were characterized, as were interspecies associations. Biofilms formed 15 min after inoculation consisted principally of single nonaggregated cells. All five strains adhered strongly to the saliva-conditioned substratum, and therefore, coadhesion played no role during the initial phase of biofilm formation. This observation does not reflect the results of in vitro coaggregation of the five strains, which depended upon the nature of the suspension medium. While the possibility cannot be excluded that some interspecies associations observed at later stages of biofilm formation were initiated by coadhesion, increase in bacterial numbers appeared to be largely a growth phenomenon regulated by the prevailing cultivation conditions.

Topical antibiotic prophylaxis for bacteremia after dental extractions

OBJECTIVE

Current prophylaxis for endocarditis in patients undergoing dental procedures consists of oral administration of amoxicillin. There is concern that the risk of anaphylaxis from systemically administered antibiotics might approach the incidence of endocarditis. Emergence of resistance among bacteria is also favored by systemically administered antibiotics. The present study was designed to assess the efficacy of topical amoxicillin given prophylactically as a mouthwash in reducing the incidence of bacteremia after dental extraction.

STUDY DESIGN

Thirty-six outpatients in a dental clinic were randomized in a 3:2:2 ratio to experimental prophylaxis of topical amoxicillin (3 g per mouthwash rinse; 15 patients), standard prophylaxis of oral amoxicillin (3 g in a single dose; 11 patients), or no prophylaxis (10 patients), respectively. Patients were stratified by severity of periodontal disease and number of teeth extracted. Data were analyzed for differences in the incidence of bacteremia by means of the 2-tailed Fisher exact test.

RESULTS

Breakthrough bacteremia after dental extraction was observed in 60% (6 of 10 patients) who received topical amoxicillin and in 89% (8 of 9 patients) who received no prophylaxis (P =.30). By comparison, breakthrough bacteremia after dental extraction was observed in 10% (1 of 10 patients) who received standard prophylaxis with oral amoxicillin (60% vs 10%; P =.05).

CONCLUSIONS

Topical amoxicillin decreased the incidence of bacteremia in comparison with no prophylaxis, but statistical significance was not achieved (P =.30). Topical amoxicillin was significantly less effective than standard prophylaxis with oral amoxicillin in decreasing the incidence of bacteremia after dental extractions.

Viable bacteria in root dentinal tubules of teeth with apical periodontitis

Two sets of teeth with apical periodontitis were collected at different geographic locations to study the identity of bacteria left in the root dentinal tubules. Root dentin of 20 of these teeth was cultured from three locations between pulp and cementum (A, B, and C). In addition dentin from eight teeth was examined histologically. Using the culturing technique bacteria were found in 77% of the dentin samples from set 1 (Amsterdam) and in 87.5% of the dentin samples from set 2 (Glasgow). At greater distance, in layer C, from the pulp bacteria were found in 62% (13 of 21) of the dentin samples. Twenty-three percent (3 of 13) of set 1 and 25% (2 of 8) of set 2 contained >50,000 colony-forming units/mg of dentin in layer C. In layers closer to the pulp higher numbers of anaerobic bacteria and gram-positive rods were found, as well as a larger number of bacterial species. Histological sections showed bacterial penetration in dentinal tubules in 5 of 8 teeth. In the other three teeth where the colony-forming units/mg recovered was <10,000, no histological signs of tubule penetration was seen. It seems clear that, in more than half of the infected roots, bacteria are present in the deep dentin close to the cementum and that anaerobic culturing of dentin is more sensitive than histology to detect these bacteria.

A model for clinical evaluation of anti-microbial effects of agents on plaque colonization

PURPOSE

To evaluate a new improved method of microbial analysis in a cross-over clinical study by investigating the efficacy of a single application of an essential oil-containing (EOC) dentifrice as compared to its vehicle control (VC) over a 6-hr period.

MATERIALS AND METHODS

Acrylic stents with retention areas for 7, 3 mm x 3 mm hydroxyapatite (HA) squares were fabricated for 12 subjects. 30 min following stent placement, one HA square was removed and sampled for viable microflora. After stent replacement, subjects were assigned either the EOC dentifrice or its VC and brushed under supervision for 1 min. Stents remained in place for the next 6 hrs. A HA square was removed at hourly intervals for 6 hrs following brushing. The microflora was analyzed for total anaerobes on Schaedler's media, for total gram-negative anaerobes on Schaedler-NV selective media, and for total Fusobacterium species on CVE selective media. Plates were incubated anaerobically at 37 degrees C for 2-5 days. Colony forming units were calculated. For each time point, pairwise t-tests were performed using the adjusted means and the pooled error term from the analysis of variance (ANOVA).

RESULTS

Treatment with the EOC dentifrice resulted in a statistically reduced plaque growth. Differences were seen as reductions in: (1) total gram-negative anaerobes seen from 1-6 hrs (P < or = 0.011), (2) total anaerobic bacteria which achieved significance at 3 hrs and continued through 6 hrs (P < or = 0.005), and (3) Fusobacterium species as seen from 4-6 hrs (P < or = 0.002).

