Molecular diagnosis of recurrent Streptococcus mutans endocarditis by PCR amplification and sequencing

Gauduchon, Valérie; Bénito, Yvonne; Célard, M.; Mouren, C; Delorme, Valérie; Philippe-Bert, J.; Etienne, Jérôme; Vandenesch, F.

doi:10.1046/j.1469-0691.2001.00183.x

Cited by 35 publications

(33 citation statements)

References 33 publications

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“…In the first, Streptococcus bovis was identified by PCR (instead of Streptococcus mutans); the initial isolate was not referred to our laboratory for phenotypic identification, but colonoscopy showed a colonic villous tumor. In the second, Streptococcus mutans was identified by PCR in a patient who had had Streptococcus mutans infective endocarditis 18 months previously and currently had interfering Escherichia coli sepsis (10). In the third, Bartonella henselae was identified in a patient with interfering Pseudomonas aeruginosa sepsis secondary to needle biopsy of the kidney.…”

Section: Discussionmentioning

confidence: 98%

Molecular Diagnosis of Infective Endocarditis by PCR Amplification and Direct Sequencing of DNA from Valve Tissue

Gauduchon¹,

Chalabreysse

Etienne³

et al. 2003

J Clin Microbiol

171

110

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We used broad-range eubacterial PCR amplification followed by direct sequencing to identify microbial pathogens in heart valve material from 29 patients with histologically confirmed infective endocarditis and 23 patients free of infective endocarditis. Microorganisms cultured by conventional techniques matched those identified by PCR in 21 cases. PCR alone identified the causative agent in three cases (Streptococcus bovis, Staphylococcus cohnii, and Coxiella burnetii), allowing better patient management. PCR corrected the initial bacteriological diagnosis in three cases (Streptococcus bovis, Streptococcus mutans, and Bartonella henselae). Among the 29 cases of histologically confirmed infective endocarditis, PCR findings were positive in 27 cases and were consistent with the bacterial morphology seen at Gram staining (26 cases) or with the results obtained by immunohistologic analysis with an anti-C. burnetii monoclonal antibody (one case). In two other cases of histologically confirmed infective endocarditis, PCR remained negative in a blood culture-negative case for which no bacteria were seen at histological analysis and in one case with visualization of cocci and blood cultures positive for Enterococcus faecalis. Ten clinical diagnoses of possible infective endocarditis were ruled out by histopathological analysis of the valves and subsequently by PCR. PCR was negative in 13 of the 14 patients in whom infective endocarditis was rejected on clinical grounds; the other patient was found to have Coxiella burnetii infective endocarditis on the basis of PCR and histopathological analysis and was subsequently included in the group of 29 definite cases. In total, PCR contributed to the diagnosis and management of infective endocarditis in 6 of 29 (20%) cases.Microbiological diagnosis of infective endocarditis is mainly based on blood culture, excised cardiac valve tissue, or infected emboli. This conventional approach is successful in 92 to 95% of cases (5, 13) in which a microorganism is present. Streptococci and enterococci account for 45 to 60% of cases of infective endocarditis (5, 13, 21). They comprise oral viridans streptococci (such as Streptococcus sanguis, Streptococcus salivarius, and Streptococcus mutans) in 17 to 41% of cases (5,12,13,20); intestinal group D streptococci such as Streptococcus bovis in 5 to 15% of cases (5, 9) (and up to 25% in recent studies [13]); and enterococci such as Enterococcus faecalis in 5 to 10% of cases (5, 13).Staphylococci represent the second most frequent group associated with infective endocarditis; Staphylococcus aureus is recovered in 15 to 23% of cases, and coagulase-negative staphylococci are recovered in 3 to 8% of cases (2, 5, 13). The remaining cases of infective endocarditis are caused by various bacteria such as Enterobacteriaceae or fungi such as Candida spp.; in addition, some bacteria are more specifically associated with infective endocarditis, such as those of the HACEK group (Haemophilus parainfluenzae, Haemophilus. aphrophilus, and Haemophilus paraphrop...

