患有重度幼儿龋齿的儿童：龋损和白斑病变内的链球菌遗传菌株。
Children with severe early childhood caries: streptococci genetic strains within carious and white spot lesions.
作者信息
Gilbert Kenneth, Joseph Raphael, Vo Alex, Patel Trusha, Chaudhry Samiya, Nguyen Uyen, Trevor Amy, Robinson Erica, Campbell Margaret, McLennan John, Houran Farielle, Wong Tristan, Flann Kendra, Wages Melissa, Palmer Elizabeth A, Peterson John, Engle John, Maier Tom, Machida Curtis A
机构信息
Academic DMD Program, School of Dentistry, Oregon Health & Science University, Portland, OR, USA.
Academic DMD Program, School of Dentistry, Oregon Health & Science University, Portland, OR, USA ; Department of Integrative Biosciences, School of Dentistry, Oregon Health & Science University, Portland, OR, USA.
出版信息
J Oral Microbiol. 2014 Oct 29;6. doi: 10.3402/jom.v6.25805. eCollection 2014.
BACKGROUND AND OBJECTIVES
Mutans streptococci (MS) are one of the major microbiological determinants of dental caries. The objectives of this study are to identify distinct MS and non-MS streptococci strains that are located at carious sites and non-carious enamel surfaces in children with severe early childhood caries (S-ECC), and assess if cariogenic MS and non-cariogenic streptococci might independently exist as primary bacterial strains on distinct sites within the dentition of individual children.
DESIGN
Dental plaque from children (N=20; aged 3-6) with S-ECC was collected from carious lesions (CLs), white spot lesions (WSLs) and non-carious enamel surfaces. Streptococcal isolates (N=10-20) from each site were subjected to polymerase chain reaction (PCR) to identify MS, and arbitrarily primed-PCR for assignment of genetic strains. Primary strains were identified as ≥50% of the total isolates surveyed at any site. In several cases, strains were characterized for acidurity using ATP-driven bioluminescence and subjected to PCR-determination of potential MS virulence products. Identification of non-MS was determined by 16S rRNA gene sequencing.
RESULTS
Sixty-four independent MS or non-MS streptococcal strains were identified. All children contained 1-6 strains. In many patients (N=11), single primary MS strains were identified throughout the dentition. In other patients (N=4), primary MS strains were identified within CLs that were distinct from primary strains found on enamel. Streptococcus gordonii strains were identified as primary strains on enamel or WSLs in four children, and in general were less aciduric than MS strains.
CONCLUSIONS
Many children with S-ECC contained only a single primary MS strain that was present in both carious and non-carious sites. In some cases, MS and non-cariogenic S. gordonii strains were found to independently exist as dominant strains at different locations within the dentition of individual children, and the aciduric potential of these strains may influence susceptibility in the development of CLs.
背景与目的
变形链球菌（MS）是龋齿的主要微生物决定因素之一。本研究的目的是鉴定重度幼儿早期龋（S-ECC）患儿龋损部位和非龋牙釉质表面的不同MS和非MS链球菌菌株，并评估致龋性MS和非致龋性链球菌是否可能作为主要菌株独立存在于个体儿童牙列的不同部位。
设计
收集20名3-6岁S-ECC患儿龋损病变（CLs）、白斑病变（WSLs）和非龋牙釉质表面的牙菌斑。对每个部位的链球菌分离株（10-20株）进行聚合酶链反应（PCR）以鉴定MS，并进行任意引物PCR以确定基因菌株。主要菌株被确定为在任何部位检测到的分离株总数的≥50%。在一些情况下，使用ATP驱动的生物发光对菌株的耐酸性进行表征，并通过PCR测定潜在的MS毒力产物。通过16S rRNA基因测序确定非MS的鉴定。
结果
鉴定出64株独立的MS或非MS链球菌菌株。所有儿童含有1-6株菌株。在许多患者（11例）中，在整个牙列中鉴定出单一的主要MS菌株。在其他患者（4例）中，在龋损病变中鉴定出的主要MS菌株与牙釉质上发现的主要菌株不同。在4名儿童中，戈登链球菌菌株被鉴定为牙釉质或白斑病变上的主要菌株，并且一般来说，其耐酸性低于MS菌株。
结论
许多S-ECC患儿仅含有单一的主要MS菌株，该菌株存在于龋损和非龋部位。在某些情况下，发现MS和非致龋性戈登链球菌菌株作为优势菌株独立存在于个体儿童牙列的不同位置，并且这些菌株的耐酸性可能会影响龋损病变发生的易感性。
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