The microbiota of periodontal pockets with different depths in therapy-resistant periodontitis

This study presents the composition of the cultivable microbiota colonising periodontal pockets of different depths among 2 patient-groups classified as non-responsive (NR-group; 11 participants) or responsive (R-group; 10 participants) to periodontal treatment. Microbiological samples from three types of pocket (< 4 mm deep A-samples; 4-5 mm B-samples; > 5 mm C-samples) were analysed by cultural methods for putative periodontitis pathogens, microbial groups constituting > or = 5% of the total cultivable flora and opportunistic pathogens. Actinomyces naeslundii, A. israelii, Bacteroides forsythus, Fusobacterium spp, Porphyromonas gingivalis, Prevotella intermedia, Peptostreptococcus micros, anaerobic streptococci and facultative anaerobic streptococci were most prevalent. Actinobacillus actinomycetemcomitans, Staphylococcus aureus, enteric rods and yeasts were less prevalent. The periodontitis pathogens Bacteroides forsythus, Fusobacterium spp, Porphyromonas gingivalis, Prevotella intermedia and Peptostreptococcus micros constituted together (on average) < or = 23% of the viable counts in the A- and B-samples of both patient groups and in the C-samples of the R-group. In the C-samples of the NR-group their mean counts were 45%. Correlations were found between smoking habits and the five pathogens in the C-samples and in pooled pocket depth samples. The results show that groups of periodontopathogens should be considered a causal factor in therapy-resistant periodontitis. Further, smoking and deep pockets can enhance a shift in the balance of the subgingival microflora predisposing a site to disease and a susceptible host may be the pre-requisite to therapy-resistant periodontitis.

Microbiological features and crevicular fluid aspartate aminotransferase enzyme activity in early onset periodontitis patients

Gingival crevicular fluid (GCF) reflects the immune and inflammatory reactions and the specific host-microbe interactions that lead to periodontal diseases. Aspartate aminotransferase enzyme (AST) is one of the components of GCF that is released as a result of cell death. In this study, periodontal sites (4 sites/patient) with a probing depth of > or =5 mm in early onset periodontitis (EOP) patients were first examined for the AST levels in GCF by the Periogard periodontal tissue monitor. To be eligible for the study, each of the patients had at least 1 AST positive site with clinical inflammatory changes (AST+, CIC+) and 1 AST negative site with no or minimum clinical inflammatory changes (AST-, CIC-). In 15 EOP patients who met the entry criteria, 30 AST+, CIC+ sites (1st group) and 19 AST-, CIC- sites (2nd group) were evaluated for microbiological variables. Certain microbial species, including Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans and Prevotella intermedia were detected more frequently (p<0.001, p<0.001 and p<0.05, respectively) in the 1st group, while gram-positive facultative organisms such as Actinomyces species were found more often (p<0.001) in the 2nd group. Parallel to the AST levels, the 2nd group had a lower number of total bacteria and proportion of obligate anaerobic and capnophilic micro-organisms than the first group (p<0.05 and p<0.05, respectively). Within the scope of this study, AST activity and microbiological data were found in agreement in the examined groups. These findings are encouraging and indicate the need for further studies to evaluate the ability of the AST test to differentiate the microbial flora of progressing sites and those that are inflamed, but not progressing.

Neutrophil response and microbiological findings around teeth and dental implants

The aim of this study was to compare the neutrophil response, measured as both functional and antigenic elastase, around teeth and titanium implants and to relate these findings to the microbiota. The 31 patients included in the study had been treated successfully for total or partial edentulism with titanium implants. Crevicular fluid and microbiological samples were taken from 3 sites: 1) crevices around teeth and 2) implants in 16 partially edentulous patients and 3) crevices around implants in 15 edentulous patients. All sites sampled showed similar degrees of inflammation assessed by gingival index and total protein concentration. The samples were analyzed for elastase activity and immunoreactive elastase. The elastase activity was significantly higher in crevices surrounding implants in partially edentulous patients compared with implants in edentulous patients. The antigenic elastase showed no difference among the 3 sites. Gram-positive cocci were the main bacterial species in all 3 groups. Edentulous patients tended to have lower frequency of black pigmenting anaerobes. No correlation of analyzed bacteria and elastase activity was found between the 3 sites. This study indicates that, despite a similar appearance of clinical parameters and absence of significant differences in the microbiota, the inflammation around implants in partially edentulous patients induces a stronger neutrophil response than does the inflammation around implants in edentulous patients.

Bacteriocin production by Fusobacterium isolates recovered from the oral cavity of human subjects with and without periodontal disease and of marmosets

Bacteriocin production has been studied in very few anaerobic bacteria, and no report is available for Fusobacterium species. In the present study a total of 167 Fusobacterium isolates were tested for bacteriocin production: 70 isolates were obtained from the oral cavity of patients with periodontal disease, 47 were recovered from healthy oral sites of human subjects and 50 from the oral cavity of Callithrix penicillata. Autoantagonism and isoantagonism were observed when the bacteriocin-producing isolates were tested against themselves. Heteroantagonism was detected by testing the Fusobacterium isolates against 14 reference strains and 2 strains of Actinobacillus actinomycetemcomitans from our laboratory collection. The auto-, iso- and heteroantagonism phenomena observed in this comparative study suggest a possible ecological role for this (these) antagonistic substance(s) in the oral environment.

Dietary guar gum and pectin stimulate intestinal microbial polyamine synthesis in rats

The effects of two highly fermentable dietary fibers (guar gum and pectin) on the type and concentrations of cecal polyamines as affected by the intestinal microflora were studied in groups of germ-free (n = 10/group) and conventional rats (n = 6/group). Both germ-free and conventional rats were randomly assigned to one of three treatments as follows: 1) fiber-free control diet, 2) control diet + 10% guar gum and 3) control diet + 10% pectin. In germ-free rats, guar gum and pectin had no effect on cecal polyamine concentrations. Putrescine was confirmed to be the major endogenous polyamine within the gut lumen. In cecal contents of conventional rats, both guar gum and pectin led to the appearance of cadaverine and to elevated putrescine concentrations in comparison with the fiber-free control diet (1.35 +/- 0.15 and 2.27 +/- 0.32, respectively, vs. 0.20 +/- 0.03 micromol/g dry weight, P < 0.05). The cecal cadaverine concentration was higher in pectin- than in guar-fed rats (8.20 +/- 0.89 vs. 1.92 +/- 0.27 micromol/g dry weight, P < 0.05). Counts of total bacteria, bacteroides, fusobacteria and enterobacteria were higher (P < 0.05) in rats fed guar gum and pectin. Bifidobacteria were found exclusively in guar-fed rats. In vitro studies on selected species representing the numerically dominant population groups of the human gut flora (bacteroides, fusobacteria, anaerobic cocci and bifidobacteria) were examined for their ability to synthesize intracellular polyamines. These experiments demonstrated the ability of bacteroides, fusobacteria and anaerobic cocci to synthesize high amounts of putrescine and spermidine. Calculations based on these results suggest that the intestinal microflora are a major source of polyamines in the contents of the large intestine.