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Section: Discussionmentioning

confidence: 98%

Molecular Diagnosis of Infective Endocarditis by PCR Amplification and Direct Sequencing of DNA from Valve Tissue

Gauduchon¹,

Chalabreysse

Etienne³

et al. 2003

J Clin Microbiol

171

110

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“…The detection of S. mutans in specimens taken from patients with IE has been reported by either conventional or molecular techniques (Gauduchon et al, 2001;Nakano et al, 2006;Nomura et al, 2006;Vose et al, 1987;Ullman et al, 1988). Since IE is initiated by the colonization of the organism on the ECM of damaged endothelium in heart tissue (Moreillon & Que, 2004), bacterial molecules associated with adhesion to ECM are considered important.…”

Section: Discussionmentioning

confidence: 99%

“…Various pieces of evidence show the association of S. mutans with some life-threatening diseases such as infective endocarditis (IE), although the major species related to IE belong to the mitis group of oral streptococci (Banas, 2004;Mylonakis & Calderwood, 2001). Moreover, continuous detections of this bacterium in specimens from patients suffering from such disease emphasize the importance of S. mutans in IE (Gauduchon et al, 2001;Nomura et al, 2006;Vose et al, 1987;Ullman et al, 1988). Indeed, studies to clarify specific components involved in IE in S. mutans have also been performed worldwide (Beg et al, 2002;Jung et al, 2009; MatsumotoNakano et al, 2009;Miller-Torbert et al, 2008).…”

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confidence: 99%

Multilocus sequence typing analysis of Streptococcus mutans strains with the cnm gene encoding collagen-binding adhesin

Lapirattanakul

Nakano

Nomura

et al. 2011

Journal of Medical Microbiology

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Streptococcus mutans is one of the oral pathogens associated with infective endocarditis (IE).With respect to bacterial binding ability to the extracellular matrix, the Cnm protein, a cell surface collagen-binding adhesin of S. mutans, is known as one of the possible virulence factors with regard to IE. In this study, we aimed to determine the distribution of the cnm gene, which encodes Cnm, in a large number of clinical isolates of S. mutans from Thai subjects. Then, the cnm-positive strains were classified using a multilocus sequence typing (MLST) scheme, which we constructed previously. In addition, the data were analysed together with our previous MLST data of cnmpositive strains from Japan and Finland in order to evaluate the clonal relationship among S. mutans strains harbouring the cnm gene. The cnm gene was detected in 12.4 % of all 750 Thai isolates, and serotype f showed the highest rate of detection (54.5 %). According to the MLST data, two clonal complex groups were revealed as the important clones related to cnm-positive S. mutans from various origins of isolation. Moreover, the collagen-binding properties of S. mutans strains with the cnm gene were significantly greater than those of strains without the gene, although four cnm-negative strains classified into two sequence types (STs), ST110 and ST136, showed extremely high collagen-binding rates suggesting the presence of additional genes involved with collagen binding in these STs. Taken together, these results provided information on both epidemiological as well as evolutional aspects of S. mutans possessing the cnm gene. INTRODUCTIONStreptococcus mutans is a well-known pathogen of dental caries (Hamada & Slade, 1980), which consists of four serotypes, c, e, f and k (Linzer et al., 1986;). The detection rate of serotype c is highest among the strains isolated from oral cavities, followed by serotype e, while serotypes f and k are regarded as being present in minor proportions . Various pieces of evidence show the association of S. mutans with some life-threatening diseases such as infective endocarditis (IE), although the major species related to IE belong to the mitis group of oral streptococci (Banas, 2004;Mylonakis & Calderwood, 2001). Moreover, continuous detections of this bacterium in specimens from patients suffering from such disease emphasize the importance of S. mutans in IE (Gauduchon et al., 2001;Nomura et al., 2006;Vose et al., 1987;Ullman et al., 1988). Indeed, studies to clarify specific components involved in IE in S. mutans have also been performed worldwide (Beg et al., 2002;Jung et al., 2009; MatsumotoNakano et al., 2009;Miller-Torbert et al., 2008).IE is initiated by the binding of bacterial surface molecules to host extracellular matrix (ECM) proteins exposed on damaged heart tissue (Moreillon & Que, 2004). In S. mutans, collagen-binding adhesin or Cnm protein, encoded by the cnm gene, was reported as a strain-specific collagen-binding molecule (Sato et al., 2004). The Cnm protein possesses a collagen-binding domain (CBD) in ...

