Oral Gram-Negative Species

Transcription

1 口腔微生物與免疫學 Oral microbiology & immunology 學習目標 讓學生能瞭解口腔內感染疾病之疾病發生論中致病菌之致病機轉與宿主的免疫反應 周幸華 Hsin-Hua Hua Chou, D.D.S., Ph.D. 日本國立岡山大學齒學博士美國波士頓大學客座交換學者萬芳醫院牙周病科主治醫師台北醫學大學牙醫學系助理教授 參考資料 1. Contemporary oral microbiology and immunology. Slots Jorgen and Martin A Taubman. Mosby. 2. Oral microbiology and immunology. Michael G Newman and Russel Nisengard. Saunders. 3. 齒學微生物學. 醫齒藥出版株式會社. 4. 相關期刊論文 Summary 從口腔內微生物之感染及人體免疫發炎反應的學理觀點來介紹口腔內感染疾病 (infectious disease). 之疾病發生論 (pathogenesis) 從口腔內之特定感染菌種的致病因子及致病機轉開始講解至宿主的免疫反應及免疫反應所導致的口腔內之硬組織及軟組織的破壞機轉 Bacterial Cell Wall Oral Gram-Positive Species Gram-Negative Cell Wal Gram-Positive Cell Wall Rods Cocci Non-sporing Spores Formed Facultative*Anaerobic FacultativeAnaerobic Anaerobic BifidobacteriumBacillus Clostridium Facultative* Peptococcus Eubacterium Peptostreptococc Teichoic acid Aerobic Anaerobic Catalase Postive Catalase Negative Rothia Corynebacterium Actinomyces Staphylococcus Gemella PropionibacteriumStomatococcus Streptococcus Lactobacillus 1

2 Early colonizer Streptococcus sp. S. gordonii S. intermedius S. mitis S. oralis S. sanguis Purple complex and green complex 2 nd and 3 rd colonizer V. parvula A. odontolyticus A.a. type a C. gingivalis C. ochracea C. sputigena E. corrodens Purple complex and green complex 2 nd and 3 rd colonizer Streptococcus sp. S. gordonii S. intermedius S. mitis S. oralis S. sanguis V. parvula A. odontolyticus A.a. type a C. gingivalis C. ochracea C. sputigena E. corrodens C. rectus C. gracilis C. showae E. nodatum S. constellatus P. intermedia P. nigrescens P. micros F. nucleatum Microbial complexes in subgingival plaque Socransky, Periodontology 2000 Rods Spirochetes Cocci Aerobes Neisseria Veillonella Nonmotile Motile Facultative* Selenomonas Formate and fumarate Prophyromon Centipeda Asaccharolytic metabolism as Prevotella SaccharolyticEikenella Mitsuokella Haemophilus Motile Nonmotile Bacteroides Actinobacterium Wolinella B.gracilis Fusobacteriu Cardiobacterium Campylobacter m 2

3 Periodontitis Microbial complexes in subgingival plaque Socransky, Periodontology 2000 Microbiology of Periimplantitis AA: A. actinomycetemcomitans EK: Eikenella corrodens PG: P. gingivalis SE: Selenomonas spp. PM: Prevotella melaninogenica CR: C. rectus CA: spp. AN: Actinomyces naeslundi PI: P. intermedia VE: Veillonella spp. AV: Actinomyces viscosus AO: Actinomyces odontolyticus Peri-implantitis Rods Spirochetes Cocci Aerobes Neisseria Veillonella Nonmotile Motile Facultative* Selenomonas Formate and fumarate Porphyromon Centipeda Asaccharolytic metabolism as Prevotella SaccharolyticEikenella Mitsuokella Haemophilus Motile Nonmotile Bacteroides Actinobacterium Wolinella B.gracilis Fusobacteriu Cardiobacterium Campylobacter m 3

4 Asaccharolytic Black-pigmented Rods Genus Porphyromonas Nonfermentative, Dark-Pigmented Species: Porphyromonas P h gingivalis i Porphyromonas endodontalis Porphyromonas asaccharolytica Bacteroides salivosus Porphyromonas ginigvalis Characteristic: nonmotile medium-length rods to cocci. Porphyromonas ginigvalis Culture and Identification: Dark pigmented colonies on blood agar. Yellow to green color of young colonies. Unpigmented on media contain no blood Porphyromonas ginigvalis Rapid cultural methods : lack of colony flurorescence. positive trypsin-like (BANA test) activi BANA Test: trypsin-like enzyme that can be detected the hydrolysis of benzoyl-dl-arginine-2-naphthylam Trypsin: carboxyl side of arginine and lysine. Proteolytic activity varies. Major site of colonization: subgingival sulc Porphyromonas ginigvalis Metabolism and energy: Hemin-iron and protoporphyrin source for growth. Relatively aerotolerant, does not ferment carbohydrates. Pathogenicity: An aggressive periodontal pathogen. 4