Development of an anaerobic bacterial leakage model

The majority of bacteria associated with infections of endodontic origin are strict anaerobes. The purpose of this study was to develop an endodontic microleakage model using strict anaerobic bacteria in a two-chamber system. Nine species of anaerobic bacteria were tested for viability and detection by either turbidity or color change of the broth. A survey of pH chromogenic substrates revealed that bromcresol purple (pH 5.2 = yellow, pH 6.8 = purple) could be used as a chromogenic indicator to detect the growth of anaerobic bacteria. Peptone-yeast extract-glucose broth (PYG) and brain heart infusion broth (BHI) were each used alone and with bromcresol purple (bpPYG, bpBHI) in this study. Fusobacterium nucleatum and F. necrophorum were viable in all four media for > 2 wk and produced both turbidity and a color change after only 1 day of incubation. Veillonella parvula in either bpBHI or BHI and Peptostreptococcus anaerobius in either bpPYG or BHI were viable for > 2 wk and showed a color change or turbidity after 1 or 2 days. The results indicate that leakage of strict anaerobes may be evaluated in a two-chamber system.

A clinical and microbiological evaluation of systemic and local metronidazole delivery in adult periodontitis patients

The present study describes results on selected clinical and microbiological parameters obtained by treatment with local (Elyzol) and systemic (Flagyl) use of metronidazole alone and/or mechanical subgingival debridement in adult periodontitis. Patients were randomly divided into local and systemic treatment groups each comprising 5 individuals in each of whom 4 sites (one site/ quadrant) with a probing depth of > or = 5 mm were selected and treated with separate treatment modalities. The overall treatment design provided 6 different test groups. Groups of quadrants received: (1) scaling and root planing; (2) local metronidazole treatment; (3) systemic metronidazole treatment; (4) local metronidazole combined with scaling and root planing; (5) systemic metronidazole combined with scaling and root planing; (6) no treatment. The microbiological and clinical effects of treatment modalities were monitored over a period of 42 days. All treatments resulted in clinical improvements (gingivitis, probing pocket depth, attachment level) except for the untreated group. Parallel to the clinical changes, all treatments reduced the number of total bacteria and proportions of obligately anaerobic microorganisms. Although both of the combined treatment groups responded to therapy with better resolution of infection that the pure mechanical and pure metronidazole treatments, local metronidazole in combination with scaling and root planing seems to be more effective in terms of producing both clinical and microbial improvements.

Early echo-guided percutaneous aspiration of peripheral lung abscesses in children: report of two cases

A 9 year-old boy and a 7 year-old girl suffered from fever and chest pains before they were brought to Chang Gung Children's Hospital. Chest radiographs and computed tomography scans showed lung abscesses with pleural attachment, and using echo-guidance, percutaneous aspirations were done which confirmed the growth of Fusobacterium sp, and Veillonella parvula respectively, both of which are susceptible to penicillin G. The fever and chest pains subsided within 24 hours after the procedure. We suggest using early percutaneous aspiration of peripheral located lung abscesses soon after admission, rather than after a 10-14 day trial of antibiotic therapy: it can be a safe and cost-effective procedure to shorten the duration of the parenteral antibiotic treatment and hospitalization.

Isolation and identification of intestinal bacteria from Japanese tree frog (Hlya japonica) with the special reference to anaerobic bacteria

The bacteria in the large intestines of eight Japanese tree frogs (Hlya japonica) were enumerated by using an anaerobic culture system. The microorganisms at approximately 3.1 x 10(9) bacteria per g (wet weight) of intestinal contents were present in the intestine of all the frogs tested. No difference of the total bacteria in the frog intestine was observed between two different incubation-temperatures (room temperature and 37 degrees C). Eleven genera and 16 species were isolated from the frog intestine. In most frogs, Bacteroides (B.) caccae and B. vulgatus were detected as the predominant organisms. Escherichia coli was also present in greater numbers in the intestine. Other bacteria isolated at high dilutions were strict anaerobes, including Fusobacterium and Clostridium. Enterococcus faecalis was frequently isolated from the frog intestine. However, four genera of Bifidobacterium, Eubacterium, Peptostreptococcus, and Lactobacillus were not isolated from the frog intestine.

Sugar metabolism by fusobacteria: regulation of transport, phosphorylation, and polymer formation by Fusobacterium mortiferum ATCC 25557

Strains of eight Fusobacterium species differed in the ability to use sugars as energy sources for growth. For Fusobacterium russii ATCC 25533, F. gonidiaformans ATCC 25563, and F. nucleatum ATCC 10953 (except for fructose), growth was marginal to poor on all of the sugars tested. Other species displayed reasonable growth on glucose, fructose, mannose, and galactose, and two strains of F. mortiferum (ATCC 25557 and ATCC 9817) grew well on six of the sugars tested, including sucrose and maltose. Glucose transport by resting cells of most of the species was dependent upon (or markedly stimulated by) the presence of a fermentable amino acid. By contrast, F. mortiferum cells rapidly accumulated glucose and other sugars in the absence of amino acids. Although these cells were constitutive for glucose uptake, accumulation of other sugars was specifically induced by growth of F. mortiferum on the appropriate sugar. Spectrophotometric analyses and in situ staining of anionic polyacrylamide gels showed that glucose and fructose (mannose) are phosphorylated by separate ATP-dependent kinases. Fructokinase was stable in air at 4 degrees C, but under these conditions, greater than 70% of the glucokinase activity was lost. After overnight dialysis of the extract, no glucokinase activity was detectable; however, 65% of the initial enzyme activity was retained by inclusion of 1 mM dithiothreitol in the dialysis buffer. Thin-section electron microscopy showed that cells of F. mortiferum produced various amounts of intracellular glycogen during growth on the following sugars (in decreasing order of formation): galactose greater than sucrose greater than glucose greater than mannose greater than fructose. Mechanisms for sugar transport regulation, phosphorylation, and polymer synthesis by F. mortiferum cells are proposed.

