Clinical Oral Microbiology (eBook)

T. Wallace MacFarlane, Lakshman P. Samaranayake (Autoren)

eBook Download: PDF | EPUB

2014 | 1. Auflage
296 Seiten
Elsevier Science (Verlag)
978-1-4831-8363-3 (ISBN)

Infos

Clinical Oral Microbiology describes the significant models of monomicrobial and polymicrobial mechanisms of pathogenicity to appreciate the multifactorial nature of many infections. This book provides an understanding in the development of the science and practice of clinical oral microbiology. Organized into five parts encompassing 17 chapters, this book begins with an overview of the various types of oral and dental infections. This text then describes the different environmental characteristics of the human mouth, which consists of a complex mixture of microbial species of bacteria, fungi, mycoplasma, and protozoa. Other chapters consider the relative proportions of oral microorganisms in health. This book discusses as well the interplay of the etiological factors in dental caries. The final chapter deals with the transmission of infectious agents among patients and staff within a hospital environment, which is commonly called as cross-infection. This book is a valuable resource for microbiologists, dentists, oral pathologists, clinicians, and practitioners.

Inhalt

Front Cover 1
Clinical Oral Microbiology 2
Copyright Page 3
Table of Contents 10
Foreword 4
Preface 6
Acknowledgements 8
Chapter 1. 
14 
Part 1: 
18 
Chapter 2. 
20 
Study of the oral microbial flora 21
Chapter 3. 
34 
The oral environment 34
Acquisition of the normal oral microflora 39
Dental plaque 40
Part 2: Diseases related to dental plaque 46
Chapter 4. Microbiology of dental caries 48
Clinical presentation and diagnosis 48
Aetiology 49
Management of dental caries 57
Prevention of dental caries 59
Chapter 5. Microbiology of periodontal diseases 64
Types of periodontal disease 64
Factors involved in periodontal diseases 65
Chronic gingivitis 73
The transitional stage 75
Chronic periodontitis 76
Localized juvenile periodontitis 80
Prepubertal periodontitis 81
Rapidly progressive periodontitis 82
Acute ulcerative gingivitis 83
Chapter 6. Dentoalveolar infections 88
Dentoalveolar abscess 88
Ludwig's angina 95
Periodontal abscess 96
Suppurative osteomyelitis of the jaws 98
Staphylococcal submandibular lymphadenitis in children 101
Cervicofacial actinomycosis 102
Chapter 7. Microbiology in endodontic therapy 106
Source and route of infection 106
Pathogenesis of pulp and periapical infections 106
Host defence mechanisms 108
Microbiology 108
Role of microbiology in endodontics 109
Microbiological sampling from root canals 111
Treatment 111
Part 3: Infections involving the oral and perioral tissues 114
Chapter 8. Bacterial infections 116
Tonsillitis and pharyngitis 116
Gonorrhoea 116
Syphilis 120
Tuberculosis 125
Leprosy 128
Tetanus 132
Chapter 9. Fungal infections 135
Oral candidosis 136
Candidoses confined to the oral and perioral tissues 137
Oral manifestations of mucocutaneous candidoses 147
Oral manifestations of systemic mycoses 150
Chapter 10. Viral infections 153
Interaction of virus and host cells 154
Recovery and immunity to virus infection 155
Herpes virus infections 156
Varicella zoster infection 161
Infectious mononucleosis 164
Cytomegalovirus disease 165
Coxsackie A virus infections 165
Paramyxovirus infections 168
Viruses and cancer 169
Chapter 11. Salivary gland infections 171
Viral infections of salivary glands 172
Bacterial infections of salivary glands 174
Oral infection consequential to xerostomia 179
Chapter 12. Infections in medically compromised patients 180
Infective endocarditis 180
Recommendations on antibiotic prophylaxis 187
Prostheses 190
Immunocompromised patients 190
Oral and dental infections in compromised patients 192
Xerostomia and Sjögren's syndrome 195
Part 4: Diagnostic oral microbiology 198
Chapter 13. Use of the microbiology laboratory 200
Requesting a microbiology report 200
Specimen collection from oral infections 204
Diagnosis of fungal infections 211
The use of laboratory investigations in the management of antimicrobial therapy 213
Chapter 14. Antimicrobial chemotherapy 217
Bacteriostatic and bactericidal antimicrobial agents 217
General principles of antimicrobial therapy 218
Antimicrobial prophylaxis 220
Prescribing an antimicrobial agent 221
Pharmacodynamics an antimicrobial agents 222
Failure of antimicrobial therapy 224
Antimicrobials commonly used in dentistry 224
Part 5: Cross-infection in dentistry 234
Chapter 15. Viral hepatitis 236
Hepatitis A 238
Hepatitis . 239
Non-A non-B (NANB) hepatitis 249
Delta hepatitis (hepatitis D) 249
Chapter 16. Human immunodeficiency virus and acquired immune deficiency syndrome 252
Definition of AIDS 252
Epidemiology 253
Human immunodeficiency virus 253
Natural history and clinical features of AIDS 256
Oral manifestations of AIDS 258
Transmission of AIDS 263
Chapter 17. Cross-infection and sterilization 267
Cross-infection in the dental surgery 267
Prevention of cross-infection 269
Dental treatment of high-risk patients 276
Appendices 278
Appendix 1: Code of practice for the use of protective clothing and other procedures associated with the prevention of cross-infection during dental treatment 280
Appendix 2: Additional procedures available when treating known high-risk infective patients 287
Index 290

