von Troil-Lindén B, Saarela M, Mättö J, Alaluusua S, Jousimies-Somer H, Asikainen S
Department of Periodontology, University of Helsinki, Finland.
J Clin Periodontol. 1996 Jun;23(6):601-7. doi: 10.1111/j.1600-051x.1996.tb01831.x.
To clarify the source of re-emerging periodontal pathogens after treatment, we compared the ribotypes of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia/Prevotella nigrescens group and Campylobacter rectus before and after treatment in 7 periodontitis patients and in 6 of the spouses. The patients harbored A. actinomycetemcomitans, P. gingivalis, P. intermedia/P. nigrescens group or C. rectus in their subgingival or salivary samples before treatment. The respective bacterial species were not detected 1 month after treatment, but reappeared by 6 months later. When available, 4 random colonies of each of the 4 species were isolated from both subgingival and salivary samples at each sampling occasion, the isolates were subcultured, identified and typed applying pheno- and genotypic intraspecies characterization methods. Altogether 90 strains of A. actinomycetemcomitans, P. gingivalis, P. intermedia/P. nigrescens group and C. rectus were available from 2, 3, 2 and 4 patients, respectively. The pre- and post-treatment ribotypes of A. actinomycetemcomitans-, P. gingivalis- and P. intermedia/P. nigrescens group-isolates were identical in all respective patients. The pre- and post-treatment ribotypes of C. rectus were identical in 1 of 4 patients, whereas 2 patients harbored a previously not detected post-treatment ribotype and 1 patient harbored the initial and a previously not detected post-treatment ribotype. To study the possibility that periodontitis patients may acquire strains from the spouse after treatment, isolates of A. actinomycetemcomitans, P. gingivalis, P. intermedia/P. nigrescens group and C. rectus (n = 95) from the patients' spouses were ribotyped and compared with those of the patients. The patient exhibited his own post-treatment ribotypes, different from those of the spouse, of A. actinomycetemcomitans and P. gingivalis in 1 couple and of P. intermedia/P. nigrescens group and C. rectus in 1 couple. In the 2 patients who harbored a previously not detected post-treatment ribotype of C. rectus, one patient shared the new ribotype with the spouse, whereas the other one did not. Although an exogenous source cannot be fully ruled out, the patient's own oral flora seems to be the main source of re-emerging periodontal pathogens after treatment.
为了明确治疗后牙周病原体再次出现的来源，我们比较了7例牙周炎患者及其6位配偶治疗前后伴放线放线杆菌、牙龈卟啉单胞菌、中间普氏菌/变黑普氏菌组和直肠弯曲菌的核糖型。治疗前，患者的龈下或唾液样本中存在伴放线放线杆菌、牙龈卟啉单胞菌、中间普氏菌/变黑普氏菌组或直肠弯曲菌。治疗1个月后未检测到相应细菌种类，但6个月后再次出现。每次采样时，从龈下和唾液样本中分别随机分离出这4种细菌的4个菌落，对分离株进行传代培养，应用表型和基因型种内鉴定方法进行鉴定和分型。分别从2例、3例、2例和4例患者中获得了总共90株伴放线放线杆菌、牙龈卟啉单胞菌、中间普氏菌/变黑普氏菌组和直肠弯曲菌。伴放线放线杆菌、牙龈卟啉单胞菌和中间普氏菌/变黑普氏菌组分离株治疗前后的核糖型在所有相应患者中均相同。4例患者中有1例直肠弯曲菌治疗前后的核糖型相同，而2例患者携带一种治疗后未检测到的核糖型，1例患者同时携带初始核糖型和一种治疗后未检测到的核糖型。为了研究牙周炎患者治疗后是否可能从配偶处获得菌株，对患者配偶的伴放线放线杆菌、牙龈卟啉单胞菌、中间普氏菌/变黑普氏菌组和直肠弯曲菌（n = 95）分离株进行核糖型分析，并与患者的分离株进行比较。在1对夫妇中，患者伴放线放线杆菌和牙龈卟啉单胞菌治疗后的核糖型与配偶不同；在1对夫妇中，患者中间普氏菌/变黑普氏菌组和直肠弯曲菌治疗后的核糖型与配偶不同。在2例携带治疗后未检测到的直肠弯曲菌核糖型的患者中，1例患者与配偶共享新的核糖型，而另1例患者则没有。虽然不能完全排除外源来源，但患者自身的口腔菌群似乎是治疗后牙周病原体再次出现的主要来源。