A selective medium for Fusobacterium spp

A new selective medium (JVN) for the isolation of Fusobacterium spp. from clinical material is described. The medium incorporates josamycin, vancomycin and norfloxacin (at 3, 4 and 1 microgram/ml, respectively) as the selective agents, plus 5% defibrinated horse blood in Fastidious Anaerobe Agar Base (Lab M). This formula allowed luxuriant growth of all 82 strains (eight recognized species) of fusobacteria tested, while significantly inhibiting 51/51 (100%) strains of facultative anaerobes and 45/51 (88%) strains of other obligate anaerobes. JVN medium allowed the successful isolation of strains of Fusobacterium naviforme, F. nucleatum and F. necrophorum from the gingivae of 9/16 healthy volunteers, and strains of F. varium and F. mortiferum from faecal suspensions seeded with these organisms.

Aspects of the growth and metabolism of Fusobacterium nucleatum ATCC 10953 in continuous culture

Fusobacterium nucleatum ATCC 10953, a type strain of one of the newly proposed subspecies of this group of organisms, was grown anaerobically in continuous culture in a chemically defined medium. Its response to conditions of varying pH, nutritional environment, and imposed growth rate were then examined. The organism failed to grow at pH 7.8 but grew at pH 5.8, although the cell yield was greatly reduced. At pH 6.8 the cell yield was halved and less than 50% of available glucose was consumed. The optimum growth pH was around 7.4 when the culture appeared to be limited for both glucose and the amino acids glutamate, histidine and serine. Some intracellular polyglucose (IP) was produced and acetate, butyrate and ammonia were the major fermentation end-products, as they were under all growth conditions tested. Increasing the available glucose or amino acids did not alter cell numbers but the amount of IP was greatly increased. When glucose was omitted from the medium, the cell yield was halved and the culture then became limited for lysine as well as for glutamate, histidine and serine. Growth rate had little overall effect on the organism's physiology and the maximum growth rate at pH 7.4 was 0.20 h-1, a doubling time of 3.5 h. Glucose was thus channelled into stable IP synthesis only when the growth limitation imposed by lack of fermentable amino acids was relieved. The metabolism of IP and the ability to obtain carbon and energy from a variety of substrates may explain why F. nucleatum is one of the most commonly detected organisms in subgingival dental plaque.

Further observations on enhancement of the infectivity of Fusobacterium necrophorum by other bacteria

It had already been shown with a single virulent strain (A42) of Fusobacterium necrophorum that suspension of the fusobacteria in sub-lethal doses of broth cultures of other bacteria reduced the minimum infective dose (greater than 10(6) organisms) for mice by subcutaneous inoculation, sometimes to less than 10 organisms. The present study extended the known range of bacteria with strong infectivity-enhancing properties to include Bacillus cereus, Klebsiella oxytoca and Staphylococcus aureus; and those with weaker effect to include Bacillus subtilis, 'Bacteroides melaninogenicus', Clostridium sporogenes, Pasteurella haemolytica, and Proteus mirabilis. The study also showed that five further virulent strains of F. necrophorum closely resembled A42 in respect of striking susceptibility to infectivity enhancement by Escherichia coli. Actinomyces (Corynebacterium) pyogenes and S. aureus. One further strain (A6) of F. necrophorum resembled A42 in respect of strong infectivity enhancement by A. pyogenes, S. aureus, B. cereus and K. oxytoca but differed from it and the other five strains in being only slightly affected by E. coli. This work was a necessary prelude to the development of a method, based on infectivity enhancement, for the detection and isolation of F. necrophorum present in small numbers in heavily contaminated material such as faeces.

Regulation of fructose metabolism and polymer synthesis by Fusobacterium nucleatum ATCC 10953

Energy for the anaerobic growth of Fusobacterium nucleatum ATCC 10953 can be derived from the fermentation of sugar (fructose) or amino acid (glutamate). During growth on fructose, the cells formed large intracellular granules which after extraction yielded glucose by either acid or enzymatic hydrolysis. The endogenous polymer was subsequently metabolized, and after overnight incubation of the cells in buffer, the glucan granules were no longer detectable by electron microscopy. Anaerobically, washed cells grown previously on fructose fermented this sugar to a mixture of lactic, acetic, and butyric acids, and little intracellular glucan was formed. Aerobically, the cells slowly metabolized fructose to acetate. Provision of glutamic acid as an additional energy (ATP) source elicited rapid synthesis of polymer by glycolyzing cells. Intracellular granules were not present in glutamate-grown cells, and under anaerobic conditions, the resting cells failed to metabolize [14C] fructose. However, the addition of glutamic acid to the suspension resulted in the rapid accumulation of sugar by the cells. Approximately 15% of the 14C-labeled material was extractable with boiling water, and by 31P nuclear magnetic resonance spectroscopy, this phosphorylated derivative was identified as [14C]fructose-1-phosphate. The nonextractable material represented [14C]glucan polymer. Fructose-1-phosphate kinase activity in fructose-grown cells was fivefold greater than that in glutamate-grown cells. We suggest that the activity of fructose-1-phosphate kinase and the availability of ATP regulate the flow of fructose into either the glycolytic or polymer-synthesizing pathway in F. nucleatum.

