Bakhsh Abdulaziz, Moyes David, Mannocci Francesco, Proctor Gordon, Niazi Sadia
Department of Restorative Dentistry, Division of Endodontics, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia.
Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Host-Microbiome Interactions, Guy's Dental Hospital, King's College London, London, UK.
J Endod. 2025 Feb;51(2):140-149. doi: 10.1016/j.joen.2024.11.009. Epub 2024 Nov 22.
Nosocomial endodontic infections can cause treatment failure and are potential risk of bacteremia. This study is aimed to investigate bacteremia associated with apical periodontitis and immediate postendodontic treatment using next-generation sequencing. The study will also elucidate if the endodontic nosocomial pathogens are present in the blood microbiome.
Saliva, blood, and intracanal samples were collected from patients undergoing endodontic treatment (n = 65), while gloves samples were collected from the operator. Bacterial DNA was extracted and the targeted 16S ribosomal ribonucleic acid gene was sequenced using the Illumina Miseq 300 platform for the V1-V2 hypervariable region. The alpha and beta diversities were carried out using the phyloseq package (version-1.36.0) in R (version-4.1). Differences in abundance and diversity were calculated using Mann-Whitney test. Linear discriminant analysis Effect Size was used to compare the biological relevance between different sample sources.
The phyla firmicutes, actinobacteria, proteobacteria, and bacteroidetes were identified from all sample sources. In blood and glove samples, Cutibacterium genus was highly abundant (14.6%, 17.7%, respectively), while in intracanal samples, Enterococcus took precedence (18.2%). Saliva samples exhibited Prevotella as the most abundant genera (17.9%). Common genera were present between intracanal and postoperative blood samples. Circos graph showed that all the phyla identified from a patient were consistently present in all the samples investigated from the same patient.
Nosocomial endodontic pathogens being predominant in both; gloves and blood samples, along with common genera present in all sample sources, suggests a potential pathway of transfer of pathogens from saliva to gloves, intracanal, and blood, thus providing evidence of nosocomial endodontic bacteremia.
医院内牙髓感染可导致治疗失败，且存在菌血症的潜在风险。本研究旨在使用下一代测序技术调查与根尖周炎及牙髓治疗后即刻相关的菌血症。该研究还将阐明血液微生物群中是否存在医院内牙髓病原体。
从接受牙髓治疗的患者（n = 65）中采集唾液、血液和根管内样本，同时从操作人员处采集手套样本。提取细菌DNA，并使用Illumina Miseq 300平台对V1-V2高变区的靶向16S核糖体核糖核酸基因进行测序。使用R（版本4.1）中的phyloseq软件包（版本1.36.0）进行α和β多样性分析。使用曼-惠特尼检验计算丰度和多样性的差异。使用线性判别分析效应大小来比较不同样本来源之间的生物学相关性。
在所有样本来源中均鉴定出厚壁菌门、放线菌门、变形菌门和拟杆菌门。在血液和手套样本中，棒状杆菌属含量很高（分别为14.6%、17.7%），而在根管内样本中，肠球菌占主导地位（18.2%）。唾液样本中普雷沃菌属为最丰富的属（17.9%）。根管内样本和术后血液样本中存在共同的属。Circos图显示，从一名患者鉴定出的所有门在该患者的所有调查样本中均一致存在。
医院内牙髓病原体在手套和血液样本中均占主导地位，且所有样本来源中均存在共同的属，这表明病原体从唾液转移至手套、根管内和血液的潜在途径，从而为医院内牙髓菌血症提供了证据。