5 Porphyromonas endodontalis Distinguishes P. endodontalis from P. gingivalis :Trypsin (BANA test) negative, Not agglutinate sheep erythrocytes. Isolated from dental root canals and from human periodontal pockets. A likely cause of endodontic abscess. Saccharolytic black-pigmented rods Genus Prevotella Prevotella melaninogenica Prevotella denticola Prevotella loeschei Prevotella intermedi Prevotella corporis Bacteroid Macacae Bacteroid Levii Rods Spirochetes Cocci Aerobes Neisseria Veillinella Facultative* Formate and fumarate Motile metabolism NonmotileSelenomonas Asaccharolytic Prophyromonas CentipedaSaccharolytic Eikenella Prevotella Haemophilus Motile Nonmotile Mitsuokella Actinobacterium Wolinella B.gracilis Bacteroides Cardiobacterium Campylobacter Fusobacterium Prevotella melaninogenica Black pigment: protoheme instead of melanin. Requires hemin and menadione for growth. 5

6 Prevotella melaninogenica Anaerobic with a fermentative metabolism: β-galactosidase (MUG) positive: Hydrolyze lactose to galactose and glucose. β-hemolytic on rabbit blood agar The primary niche of P. melaninogenica, Prevotella denticola, P. loescheii are subgingival sites. Putative periodontal pathogens. Lactose-inhibitable coaggretion Prevotella intermedia The epithet intermedius - intermediate lowering of ph in glucose broth between non-fermenting species (Porphyromonas) and saccharolytic species (P. melaninogenicus). Rapid identification- 1. Black colonies on blood- containing media. 2. Fluoresence with a brick red hue under UV light. 3. Negative MUG test. Prevotella intermedia A strict anaerobes that ferments glucose (final ph 4.9 to 5.4) dextrin, maltose, sucrose, fructose, and may ferment glycogen, and insulin. Menadione can be essential for expression of carbohydrate fermentation. A periodontal pathogen. Mean proportions of specific periodontal pathogens 9 F.n. P.i. 8 P.g active inactive healthy Saccharolytic Nonpigmented Rods Genus Prevotella Genus Bacteroides Prevotella oralis Bacteroides Prevotella veroralisoulorum Bacteroides Prevotella buccalis heparinolyticus Prevotella oris Bacteroides zoogleoforman s Bacteroides f th 6

7 Rods Spirochetes Cocci Aerobes Neisseria Veillinella Facultative* Formate and fumarate Motile metabolism NonmotileSelenomonas Asaccharolytic Prophyromonas CentipedaSaccharolytic Eikenella Prevotella Haemophilus Motile Nonmotile Mitsuokella Actinobacterium Wolinella B.gracilis Bacteroides Cardiobacterium Campylobacter Fusobacterium The specific epithet forsythus was named Forsyth Dental Center, Boston. Culture and identification: Colonies of other species such as Fusobacterium nucleatum stimulate growth of B. forsythus in a satellite fashion. Characteristics: Cells appear fusiform (with tapered ends), with filamentous forms up to 30 μm. Cells may have central swelling, and cultures frequently demonstrate large spheres. Cells are nonmotile and have no flagella. B. forsythus is a strict anaerobe. It demonstrates strong trypsin-like BANA activity. Strains are esculin positive. Trypsin-like (BANA test) activity. BANA Test: trypsin-like enzyme that can be detected by the hydrolysis of benzoyl-dlarginine-2-naphthylamine. Trypsin: carboxyl side of arginine and lysine. It requires exogenous N-acetylmuramic acid for cell growth. B. forsythus is the only from the human gingival crevice, and strongly putative pathogen in human periodontal disease. 7

8 Microbial complexes in subgingival plaque Socransky, Periodontology 2000 Rods Spirochetes Cocci Aerobes Neisseria Veillonella Nonmotile Motile Facultative* Selenomonas Formate and fumarate Porphyromon Centipeda Asaccharolytic metabolism as Prevotella SaccharolyticEikenella Mitsuokella Haemophilus Motile Nonmotile Bacteroides Actinobacterium Wolinella B.gracilis Fusobacteriu Cardiobacterium Campylobacter m Other Nonpigmented Bacteroides Genus Fusobacterium Fusobacterium nucleatum Fusobacterium perioodonticum Fusobacterium alocis Fusobacterium sulci Genus buccalis Genus Fusobacterium The genus Fusobacterium was small rods that are spindle shaped (fusus). Fusobacterium are non- spore-forming, nonmotile, anaerobic, or weakly fermentative. Fusobacterium nucleatum Have fusiform or tapered or pointed ends. Fusiform species in other gerea include B. forsythus, and B. gracilis. The epithet nucleatum means having a kernel or nucleated. Cells often have central swellings, but cells are not flagellated. Fusobacterium nucleatum F. nucleatum derives energy from amino acid metabolism, and most strains produce a deoxyribonuclease. The major site of colonization of F. nucleatum is gingival i sulcus. F. nucleatum has also been isolated from infections of the upper respiratory tract. A periodontal pathogen. 8