Growth conditions and outer membrane proteins of Fusobacterium nucleatum

Fusobacterium nucleatum strains ATCC 10953, ATCC 25586, F1 F3, F6, and Fev1 were grown in different media. The influence of growth conditions on the outer membrane proteins (OMPs) was analyzed by sodium dodecyl sulfate--polyacrylamide gel electrophoresis (SDS-PAGE). There were no apparent differences in the outer membrane protein profiles when cells in the same phase of growth in various rich media were compared. Differences, however, were observed between early logarithmic phase and stationary phase cells. Thus several proteins were only synthesized during late logarithmic and stationary phase. Synthesis of some of these proteins, in particular a 65K and a 14K protein, seemed to depend on the presence of peptides in the medium. In a complete medium, these proteins were synthesized after depletion of some amino acids, and peptides were then utilized.

Effects of methanol on the growth of gastrointestinal anaerobes

The effects of methanol on the growth of representative, predominant, anaerobic gut bacteria were studied. Growth yields and rates were determined in a base medium to which methanol was added to produce media with methanol concentrations varying, in twofold steps, over a concentration range of 0.01 to 25%, by volume. The growth of many of the organisms was completely inhibited by a methanol concentration equal to, or less than, 6.2%. Isolates representing cellulolytic species were completely inhibited at a methanol concentration of 3.1%, and inhibitory effects on the yield of some cellulolytic isolates were found at a methanol concentration as small as 0.01%. Although most of the organisms studied were inhibited at relatively small methanol concentrations, isolates of Selenomonas ruminantium, Bacteroides ovatus, and Fusobacterium necrophorum were relatively methanol resistant. A methanol concentration of 12.5% was required to completely inhibit S. ruminantium. Substantial growth of B. ovatus was obtained in media containing 12.5% methanol, and for F. necrophorum, substantial growth occurred in media containing 25% methanol. The yields of F. necrophorum strain B85 and S. ruminantium strain PC18 were enhanced by relatively small methanol concentrations and reduced with further methanol concentration increase Anaerobic, nonsporing gut bacteria exhibit a diversity of responses to methanol.

Utilization of amino acids and peptides by Fusobacterium nucleatum

Fusobacterium nucleatum strains ATCC 10953, Fevl, F1, F3, and F6 utilized amino acids, in particular glutamate, histidine, and aspartate were common to all strains. Strain differences were observed in the utilization of threonine, serine, lysine, tyrosine, and methionine, and only strain ATCC 10953 utilized all these amino acids. The glutamate and histidine pools were in all cases fully depleted before the other amino acids were attacked and at the same time all strains except 10953 started to utilize peptides at a noticeable rate. For strain Fevl, glutamyl- and aspartyl-containing peptides seemed to be of considerable nutritional importance, and this strain did not grow on a medium based on amino acids alone. On the other hand, strain 10953 did not utilize any peptides to a noticeable extent, and it could grow on an amino acid based medium.

Classification and distribution of large intestinal bacteria in nonhibernating and hibernating leopard frogs (Rana pipiens)

The large intestinal flora of the leopard frog, Rana pipiens, was examined to determine whether differences existed between the nonhibernating and hibernating states of the animal and to determine the relative concentrations and proportions of potential frog pathogens. Hibernators had a logarithmic decrease of bacteria per milligram of intestine averaging one, and significantly greater proportions of facultative bacteria and psychrophiles relative to nonhibernators. The predominant anaerobic bacteria were gram-positive Clostridium species and gram-negative Bacteroides and Fusobacterium species. The predominant facultative bacteria were enterobacteria in nonhibernators but Pseudomonas species in hibernators. Many species of Pseudomonas are pathogenic for frogs, and thus the intestinal flora in hibernators may be a potential source of infectious disease.

Semiquantitative culture results and pathogenic significance of obligate anaerobes in peritonsillar abscesses

We studied the bacteria in consecutive peritonsillar abscesses using semiquantitation of the primary culture findings and correlated the results to clinical parameters. Puncture-aspirated pus from 42 abscesses yielded 133 isolates. Group A streptococci were isolated 10 times and, unlike other bacteria, were isolated 4 times in pure culture; other beta-hemolytic streptococci were found in 8 abscesses, and anaerobes were found in 28. The infections were polymicrobial, with two to seven bacteria in 83%. Anaerobes were more abundant than nonanaerobes; members of the genera Streptococcus, Bacteroides, Peptostreptococcus, and Fusobacterium were the most important quantitatively, considering both frequency and abundance. In patients with ongoing antibiotic treatment, nonanaerobes (but not anaerobes) were less abundant than in untreated patients. The abundance of obligate anaerobes (specifically cocci and gram-positive rods) correlated to the severity of illness as defined by fever and short duration before hospitalization. With other groups of bacteria, no such correlation was found. The correlation was not explained by a difference between the antibiotic-treated and the untreated patients. The results indicate the value of the semiquantitation of culture data and the frequency and pathogenic significance of obligate anaerobes in peritonsillar abscesses.

