Essential microbiology for dentistry

391 Pages·2016·27.24 MB·English

by  Samaranayake Lakshman.

Essential microbiology for dentistry
Commissioning Editor: Alison Taylor
Development Editor: Carole McMurray
Project Manager: Frances Affleck
Designer: Kirsteen Wright
Illustration Manager: Merlyn Harvey
Illustrator: Robert Britton
Essential microbiology
for dentistry
FOURTH EDITION
Lakshman Samaranayake
DSc(h.c.) FDSRCSE(Hon), DDS (Glas), FRCPath (UK), FHKCPath, FCDSHK,
FHKAM(Path) FHKAM(DSurg)
Dean of Dentistry, Tam Wah-Ching Endowed Professor in Dental Science,
Chair Professor of Oral Microbiology, Faculty of Dentistry,
The University of Hong Kong, Hong Kong
Honorary Professor, Eastman Dental Institute for Oral Health Care Sciences,
University of London, UK
Advisory Professor, Shanghai Jiao Tong University, School of Medicine, China
Visiting Professor, Guanghua College of Stomatology, Sun Yat-sen University,
Guangzhou, China
Adjunct Professor, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2012
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First edition 1996
Second edition 2002
Third edition 2006
Fourth edition 2012
ISBN 9780702034848
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Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understand-
ing, changes in research methods, professional practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any informa-
tion, methods, compounds, or experiments described herein. In using such information or methods they should be mindful
of their own safety and the safety of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information
provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recom-
mended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of
practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages
and the best treatment for each individual patient, and to take all appropriate safety precautions.
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Preface
Welcome to the fourth edition of Essential Microbiology for Heitz-Mayfield); current guidelines on antimicrobial
Dentistry! prophylaxis; and updated recommendations on infection
It is now 15 years since the first edition of this tome was control procedures.
published in 1996, and since then, the science of infectious Of course, a tome of this nature cannot be produced
diseases has advanced in leaps and bounds. The two major without the help of many friends and colleagues. The origi-
reasons for these transformational changes have been the nal contributors to the immunology section included
exploding new technology that delivers novel tools for Dr Brian Jones and Dr Liwei Lu, Department of Pathology,
researchers for the identification and reclassification of University of Hong Kong, and the latter has once again
organisms, and the emergence of novel organisms, particu- revised the text with the help of Dr Ulett, as mentioned
larly new viruses that change the landscape of dental and above. Once again, I am indebted to the following colleagues
medical practice. For instance, the new pyrosequencing tech- worldwide, who graciously permitted the reproduction of
nology has revolutionized the field of microbial taxonomy their work: Professor H Jenkinson, University of Bristol, UK
and identification of, in particular, the uncultivable bacteria, (Fig. 3.9); Dr Bernard Low, Malaysia (Fig. 5.1); Dr Annette
leading to a radical rethink on the quantity and quality of Motte, Free University of Berlin, Germany (Fig. 31.6); Dr
the flora that inhabit the human body, including the oral Leanor Haley, CDC, Atlanta, USA; and Professor MAO Lewis,
cavity. In this, the fourth edition of this book, I have University of Wales, UK (Figs 34.1 and 34.3). Figures 37.4
attempted to incorporate the new data as much as possible and 37.8 are reproduced from UK Health Technical
while maintaining its popular concise, yet comprehensive Memorandum No. 01-05, 2009, with permission from
formatting. Crown Copyright.
The fact that you are now reading the fourth edition of the As always, the publishing team at Elsevier led by Frances
book is testimony to its popularity, with more than 25 000 Affleck and Carole McMurray has pushed me hard to beat
copies sold in all five continents; Polish and Korean transla- the deadlines despite my other myriad duties. Their profes-
tions of the book are also now in print. For this, I am deeply sionalism and patience has my admiration and gratitude.
