Viral-bacterial associations in acute apical abscesses

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Aug;112(2):264-71. doi: 10.1016/j.tripleo.2011.01.029. Epub 2011 Apr 19.

Abstract

Objective: Viral-bacterial and bacterial synergism have been suggested to contribute to the pathogenesis of several human diseases. This study sought to investigate the possible associations between 9 candidate endodontic bacterial pathogens and 9 human viruses in samples from acute apical abscesses.

Study design: DNA extracts from purulent exudate aspirates of 33 cases of acute apical abscess were surveyed for the presence of 9 selected bacterial species using a 16S ribosomal RNA gene-based nested polymerase chain reaction (PCR) approach. Single or nested PCR assays were used for detection of the human papillomavirus (HPV) and herpesviruses types 1 to 8.

Results: Two-thirds of the abscess samples were positive for at least one of the target viruses. Specifically, the most frequently detected viruses were HHV-8 (54.5%); HPV (9%); and varicella zoster virus (VZV), Epstein-Barr virus (EBV), and HHV-6 (6%). Bacterial DNA was present in all cases and the most prevalent bacterial species were Treponema denticola (70%), Tannerella forsythia (67%), Porphyromonas endodontalis (67%), Dialister invisus (61%), and Dialister pneumosintes (57.5%). HHV-8 was positively associated with 7 of the target bacterial species and HPV with 4, but all these associations were weak. Several bacterial pairs showed a moderate positive association. Viral coinfection was found in 6 abscess cases, but no significant viral association could be determined.

Conclusions: Findings demonstrated that bacterial and viral DNA occurred concomitantly in two-thirds of the samples from endodontic abscesses. Although this may suggest a role for viruses in the etiology of apical abscesses, the possibility also exists that the presence of viruses in abscess samples is merely a consequence of the bacterially induced disease process. Further studies are necessary to clarify the role of these viral-bacterial interactions, if any, in the pathogenesis of acute apical abscesses.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Bacteroidaceae Infections / microbiology
  • Bacteroides Infections / microbiology
  • DNA, Bacterial / analysis
  • DNA, Viral / analysis
  • Epstein-Barr Virus Infections / virology
  • Gram-Negative Anaerobic Straight, Curved, and Helical Rods / classification
  • Gram-Negative Bacterial Infections / microbiology*
  • Herpes Zoster / virology
  • Herpesviridae / classification
  • Herpesviridae Infections / virology*
  • Herpesvirus 6, Human / isolation & purification
  • Herpesvirus 8, Human / isolation & purification
  • Humans
  • Middle Aged
  • Papillomavirus Infections / virology
  • Periapical Abscess / microbiology*
  • Periapical Abscess / virology
  • Polymerase Chain Reaction
  • Porphyromonas gingivalis / isolation & purification
  • RNA, Bacterial / analysis
  • RNA, Ribosomal, 16S / analysis
  • Roseolovirus Infections / virology
  • Treponema denticola / isolation & purification
  • Treponemal Infections / microbiology
  • Young Adult

Substances

  • DNA, Bacterial
  • DNA, Viral
  • RNA, Bacterial
  • RNA, Ribosomal, 16S