Avaliação da microbiota associada a osteomielite crônica dos maxilares através de meio de cultura e PCR
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Data
2010-02-26
Autores
Costa, Iracy [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
A osteomielite crônica de maxila e mandíbula é rara em países industrializados e sua ocorrência, nos países em desenvolvimento, está associada a trauma e procedimentos cirúrgicos, sendo que sua etiologia não foi estudada profundamente. O objetivo desse estudo foi avaliar a microbiota associada com a osteomielite de mandíbula e maxila em pacientes brasileiros. Após exames clínicos e radiográficos, amostras de seqüestros ósseos, secreção purulenta e biopsias de tecido granulomatoso de vinte e dois pacientes com osteomielite crônica da mandíbula e maxila foram cultivadas e submetidas à detecção de um conjunto de patógenos através do método do PCR. O isolamento bacteriano foi realizado em ágar “fastidious anaerobe” suplementado com hemina, menadiona e sangue de cavalo, para os microrganismos anaeróbios, e em ágar de tripticaseína de soja suplementado com extrato de levedura e sangue de cavalo, para os aeróbios e anaeróbios facultativos. Cada paciente apresentava uma única lesão. As placas foram incubadas em anaerobiose e aerobiose, a 37oC, por 14 e 3 dias, respectivamente. Bactérias foram cultivadas de 10 amostras de pacientes e os gêneros Actinomyces, Fusobacterium, Parvimonas e Staphylococcus foram os mais freqüentes. Através do PCR, DNA bacteriano foi detectado em amostras de 20 pacientes. Os resultados sugerem que as osteomielites crônicas dos maxilares geralmente são infecções anaeróbias mistas, reforçando o conceito de que estão relacionadas principalmente aos microrganismos do ecossistema bucal e que as infecções periapicais e periodontais podem atuar como fatores predisponentes.
Chronic osteomyelitis of the maxilla and mandible is rare in industrialized countries and its occurrence in developing countries is associated with trauma and surgery, and its microbial etiology has not been studied thoroughly. The aim of this investigation was to evaluate the microbiota associated with osteomyelitis of the mandible and maxilla from some Brazilian patients. After clinical and radiographic evaluation, samples of bone sequestra, purulent secretion, and biopsies of granulomatous tissues from twenty-two patients with chronic osteomyelitis of the mandible and maxilla were cultivated and submitted for pathogen detection by using a PCR method. Each patient harbored a single lesion. Bacterial isolation was performed on fastidious anaerobe agar supplemented with hemin, menadione and horse blood for anaerobes; and on tryptic soy agar supplemented with yeast extract and horse blood for facultative bacteria and aerobes. Plates were incubated in anaerobiosis and aerobiosis, at 37oC during 14 and 3 days, respectively. Bacteria were cultivated from ten patient samples; and genera Actinomyces, Fusobacterium, Parvimonas, and Staphylococcus were the most frequent. By PCR, bacterial DNA was detected from thirteen patient samples. The results suggest that cases of chronic osteomyelitis of the jaws are usually mixed anaerobic infections, reinforcing the concept that osteomyelitis of the jaws are mainly related to microorganisms from the oral environment, and periapical and periodontal infections may act as predisposing factors.
Chronic osteomyelitis of the maxilla and mandible is rare in industrialized countries and its occurrence in developing countries is associated with trauma and surgery, and its microbial etiology has not been studied thoroughly. The aim of this investigation was to evaluate the microbiota associated with osteomyelitis of the mandible and maxilla from some Brazilian patients. After clinical and radiographic evaluation, samples of bone sequestra, purulent secretion, and biopsies of granulomatous tissues from twenty-two patients with chronic osteomyelitis of the mandible and maxilla were cultivated and submitted for pathogen detection by using a PCR method. Each patient harbored a single lesion. Bacterial isolation was performed on fastidious anaerobe agar supplemented with hemin, menadione and horse blood for anaerobes; and on tryptic soy agar supplemented with yeast extract and horse blood for facultative bacteria and aerobes. Plates were incubated in anaerobiosis and aerobiosis, at 37oC during 14 and 3 days, respectively. Bacteria were cultivated from ten patient samples; and genera Actinomyces, Fusobacterium, Parvimonas, and Staphylococcus were the most frequent. By PCR, bacterial DNA was detected from thirteen patient samples. The results suggest that cases of chronic osteomyelitis of the jaws are usually mixed anaerobic infections, reinforcing the concept that osteomyelitis of the jaws are mainly related to microorganisms from the oral environment, and periapical and periodontal infections may act as predisposing factors.
Descrição
Palavras-chave
Osteomielite, Bacterias, Mandíbula, Reação em cadeia de polimerase, Maxila, Reação em cadeia da polimerase, Osteomyelitis, Bacteria, Maxilla, Mandible
Como citar
COSTA, Iracy. Avaliação da microbiota associada a osteomielite crônica dos maxilares através de meio de cultura e PCR. 2010. 66 f. Tese (doutorado) - Universidade Estadual Paulista, Faculdade de Odontologia de Araçatuba, 2010.