Enrichment of subgingival microflora on human serum leading to accumulation of Bacteroides species, Peptostreptococci and Fusobacteria

This study was undertaken to identify ecological factors that favour opportunistic pathogenic species in the subgingival microflora. In a first approach, human serum as a substitute for gingival exudate, was used for batch-wise enrichment of subgingival plaque. The microflora resulting after 5-6 enrichment steps consisted of black-pigmented and non-black-pigmented Bacteroides species, Peptostreptococcus micros and Fusobacterium nucleatum as the main organisms. It is noted that the same group of species was found to be enriched independent upon the origin of the subgingival plaque sample. It was suggested that these organisms are favoured by the increased flow of gingival exudate during inflammation. The consortium of organisms was capable of selective degradation of serum (glyco-)proteins. Four different types of degradation occurred. After a prolonged period of growth complete degradation of immunoglobulins, haptoglobin, transferrin and complement C3c was observed. Partial degradation of immunoglobulins, haptoglobin, transferrin, albumin, alpha 1-antitrypsin and complement C3c and C4 was generally observed after 48 h of growth. Besides, immunoglobulin protease activity yielding Fc and Fab fragments was found. The consortium was also capable of consuming carbohydrate side-chains as indicated by an altered electrophoretic mobility of the serum glycoproteins.

Viability of lyophilized anaerobes in two media

Viability of 15 species of anaerobes was followed after freeze-drying and storage for 1 year. Organisms maintained in a 12% sucrose concentration in chopped meat carbohydrate broth survived longer and maintained higher viability counts than those organisms in double-strength skim milk.

Comparison of populations of human faecal bacteria before and after in vitro incubation with plant cell wall substrates

Human faecal slurries were incubated anaerobically with larchwood xylan, oat spelt xylan, wheat bran, apple cell walls or sugar beet pulp as sole carbon sources. The populations which developed during incubation were different from the inoculum, the most marked changes being an increase in the number of Bacteroides species and a decrease in the number of Fusobacterium species for all carbon sources tested. With a water-soluble preparation of larchwood xylan the population was dominated by species able to ferment this substrate, in contrast to the population which developed with the insoluble substrates. The ability to use one plant cell wall substrate appeared to be related to the ability to use others. Strains capable of using plant cell wall substrates included Bacteroides spp., Clostridium clostridiiforme, Bifidobacterium longum, Fusobacterium spp. and Escherichia coli. When incubation with two contrasting substrates (bran and larchwood xylan) was replicated, the populations which developed were reproducibly different from the inoculum and from each other.

Factors affecting antimicrobial susceptibility of Fusobacterium species

Fifteen clinical isolates of Fusobacterium species were studied to determine their quality of growth on five agar media, their susceptibility to penicillin, cephalothin, cefoxitin, and cefotaxime, the inoculum effect, and the presence of L forms and beta-lactamase. Wilkins-Chalgren agar supported confluent growth best, but Fusobacterium nucleatum exhibited poor growth on all agar media. Most isolates exhibited poor reproducibility of MIC results with repeated agar dilution testing. However, most isolates were susceptible to all antibiotics at the breakpoint concentrations. No inoculum effect was observed, but preparation of an inoculum at a 0.5 McFarland nephelometric standard produced a lower than expected number of CFU (10(6) CFU) in some isolates. L forms were frequently seen. No beta-lactamase was found. The variability in MICs seen with beta-lactam antibiotics was not found when clindamycin was tested. MIC studies with Fusobacterium spp. may be complicated by poor growth on agar media, poor reproducibility, and small inoculum size.

The growth of oral bacteria on saliva

The present experiments were aimed at studying the degradation of salivary glycoproteins by the oral microflora. To this end, S. sanguis I strain Ny476 and S. sanguis II (S. mitior) strain Ny581 were grown continuously in human-whole saliva. Under these conditions, the strains produced a variety of cell-associated hydrolytic activities, including glycosidases, exo- and endopeptidases, and esterases. S. sanguis II generally exhibited higher levels of enzyme activity than did S. sanguis I, in particular of neuraminidase that was produced only by S. sanguis II. In accordance, S. sanguis II had a higher cell yield and consumed a higher proportion of the sugars and sialic acid in the glycoproteins than did S. sanguis I. Interestingly, S. sanguis I, which is devoid of neuraminidase, is known to have a lectin with specificity for sialic acid, whereas S. sanguis II has affinity for galactose residues in the glycoproteins. We propose that specific binding of glycoproteins by oral bacteria constitutes a mechanism to collect nutrients in the vicinity of the cell. The special ability of S. sanguis II to utilize saliva for growth was further exemplified by its selection in batch-wise enrichments of dental plaque on saliva. The microflora in these enrichment cultures always consisted of Peptostreptococcus micros, S. sanguis II, and Fusobacterium nucleatum as the dominant organisms. Further, S. mitis and Gemella haemolysans were generally found to be present. The enrichment cultures produced a wide variety of mainly cell-bound hydrolytic enzymes. This resulted in almost complete breakdown of salivary glycoproteins in the culture.

Potent antagonism of Escherichia coli, Bacteroides ovatus, Fusobacterium varium, and Enterococcus faecalis, alone or in combination, for enteropathogens in anaerobic continuous flow cultures

Interactions between representative strains of four predominant resident bacteria of the human colon, Escherichia coli, Enterococcus faecalis, Bacteroides ovatus, and Fusobacterium varium, and strains of seven enteropathogens, Yersinia enterocolitica, Shigella flexneri, Salmonella typhimurium, Vibrio parahaemolyticus, V. cholerae serogroup non O1, Staphylococcus aureus, and Clostridium perfringens, were examined in studies with an anaerobic continuous flow culture system and medium resembling the content of the mouse caecum (MCM). Potent unilateral antagonism attributable to synergic activities of the resident bacteria against the enteropathogens was evident. The four resident bacteria persisted at levels of c. 10(6) cfu/ml or more in single and in any mixed cultures of the resident species. The seven enteropathogens also persisted in single cultures. In contrast, Y. enterocolitica was excluded in several days in mixed cultures with each of the four resident bacteria. Sh. Flexneri and Staph. aureus were excluded in the presence of E. coli alone. C. perfringens, V. parahaemolyticus and V. cholerae serogroup non O1 were excluded in the presence of E. coli with B. ovatus and, in some cases, with additional species. S. typhimurium was the most resistant; only c. 10(2)-fold reduction of the population level was observed in mixed culture with all four of the resident species. When the amounts of some components in the medium, such as peptone and yeast extract, were increased, C. perfringens grew and persisted even in the presence of the four resident bacteria. Sh. flexneri, in contrast decreased steadily, even in enriched media.