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“…Oral streptococcal species are major components of the oral microflora that are known to occasionally cause bacteremia and IE (13). Streptococcus mutans, a major pathogenic agent of dental caries, has also been isolated from the blood of patients with IE, strongly suggesting a close relationship of the pathogen with IE (5,23,24).…”

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Detection of Cariogenic Streptococcus mutans in Extirpated Heart Valve and Atheromatous Plaque Specimens

Nakano¹,

Inaba

Nomura³

et al. 2006

J Clin Microbiol

214

209

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The involvement of oral bacteria in the pathogenesis of cardiovascular diseases has been the focus of attention in many studies, and several periodontal pathogens have been detected in diseased cardiovascular lesions, suggesting relationships between oral microorganisms and cardiovascular diseases. However, no information is available regarding the involvement of cariogenic pathogens such as Streptococcus mutans. The presence of oral streptococcal species and periodontitis-related bacteria in 35 heart valve and 27 atheromatous plaque clinical specimens, as well as 32 dental plaque specimens from the same subjects, was analyzed using a PCR method. Furthermore, broad-range PCR with DNA sequencing analysis was employed to identify the bacterial species in those samples. Streptococcus mutans was frequently detected in the heart valve (69%) and atheromatous plaque (74%) specimens, while other bacterial species, including those related to periodontitis, were detected with much lower frequencies. The bacterial composition in cardiovascular tissues was found to be markedly distinct from that in dental plaque, with only a limited number of species, including S. mutans, in the cardiovascular regions shown to have possibly originated from the oral cavity. Semiquantitative assay results revealed that S. mutans was detected in significant quantities in the heart valve (40%) and atheromatous plaque (48%) specimens, whereas the quantities of all other tested bacterial species, including several related to periodontitis, were negligible in the cardiovascular samples. These results indicate that S. mutans is a possible causative agent of cardiovascular disease.Accumulated evidence suggests that oral bacterial pathogens are associated with several kinds of systemic diseases, such as infective endocarditis (IE), cardiovascular diseases, bacterial pneumonia, low birth weight, and diabetes mellitus (12). Those associations are speculated to be initiated by transient or prolonged bacteremia caused by oral infection: i.e., from professional dental treatments and daily oral care practices such as tooth brushing and flossing, as well as from food chewing, which possibly induces dissemination of oral bacteria into the bloodstream (21). Oral streptococcal species are major components of the oral microflora that are known to occasionally cause bacteremia and IE (13). Streptococcus mutans, a major pathogenic agent of dental caries, has also been isolated from the blood of patients with IE, strongly suggesting a close relationship of the pathogen with IE (5, 23, 24).The recent development of several molecular techniques has enabled prompt identification of targeted bacterial species in specimens with significantly improved specificity and sensitivity. PCR methods using primers constructed with a species-specific nucleotide alignment are widely used for the detection of specific species. In addition, broad-range eubacterial PCR with amplification of bacterial DNA and subsequent direct sequencing is considered to be a reliable diagnostic tool ...

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Molecular diagnosis of recurrent Streptococcus mutans endocarditis by PCR amplification and sequencing

Cited by 35 publications

References 33 publications

Molecular Diagnosis of Infective Endocarditis by PCR Amplification and Direct Sequencing of DNA from Valve Tissue

Molecular Diagnosis of Infective Endocarditis by PCR Amplification and Direct Sequencing of DNA from Valve Tissue

Multilocus sequence typing analysis of Streptococcus mutans strains with the cnm gene encoding collagen-binding adhesin

Detection of Cariogenic Streptococcus mutans in Extirpated Heart Valve and Atheromatous Plaque Specimens

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