PurposeTo investigate the antibacterial effect and the effect on the material properties of a novel delivery system with Irgasan as active agent and methacrylated polymerizable Irgasan when added to experimental dental resin composites.Materials and MethodsA delivery system based on novel polymeric hollow beads, loaded with Irgasan and methacrylated polymerizable Irgasan as active agents were used to manufacture three commonly formulated experimental resin composites. The non-modified resin was used as standard (ST). Material A contained the delivery system providing 4 % (m/m) Irgasan, material B contained 4 % (m/m) methacrylated Irgasan and material C 8 % (m/m) methacrylated Irgasan. Flexural strength (FS), flexural modulus (FM), water sorption (WS), solubility (SL), surface roughness Ra, polymerization shrinkage, contact angle Θ, total surface free energy γS and its apolar γS
LW, polar γS
AB, Lewis acid γS
+and base γS
- term as well as bacterial viability were determined. Significance was p < 0.05.ResultsThe materials A to C were not unacceptably influenced by the modifications and achieved the minimum values for FS, WS and SL as requested by EN ISO 4049 and did not differ from ST what was also found for Ra. Only A had lower FM than ST. Θ of A and C was higher and γS
AB of A and B was lower than of ST. Materials A to C had higher γS
+ than ST. The antibacterial effect of materials A to C was significantly increased when compared with ST meaning that significantly less vital cells were found.ConclusionDental resin composites with small quantities of a novel antibacterially doped delivery system or with an antibacterial monomer provided acceptable physical properties and good antibacterial effectiveness. The sorption material being part of the delivery system can be used as a vehicle for any other active agent.
Mycoplasma salivarium, preferentially an inhabitant of the human oral cavity, has rarely been found in other locations associated with disease. We describe here, for what is believed to be the first time, the detection of M. salivarium, together with Candida glabrata, in an occluded biliary stent of an icteric, cholestatic patient.
Case reportA 71-year-old man with known alcoholic liver cirrhosis was admitted with painless jaundice, an increase in abdominal circumference, dark urine and acholic faeces of 7 days' duration. Abdominal sonography revealed a cirrhotic liver with enlarged intra-and extra-hepatic bile ducts (common bile duct 12 mm), gall bladder hydrops, and moderate ascites in the abdomen. Ascites yielded the growth of coagulasenegative staphylococci. The patient was treated with ceftriaxone, and due to hyperthyroidism with carbimazole and perchlorate.Gastroscopy and endosonography revealed oesophageal varices grade II, ulcera duodeni and portal-hypertensive gastropathy. Furthermore, endosonography and sonography revealed a possible distal cholangio-carcinoma leading to biliary tract obstruction. A malignant stricture was detected in endoscopic retrograde cholangio-pancreotography (ERCP) and in cytology of a brush sample. Drainage of the biliary tract was performed by endoscopic placement of a plastic stent (60 mm, 10 French diameter) across the stricture.As bilirubin values remained increased, suggesting early stent occlusion, the stent was replaced by ERCP (thus avoiding contaminations) 2 days later. The main channel and the flaps of the stent were occluded with sludge. Within 24 h the patient developed temperatures of 39 u C and became dyspnoeic, respiratory insufficient and acidotic suggestive of early sepsis leading to hypotension and acute renal failure. The patient was transferred to the intensive care unit intubated, and ventilated and continuous venovenous haemofiltration was started.Bile and blood cultures were positive for Candida glabrata. Despite therapy with voriconazole and imipenem the patient died with clinical signs of sepsis 12 days after admission to hospital.In the context of studying bacterial communities in biofilm formation, the patient's stent, removed due to occlusion, was used in analysis by PCR. The biofilm was mechanically scraped off the inner surface of the stent. Total DNA was isolated using an EZ1 Biorobot from Qiagen and amplified in fungal 18-28S rDNA PCR with primers 18S-1508f (59-TCC GTA GGT GAA CCT GCG G-39) and 28S-197r (59-TCC TCC GCT TAT TGA TAT GC-39), and in eubacterial
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