Genetic and physiological effects of subinhibitory concentrations of oral antimicrobial agents on Streptococcus mutans biofilms

Filho, Jaime Gazola; Vizoto, Natália Leal; Loesch, Maria Luiza de Aguiar; Sena, Marina Dias de; Camara, Danielle Mendes da; Caiaffa, Karina Sampaio; Mattos-Graner, Renata O.; Duque, Cristiane

doi:10.1016/j.micpath.2020.104669

Cited by 5 publications

(6 citation statements)

References 28 publications

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“…Articles were published between 1976 and 2021, although the majority (95%) were published this century. The antiseptics used included five different CHX salts (digluconate 33 , 35 , 37 , 40 , 47 , 50 , 55 – 58 , 61 , 63 , 67 , 69 , 74 , 75 , 81 , 83 , 88 , 90 , 94 , 97 , 99 , 101 , 106 , 107 , 111 , 113 , gluconate 34 , 36 , 42 , 42 , 53 , 91 , 102 , 103 , 108 , 108 , 109 , 112 , dichlorohydrate 85 – 87 , diacetate 71 , 99 and dihydrochloride 96 ) and povidone-iodine 37 , 46 , 49 , 70 , 76 , 91 . In total, MBC data from 6218 microbes were extracted.…”

Section: Resultsmentioning

confidence: 99%

“…Overall, 25 studies reported the MBC of CHX for Streptococci species; observations of viridans Streptococci were most common 44 , 45 , 47 , 48 , 52 – 54 , 58 , 66 , 69 , 75 , 77 – 79 , 81 , 82 , 84 – 86 , 89 , 99 , 100 , 103 , 105 , 106 and 1 study 106 provided an estimate for Streptococcus pyogenes (Lancefield group A). The pooled mean MBC of CHX for Streptococci was 9 mg/L (95% CI 5, 12; I 2 99%).…”

Section: Resultsmentioning

confidence: 99%

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Bacterial sensitivity to chlorhexidine and povidone-iodine antiseptics over time: a systematic review and meta-analysis of human-derived data

Aftab

Dodhia

Jeanes

et al. 2023

Sci Rep

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Surgical site infection (SSI) is the most common complication of surgery, increasing healthcare costs and hospital stay. Chlorhexidine (CHX) and povidone-iodine (PVI) are used for skin antisepsis, minimising SSIs. There is concern that resistance to topical biocides may be emergeing, although the potential clinical implications remain unclear. The objective of this systematic review was to determine whether the minimum bactericidal concentration (MBC) of topical preparations of CHX or PVI have changed over time, in microbes relevant to SSI. We included studies reporting the MBC of laboratory and clinical isolates of common microbes to CHX and PVI. We excluded studies using non-human samples and antimicrobial solvents or mixtures with other active substances. MBC was pooled in random effects meta-analyses and the change in MBC over time was explored using meta-regression. Seventy-nine studies were included, analysing 6218 microbes over 45 years. Most studies investigated CHX (93%), with insufficient data for meta-analysis of PVI. There was no change in the MBC of CHX to Staphylococci or Streptococci over time. Overall, we find no evidence of reduced susceptibility of common SSI-causing microbes to CHX over time. This provides reassurance and confidence in the worldwide guidance that CHX should remain the first-choice agent for surgical skin antisepsis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Bacterial sensitivity to chlorhexidine and povidone-iodine antiseptics over time: a systematic review and meta-analysis of human-derived data

Aftab

Dodhia

Jeanes

et al. 2023

Sci Rep

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“…mutans biofilms to quaternary ammonium were shown to select persister cells with increased transcription of vicR and downstream gtfB / C , which in turn show increased capacity to form biofilms [64]. Upregulation of vicRK , as well as covR , was also observed in response to sub-MIC levels of chlorhexidine associated with sodium fluoride [65]. Moreover, spontaneous mutations in vicK (also known as yycG ) and/or vicR ( yycF ) found in Staphylococcus aureus exposed to sub-lethal doses of daptomycin and vancomycin were associated with intermediate resistance to these antibiotics [66–68], as well as changes in virulence and biofilm formation phenotypes [67].…”

Section: Discussionmentioning

confidence: 99%

VicRK and CovR polymorphisms in Streptococcus mutans strains associated with cardiovascular infections

