Pathology
Detecting Gram-Positive Anaerobic Cocci Directly From the Clinical Samples by Multiplex Polymerase Chain Reaction in Odontogenic Infections

https://doi.org/10.1016/j.joms.2014.08.021Get rights and content

Purpose

Gram-positive anaerobic cocci (GPAC) can be isolated as pathogens from odontogenic infections. Culturing GPAC is time consuming and labor intensive. The objectives of the present study were to examine the utility of polymerase chain reaction (PCR) in directly detecting the presence of GPAC in clinical samples obtained from patients with odontogenic infections and to compare the distribution of GPAC in infected and healthy tissue.

Materials and Methods

In the present case-control study, the infected tissue from patients and oral mucosal swabs from healthy control subjects were subjected to anaerobic culture and direct PCR analysis for the presence of GPAC. The McNemar, chi-square, and Fisher exact tests and kappa analysis were used for the statistical analyses. P < .05 was regarded as significant.

Results

The patient group included 13 men and 14 women, including 9 patients diagnosed with granulation of tooth extraction, 6 with impacted tooth follicles, 4 with peri-implantitis, 3 with abscesses, 2 with epithelial cysts, 2 with infected cysts, and 1 with an oroantral fistula. The control group included 14 men and 12 women. All the patient and control samples contained at least 1 GPAC. The groups did not differ by method of determining GPAC presence, but more microorganisms were detected when clinical samples were directly used for PCR analysis than when cultured bacteria were used (P = .001).

Conclusions

The presence of GPAC in infected tissue cannot be directly related to the development of odontogenic infections. PCR performed directly on clinical material is a sensitive and specific method that can detect GPAC and save time.

Section snippets

Study Design and Study Groups

The present study was designed as a case-control study. The patient group included patients who had applied to the outpatient clinics of the Department of Oral and Maxillofacial Surgery, Ankara University Faculty of Dentistry, from January 2011 to December 2012, for the evaluation and management of odontogenic infections. These patients had been diagnosed with various odontogenic infections, including granulation of tooth extraction in 9, impacted tooth follicles in 6, peri-implantitis in 4,

Results

A total of 53 subjects were included in the present study. The patient group consisted of 27 patients (13 men [mean age 42.5 years] and 14 women [mean age 25.7 years]), including 9 patients with granulation of tooth extraction, 6 with impacted tooth follicles, 4 with peri-implantitis, 3 with abscesses, 2 with epithelial cysts, 2 with infected cyst fluid, and 1 with an oroantral fistula.

The sex-matched control group included 26 patients (14 men [mean age 26.5 years] and 12 women [mean age

Discussion

The purpose of the present study was to rapidly identify GPAC in clinical samples of patients with odontogenic infections using multiplex PCR analysis on clinical samples and to compare the GPAC strains found in subjects with acute odontogenic infections with those found in normal subjects without acute infections. Anaerobic culture is a time-consuming method that requires at least 48 hours for the growth of the microorganisms. Identifying the cultured bacteria takes at least another 24 to

References (20)

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This work was supported by funding received from the Ankara University Scientific Research Projects Directorate (project no. 20050802076).

Conflict of Interest Disclosures: None of the authors reported any disclosures.

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Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.