RESUMEN
Human dental plaque is thought to contribute to disease, not only in the oral cavity but also at other body sites. To investigate the pathogenicity of dental plaque in tissues remote from the mouth, we examined the ability of human supragingival dental plaque to induce infective endocarditis (IE) in rats. In total, 15 out of 27 catheterized rats survived after intravenous injections with human supragingival dental plaque suspensions containing 3 x 10(6) colony-forming units (CFU) of bacterial cells. In surviving rats, infected vegetations were formed in all except one rat. The microbial composition of the infected vegetations was different from that of the respective dental plaque inocula, with Streptococcus oralis comprising the majority of the isolates. In rats affected with endocarditis, the aortic sinus was filled with fibrinous vegetation containing bacteria. Inflammatory cells infiltrated the aortic valve, the aorta adjacent to the valve, and the cardiac muscles. The inoculation of catheterized rats with a cell suspension of S. oralis isolate (5 x 10(6) CFU) was not lethal but capable of inducing endocarditis in all animals. The results suggest that if dental plaque were introduced into the bloodstream, it could serve as a potent source of bacteria causing IE in humans.
Asunto(s)
Válvula Aórtica/microbiología , Bacteriemia/complicaciones , Placa Dental/complicaciones , Endocarditis/microbiología , Streptococcus oralis/patogenicidad , Adulto , Animales , Válvula Aórtica/patología , Bacteriemia/microbiología , Biopelículas , Placa Dental/microbiología , Modelos Animales de Enfermedad , Endocarditis/patología , Femenino , Humanos , Masculino , Ratas , Ratas Wistar , Seno Aórtico/microbiología , Seno Aórtico/patología , Streptococcus oralis/aislamiento & purificaciónRESUMEN
Human dental plaque consists of a wide variety of microorganisms, some of which are believed to cause systemic infections, including abscesses, at various sites in the body. To confirm this hypothesis experimentally, we examined the abscess-forming ability of native dental plaque in mice, the microbial features of the infectious locus produced by the plaque, and the anti-phagocytic property of microbial isolates. Aliquots of a suspension of supragingival dental plaque containing 6 x 10(6) colony-forming unit of bacteria were injected subcutaneously into the dorsa of mice. Abscess formation was induced in 76 of 85 mice using ten different plaque samples. Thirteen microorganisms were isolated from pus samples aspirated from abscess lesions. The microbial composition of pus, examined in 17 of 76 abscesses, was very simple compared to that of the plaque sample that had induced the abscess. The majority of the isolates belonged to the Streptococcus anginosus group, normally a minor component of plaque samples. S. anginosus was the most frequently detected organism and the most prevalent in seven abscesses, and Streptococcus intermedius and Streptococcus constellatus were predominant in one and three abscess samples, respectively. Each isolate of S. anginosus group produced abscesses in mice, and heat-treated supragingival dental plaque influenced the abscess-forming ability of S. anginosus isolate. These isolates possessed a high antiphagocytic capacity against human polymorphonuclear leukocytes. Our results suggest that human supragingival dental plaque itself is a source of the infectious pathogens that cause abscess formation.