Oliveira

Alves

Harth-Chú

et al. 2021

Journal of Medical Microbiology

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Introduction. Streptococcus mutans , a common species of the oral microbiome, expresses virulence genes promoting cariogenic dental biofilms, persistence in the bloodstream and cardiovascular infections. Gap statement. Virulence gene expression is variable among S. mutans strains and controlled by the transcription regulatory systems VicRK and CovR. Aim. This study investigates polymorphisms in the vicRK and covR loci in S. mutans strains isolated from the oral cavity or from the bloodstream, which were shown to differ in expression of covR, vicRK and downstream genes. Methodology. The transcriptional activities of covR, vicR and vicK were compared by RT-qPCR between blood and oral strains after exposure to human serum. PCR-amplified promoter and/or coding regions of covR and vicRK of 18 strains (11 oral and 7 blood) were sequenced and compared to the reference strain UA159. Results. Serum exposure significantly reduced covR and vicR/K transcript levels in most strains (P<0.05), but reductions were higher in oral than in blood strains. Single-nucleotide polymorphisms (SNPs) were detected in covR regulatory and coding regions, but SNPs affecting the CovR effector domain were only present in two blood strains. Although vicR was highly conserved, vicK showed several SNPs, and SNPs affecting VicK regions important for autokinase activity were found in three blood strains. Conclusions. This study reveals transcriptional and structural diversity in covR and vicR/K, and identifies polymorphisms of functional relevance in blood strains, indicating that covR and vicRK might be important loci for S. mutans adaptation to host selective pressures associated with virulence diversity.

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“…Articles were published between 1976 and 2021, although the majority (95%) were published this century. The antiseptics used included five different CHX salts (digluconate (33,35,37,40,47,50,(55)(56)(57)(58)61,63,67,69,74,75,81,83,88,90,94,97,99,101,106,107,111,113), gluconate (34,36,42,42,53,91,102,103,108,108,109,112), dichlorohydrate (85)(86)(87), diacetate (71,99) and dihydrochloride( 96)) and povidone-iodine (37,46,49,…”

Section: Study Characteristicsmentioning

confidence: 99%

Bacterial Sensitivity to Chlorhexidine and Povidone-Iodine Antiseptics Over Time: A Systematic Review and Meta-Analysis of Human-Derived Data

Aftab

Dodhia

Jeanes

et al. 2021

Preprint

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BackgroundSurgical site infection (SSI) is the most common complication of surgery, increasing healthcare costs and hospital stay. Topical biocides such as chlorhexidine (CHX) and povidone-iodine (PVI) are used for skin antisepsis to minimise SSIs. There is an increasing concern of developing resistance to topical biocides, however the clinical implications of this remains unclear.OutcomesThe objective of this review was to determine whether the Minimum Bactericidal Concentration (MBC) for topical preparations of CHX or PVI have changed over time, in microbes relevant to SSI.MethodsWe searched for studies which reported the mean bactericidal concentration (MBC) of laboratory and clinical isolates of common SSI causing microbes to CHX and PVI. We excluded samples derived from non-humans and studies using antimicrobial solvents or mixtures of biocides with other active substances. MBC was pooled in random effects meta-analyses and change in MBC over time was explored using meta-regression.Results79 studies were including, analysing 6218 microbes between 1976 and 2021. Most studies used CHX (93%) and there was insufficient data for meta-analysis of PVI. Enterobacteriales had the highest MBC for CHX (20 mg/L [95% CI 14, 25]; I2 95%) whilst MRSA had the lowest (3 mg/L [95% CI 1, 2]; I2 93%). There was no change in MBC of CHX to Staphylococci (β 0.12 [-1.13, 1.37]; I2 99%) or Streptococci (β 0.13 [-0.35, 0.62]; I2 97%).ConclusionsThere is no evidence of change in susceptibility of common SSI-causing microbes to CHX over time. This study provides reassurance that the worldwide guidance that CHX should remain the first-choice agent for skin asepsis prior to surgery.

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Genetic and physiological effects of subinhibitory concentrations of oral antimicrobial agents on Streptococcus mutans biofilms

Cited by 5 publications

References 28 publications

Bacterial sensitivity to chlorhexidine and povidone-iodine antiseptics over time: a systematic review and meta-analysis of human-derived data

Bacterial sensitivity to chlorhexidine and povidone-iodine antiseptics over time: a systematic review and meta-analysis of human-derived data

VicRK and CovR polymorphisms in Streptococcus mutans strains associated with cardiovascular infections

Bacterial Sensitivity to Chlorhexidine and Povidone-Iodine Antiseptics Over Time: A Systematic Review and Meta-Analysis of Human-Derived Data

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