The relationship between Fusobacterium species and other flora in mixed infection

Mixed infections with three Fusobacterium species and seven other bacterial species were studied in a subcutaneous abscess model in mice. Fifteen Fusobacterium isolates (eight F. nucleatum, four F. necrophorum, and three F. varium) and one isolate each of Bacteroides fragilis, B. asaccharolyticus, Staphylococcus aureus, Group A beta-haemolytic streptococcus, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa were studied. Electronmicrographs showed the presence of a thin mucopolysaccharide wall before and after inoculation into mice in 12 isolates which included all of 11 Fusobacterium isolates that induced subcutaneous abscesses. After co-inoculation of Fusobacterium isolates with other species and selective therapy with antimicrobial agents, S. aureus and K. pneumoniae were found to be of equal or greater importance in abscess induction than were Fusobacterium isolates, while Fusobacterium isolates were found to be more important than Group A streptococci and E. coli. Mutual enhancement of the numbers of organisms in mixed infections was observed with Fusobacterium spp. and K. pneumoniae, P. aeruginosa or Bacteroides spp. Suppression of Fusobacterium spp. was noticed only when they were co-inoculated with Group A streptococci. The additive or synergistic capabilities of Fusobacterium species highlighted their potential pathogenicity in infection.

The establishment of reproducible, complex communities of oral bacteria in the chemostat using defined inocula

Nine commonly isolated oral bacterial populations were inoculated into a glucose-limited and a glucose-excess (amino acid-limited) chemostat maintained at a constant pH 7.0 and a mean community generation time of 13.9 h. The bacterial populations were Streptococcus mutans ATCC 2-27351, Strep. sanguis NCTC 7865, Strep. mitior EF 186, Actinomyces viscosus WVU 627, Lactobacillus casei AC 413, Neisseria sp. A1078, Veillonella alkalescens ATCC 17745, Bacteroides intermedius T 588 and Fusobacterium nucleatum NCTC 10593. All nine populations became established in the glucose-limited chemostat although Strep. sanguis and Neisseria sp. were present only after a second and third inoculation, respectively. In contrast, even following repeated inoculations, Strep. mutans, B. intermedius and Neisseria sp. could not be maintained under glucose-excess conditions. A more extensive pattern of fermentation products and amino acid catabolism occurred under glucose-limited growth; this simultaneous utilization of mixed substrates also contributed to the higher yields (Y molar glucose) and greater species diversity of these communities. Microscopic and biochemical evidence suggested that cell-to-cell interactions and food chains were occurring among community members. To compare the reproductibility of this system, communities were established on three occasions under glucose-limitation and twice under glucose-excess conditions. The bacterial composition of the steady-state communities and their metabolic behaviour were similar when grown under identical conditions but varied in a consistent manner according to the nutrient responsible for limiting growth. Although a direct simulation of the oral cavity was not attempted, the results show that the chemostat could be used as an environmentally-related model to grow complex but reproducible communities of oral bacteria for long periods from a defined inoculum.

Lactic acid production by oral Streptococcus mitis inhibits the growth of oral Capnocytophaga

Various relationships including inhibition or stimulation of growth have been demonstrated among the bacteria present in dental plaque, both in vitro and in vivo. A large number of these relationships involved oral Streptococci. An earlier study found that strains of Streptococcus mitis inhibited the growth of potential periodontopathic microorganisms, such as Actinobacillus actinomycetemcomitans, Capnocytophaga and species of Bacteroides and Fusobacterium. The present investigation showed that this inhibitory effect resulted primarily from lactic acid production.

Distribution and effects of a defined six-member murine-derived microflora in gnotobiotic gerbils

The gnotobiotic gerbil was selected as a model with which to study the effects of colonization with a defined microflora on organ morphology, histology, and selected blood biochemical parameters. Gerbils were maintained germfree for 13 months but failed to reproduce, presumably because of the enlarged cecum. A colony of gnotobiotic gerbils that was associated with a bacterial flora consisting of Lactobacillus brevis, Streptococcus faecalis, Staphylococcus epidermidis, Bacteroides vulgatus, Enterobacter aerogenes, and a Fusobacterium sp. was established. These gnotobiotic gerbils had smaller ceca than germfree gerbils and proved capable of reproduction. Except for the presence of large numbers of Bacteroides organisms in the stomach and greater numbers of S. epidermidis in gnotobiotic gerbils, the number and location of gastrointestinal bacteria were similar in conventional and gnotobiotic gerbils. Bacteroides sp. was the second most predominant microorganism present in gnotobiotic gerbils, whereas clostridia were reported to be the second most predominant microorganism in conventional gerbils. Microscopic examination of direct-impression smears indicated that fusobacteria were present on mucosal surfaces. Intestines of gnotobiotic gerbils weighed twice as much as the intestines of conventional gerbils. Intestinal tissue water weight values from conventional and gnotobiotic gerbils were similar. Histological examination of gerbil intestinal tissue revealed no cellular hypertrophy and no evidence of inflammation in gnotobiotic gerbil intestines. Spleens of gnotobiotic gerbils showed no germinal center stimulation. Statistical differences in total serum glucose, serum protein, and hematocrit levels were found between conventional and gnotobiotic gerbils.

