Ricerca di batteri implicati nella malattia parodontale mediante esame colturale e RT-PCR

M. Gatti , M.S. Rini , F. Scandurra
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Abstract

Objective

Comparison between culture and methodical investigation of commercial real-time polymerase chain reaction (RT-PCR) for the detection of most bacterial species implicated in periodontal disease.

Materials and methods

The study evaluated the microbiological profile of 64 patients with chronic periodontitis. For each patient double samples of subgingival plaque in five sites for more than one dental element were collected using sterile paper points and transferred to a transport medium for the bacterial culture and without a transport medium for RT-PCR.

Results

The bacterial culture versus RT-PCR identified the same percentage of P. intermedia (68.75%), F. nucleatum (87.5%), and T. forsythensis (50%), and a lower percentage of P. gingivalis (56.2% vs 68.75%) and A. actinomycetemcomitans (6.25% vs 31.25%). T. denticola (87.5%) was sought out only by RT-PCR. In particular, P. intermedia (72.7%), P. gingivalis (77.7%), and T. forsythensis (37.5%) showed resistance to amoxicillin and in a lower percentage P. intermedia (40.9%), P. gingivalis (38.8%) and T. forsythensis (37.5%) to metronidazole. Fifty percent of F. nucleatum strains showed resistance to clindamycin and 44.4% of P. gingivalis strains showed resistance to ciprofloxacin.

Conclusions

Our data indicate that RT-PCR was more sensitive and specific than colture examination. Also, it has proven particularly useful in detecting pathogenic species implicated in periodontal disease that cannot be cultivated or are not easily discernible in culture, such as T. denticola. On the other hand, only culture investigation can detect multiple bacterial species simultaneously, highlight the unexpected species and above all allow the evaluation of the antibiotic-resistance. Thanks to these features, this method is still considered the gold standard in the diagnosis and monitoring of periodontal disease.

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通过培养和RT-PCR检测牙周病中的细菌
目的比较商业实时聚合酶链反应(RT-PCR)检测牙周病细菌种类的方法和培养方法。材料与方法本研究对64例慢性牙周炎患者进行微生物学分析。对于每个患者,使用无菌纸点收集五个部位的牙龈下菌斑的双重样本,用于一个以上的牙齿元件,并将其转移到细菌培养的运输介质中,而不使用运输介质进行RT-PCR。结果细菌培养与RT-PCR鉴定的中间假单胞菌(68.75%)、核仁假单胞菌(87.5%)和连生假单胞菌(50%)比例相同,牙龈假单胞菌(56.2%)和放线菌(6.25%)比例较低(31.25%)。仅用RT-PCR技术检测到牙齿田鼠(87.5%)。其中,对阿莫西林耐药的有中间假蝇(72.7%)、牙龈假蝇(77.7%)和连翘假蝇(37.5%),对甲硝唑耐药的有中间假蝇(40.9%)、牙龈假蝇(38.8%)和连翘假蝇(37.5%)。50%的核胞假单胞菌对克林霉素耐药,44.4%的牙龈假单胞菌对环丙沙星耐药。结论逆转录聚合酶链反应(RT-PCR)的敏感性和特异性高于结肠检查。此外,它已被证明在检测与牙周病有关的无法培养或在培养中不易识别的致病物种方面特别有用,例如牙齿菌。另一方面,只有培养调查才能同时检测到多种细菌种类,突出意想不到的物种,首先可以评估抗生素耐药性。由于这些特点,这种方法仍然被认为是诊断和监测牙周病的金标准。
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