Textauszug

Chapter 2

Normal oral flora

Publisher Summary

Human mouth contains a wide range of sites with different environmental characteristics; the oral flora consists of a complex mixture of microbial species, which include bacteria, mycoplasma, fungi, and protozoa. The mouth consists of a number of ecological niches that are colonized by a characteristic mixture of microorganisms. The main ecological areas of the mouth are: (1) the mucosa of the lips, cheeks, and palate; (2) the tongue; (3) the tooth surfaces—above and below the gingival margin; (4) saliva; (5) the tonsillar area; and (6) dentures, if present. Saliva, although widely used as the main sample in studying the oral microbial flora, does not give an accurate qualitative or quantitative assessment of any particular part of the mouth, and is best regarded as representing the overflow of microorganisms from the other oral sites. This chapter discusses the problems that are associated with qualitative and quantitative investigations of the oral microbial flora.

Since the human mouth contains a wide range of sites with different environmental characteristics, it is not surprising that the oral flora consists of a complex mixture of microbial species which include bacteria, mycoplasma, fungi and protozoa. It is not possible in this short book to discuss individual microbial species in detail and, therefore, only the relevant features of the more important members of the oral microflora (selected on the basis of numerical dominance and/or relation to disease) are given. Other microbial characteristics, e.g. factors related to pathogenicity, will be presented in later chapters when specific diseases are discussed. The information is presented in a tabular format (Table 2.1) so that students can refer easily to the appropriate section when they encounter a species with which they are unfamiliar.

Table 2.1

Characteristics of the main microorganisms present in the oral commensal microflora

Streptococcus

Gram-positive cocci in chains, non-motile, usually possess surface fibrils, occasionally capsulate. (Note: The term Strep. viridans has been loosely applied as a collective name for α-haemolytic oral streptococci)

Facultative anaerobes, variable haemolysis, but α most common. Selective medium, mitis salivarius agar (MSA)

Strep. sanguis

Small rubbery colonies on MSA, firmly attached to agar surface

Mainly dental plaque/Infective endocarditis, dental caries? and aphthous ulceration?