Purification and characterization of C-S lyase from Fusobacterium varium. A C-S cleavage enzyme of cysteine conjugates and some S-containing amino acids

An enzyme responsible for the carbon-sulfur bond cleavage of various S-aryl, S-aralkyl, and S-alkyl cysteines has been purified about 270-fold from Fusobacterium varium. Incubation of a cysteine conjugate of p-bromobenzene with the enzyme yielded equimolar amounts of p-bromobenzenethiol, pyruvic acid, and ammonia, indicating that the carbon-sulfur bond cleavage proceeds via an alpha, beta-elimination reaction. The enzyme activity was inhibited either by hydroxylamine or KCN and stabilized by pyridoxal phosphate, which probably acted as cofactor. The broad substrate spectrum of this enzyme suggested an important role of the intestinal microflora in the in vivo formation of methylthio-containing metabolites of various xenobiotics.

Anaerobic gram-negative faecal flora in patients with Crohn's disease and healthy subjects

The anaerobic gram-negative faecal flora of five patients with Crohn's Disease (CD) was identified and compared with that of healthy subjects. For isolation and cultivation of the anaerobic gram-negative rods a non-selective medium was used. There were no significant differences in numbers of Bacteroides and Fusobacterium spp. between patients with CD and healthy subjects. However, the numbers of the "Bacteroides fragilis" group were significantly higher in patients than in controls. The high numbers of the "B. fragilis" group in the faeces of patients were particularly due to B. vulgatus which was 6 times more frequent in patients than in healthy subjects. This indicated that B. vulgatus was responsible for the higher numbers of anaerobic gram-negative rods in the faecal flora of patients with CD.

Corncob formation between Fusobacterium nucleatum and Streptococcus sanguis

Corncob formation in dental plaque was believed to be limited to strains of Bacterionema matruchotii and Streptococcus sanguis. We observed recently that strains of Fusobacterium nucleatum also interacted with S. sanguis to form corncobs. Since the fusobacteria are among the first anaerobic filaments to colonize subgingival plaque, these interactions could serve as a connecting link between the transformation of supra- to subgingival plaque. To further characterize these interactions, quantitative in vitro studies of the kinetics of corncob formation of the fusobacteria were undertaken. These studies indicated that fewer streptococci were needed to saturate F. nucleatum strain 364 compared to strain 10953. Corncob formation with both strains was enhanced with increasing pH up to pH 8, at which point autoaggregation of the streptococci occurred. Variation in ionic strength and divalent cations had little effect on the interaction, and EDTA suppressed aggregate formation only slightly. Detergents at concentrations above 0.05% also inhibited corncob formation. Electron micrographs suggested that attachment of the cocci to the fusiforms was mediated through localized tufts of fimbriae, as they are in the Bacterionema system. However, although both trypsin and heat treatment of the streptococci inhibited corncob formation with fusobacteria, the effects were not as complete as those seen in Bacterionema species. Unlike the Bacterionema model, trypsin and heat treatment of the fusobacteria resulted in inhibition of corncob formation. These results suggest that several different receptors may be involved in corncob formation.

Mechanisms that control bacterial populations in continuous-flow culture models of mouse large intestinal flora

A previous study had established that anaerobic continuous-flow (CF) cultures of conventional mouse cecal flora were able to maintain the in vivo ecological balance among the indigenous bacterial species tested. This paper describes experiments designed to determine the mechanisms which control the population sizes of these species in such CF cultures. One strain each of Escherichia coli, Fusobacterium sp., and Eubacterium sp. were studied. Growth of these strains in filtrates of CF cultures was considerably more rapid than in the CF cultures themselves, indicating that the inhibitory activity had been lost in the process of filtration. Growth rates to match those in CF cultures could be obtained, however, by restoring the original levels of H(2)S in the culture filtrates. The inhibitory effect of H(2)S in filtrates and in dialysates of CF cultures could be abolished by adding glucose or pyruvate, but not formate or lactate. The fatty acids present in CF cultures matched those in the cecum of conventional mice in both quality and concentration. These acids could not account for the slow rates of growth of the tested strains in CF cultures, but they did cause a marked increase in the initial lag phase of E. coli growth. The results obtained are compatible with the hypothesis that the populations of most indigenous intestinal bacteria are controlled by one or a few nutritional substrates which a given strain can utilize most efficiently in the presence of H(2)S and at the prevailing conditions of pH and anaerobiosis. This hypothesis consequently implies that the populations of enterobacteria, such as the E. coli strain tested, and those of the predominant anaerobes are controlled by analogous mechanisms.

Continuous-flow cultures as in vitro models of the ecology of large intestinal flora

An anaerobic continuous-flow (CF) culture method has been developed which reproduces a number of bacterial interactions that occur in the large intestine of mice. These were determined in the following ways. (i) Bacterial counts in smears stained with 37 specific fluorescent antisera showed that the numeric balance between 37 strict anaerobes isolated from conventional mice was maintained in CF culture of conventional mouse flora in the same manner as in conventional mice. (ii) Mixed populations of various complexity of bacteria isolated from conventional mice were able to suppress Escherichia coli populations to similar levels in gnotobiotic mice and in CF cultures. (iii) Contents of CF cultures when fed to germfree mice were found to redress the germfree abnormalities studied, namely, cecal size and size of the E. coli population. Furthermore, dense layers of bacterial growth formed on the wall of CF cultures of mouse cecal flora, in a manner analogous to the colonization of mouse large intestinal mucosa. In the absence of such bacterial layers, the culture no longer exhibited these interactions. Because of the complexity and diversity of the interactions studied it is highly probable that at least the major underlying ecological control mechanisms operating in the culture model resemble those of the mouse intestine. We speculate that the somewhat surprising similarity between the ecology of the mouse large intestine and that of a CF culture in a glass vessel is due to the fact that both are dominated by thick layers of complex bacterial flora, the composition of which is controlled by their metabolic activities and by their relative ability to adhere to each other.