Strep. oralis

Variable colonial morphology similar to Strep. sanguis or small, soft and non-adherent

Tongue, cheek, plaque and saliva/Infective endocarditis

Strep. mitis

Small non-adherent colonies on MSA

Dental plaque/None

Strep. mutans

High convex, opaque colonies; extracellular polysaccharide from sucrose. Selective medium MSA + bacitracin; genetically heterogeneous with six species

Tooth surface/Dental caries

Strep. salivarius

Large mucoid colonies on MSA

Dorsum of tongue and saliva/None

Strep. milleri

CO2dependent; small non-adherent colonies on MSA. Selective medium contains sulphonamide

Gingival crevice/Dentoalveolar and endodontic infections

Anaerobic streptococcus

Small Gram-positive cocci in chains

Peptococcus spp.     Peptostreptococcus spp.

Strict anaerobes, slowly growing, usually non-haemolytic

Sub-gingival plaque/Dentoalveolar infections

Lactobacillus

Gram-positive bacilli, catalase negative

L. casei     L. ferment urn

Microaerophilic; complex nutritional requirements; aciduric; optimal pH 5.5–5.8. Selective medium, Rogosa agar, with low pH due to acetic acid

Dental plaque usually in small numbers/Extension of dental caries especially into dentine

Actinomyces

Gram-positive bacilli and filaments. Non-motile

A. israelii

Microaerophilic strict anaerobe, ‘molar’ tooth colony on blood agar

Dental plaque and tonsillar crypts/Actinomycosis and dental calculus formation

A. naeslundii

Facultative anaerobe

A. viscosus

Facultative anaerobe with requirement for CO2

Dental plaque/Root surface caries and calculus formation

A. odontolyticus

Facultative anaerobe; reddish-brown centre to colonies

Dental plaque/Extension of caries into dentine

Arachnia

Gram-positive pleomorphic bacilli

A. propionica

Strict anaerobe with similar colonial morphology to A. israelii

Dental plaque/Carious dentine, necrotic dental pulp, and chronic periodontitis?

Eubacterium

Pleomorphic Gram-positive rods or filaments

E. suburreum     E. timidum

Strict anaerobes, characterization ill defined

Dental plaque/Calculus, carious dentine, necrotic pulp and chronic periodontitis?

Bacterionema

Gram-positive pleomorphic filaments attached to a rectangular rod shaped body; ‘whip handle’ appearance

B. matruchotii

Usually facultative anaerobe; some strains strictly anaerobic

Dental plaque/Dental calculus formation

Propionibacteria

Gram-positive bacilli

P. acnes

Strict anaerobe, with white colonies surrounded with dark zone on blood agar

Dental plaque/Dentoalveolar infections?

Rothia Gram-positive branching filaments

R. dentocariosa

Usually strict aerobe, with white pigmented colonies

Saliva and dental plaque/None

Bifidobacterium

Gram-positive bacilli

B. dentium

Strict anaerobe

Dental plaque/None

Micrococcus + Staphylococcus

Gram-positive cocci, catalase positive

M. mucilagenosus Staph. aureus

Coagulase negative; large colonies adherent to blood agar surface, facultative     Coagulase positive; yellow pigmented colonies, facultative

Tongue mainly, also gingival crevice/None     Saliva of 50% of population in small numbers/Angular cheilitis

Neisseria

Gram-negative diplococci

N. lactamicus     N. pharyngis

Asaccharolytic and nonpolysaccharide producing, facultative

Tongue, saliva, oral mucosa and early plaque/None

Branhamella

Gram-negative diplococci

B. catarrhalis

Saccharolytic and polysaccharide producing, facultative

Tongue, saliva and oral mucosa/None

Veillonella

Small Gram-negative cocci

V. alcalescens

Strict anaerobe; selective medium, Rogosa’s vancomycin agar

Tongue and saliva and dental...

Produkt-Details

• Erscheint lt. Verlag: 28.6.2014
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Chirurgie
• Themenwelt: Naturwissenschaften ► Biologie
• Themenwelt: Technik
• ISBN-10: 1-4831-8363-7 / 1483183637
• ISBN-13: 978-1-4831-8363-3 / 9781483183633