grateful to the microbiology teachers in dental schools, and Last but not least, Hemamali, Dilani and Asanka have
both the undergraduates and the postgraduates who are avid lost some quality family time because of this tome, and
fans, all over the world. I am eternally grateful to them for their tolerance and
In compiling this completely revised fourth edition, understanding.
I have retained the popular features of the last few editions. In concluding, YOU, the reader, are my most important
One major feature of this edition is a new section on friend and critic! The many features of this edition are due
the oral immune system, assiduously penned by Dr Glen to your feedback over many a year, and I sincerely hope that
C Ulett, Centre for Medicine and Oral Health, Griffith the current edition is the best product thus far. Nevertheless,
University, Australia. In addition, Dr Ulett has assisted no book is perfect – so please keep on sending your com-
me in the revision of other parts of the text for which ments, either good or bad, to [email protected].
I am truly grateful. Other new features of the book
include novel information on: uncultivable bacteria and Lakshman Samaranayake
new molecular tools; biofilms and systemic disease; the Hong Kong
microbiology of peri-implantitis, (kindly written by Dr Lisa May 2011
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Contents
1. Introduction 1
Part 1: General microbiology
2. Bacterial structure and taxonomy 7
3. Bacterial physiology and genetics 15
4. Viruses and prions 27
5. Pathogenesis of microbial disease 37
6. Diagnostic microbiology and laboratory methods 49
7. Antimicrobial chemotherapy 67
Part 2: Basic immunology (contributed by Drs Liwei Lu, Brian M Jones and
Glen C Ulett)
8. The immune system and the oral cavity (contributed by Dr Glen C Ulett) 81
9. The immune response 99
10. Immunity and infection 109
Part 3: Microbes of relevance to dentistry
11. Streptococci, staphylococci and micrococci 121
12. Lactobacilli, corynebacteria and propionibacteria 129
13. Actinomycetes, clostridia and Bacillus species 133
14. Neisseriaceae, Veillonella, parvobacteria and Capnocytophaga 139
15. Enterobacteria 145
16. Vibrios, campylobacters and Wolinella 151
17. Bacteroides, Tannerella, Porphyromonas and Prevotella 155
18. Fusobacteria, Leptotrichia and spirochaetes 159
19. Mycobacteria and legionellae 165
20. Chlamydiae, rickettsiae and mycoplasmas 169
21. Viruses of relevance to dentistry 173
22. Fungi of relevance to dentistry 185
Part 4: Infections of relevance to dentistry
23. Infections of the respiratory tract 195
24. Infections of the cardiovascular system 205
25. Infections of the central nervous and locomotor systems 211
26. Infections of the gastrointestinal tract 217
27. Infections of the genitourinary tract 225
28. Skin and wound infections 233
29. Viral hepatitis 239
30. Human immunodeficiency virus infection, AIDS and infections in
compromised patients 251
Contents
Part 5: Oral microbiology
31. Normal oral flora, the oral ecosystem and plaque biofilms 265
32. Microbiology of dental caries 279
33. Microbiology of periodontal disease 287
34. Dentoalveolar infections 299
35. Oral mucosal and salivary gland infections 307
Part 6: Cross infection and control
36. Principles of infection control 325
37. Infection control procedures in dentistry 329
Answers to review questions 351
Glossary of terms and abbreviations 357
Index 367
viii
1
CHAPTER
Introduction
Microbiology (Greek: mīkros small; bios life), so called discipline of microbiology is intimately woven into the
because it primarily deals with organisms too small for the fabric of dentistry and comprises a crucial component of the
naked eye to see, encompasses the study of organisms that dental curriculum.
cause disease, the host response to infection and ways in It should also be realized that new microbial diseases
which such infection may be prevented. For our purposes emerge incessantly (due to reasons given below), and the
the subject can be broadly classified into general, medical book you are now holding is a primer for understanding and
and oral microbiology. managing such future scenarios, especially in the context of
Dental students need both a basic understanding of infection control.
general and medical microbiology, and a detailed knowledge
of clinical oral microbiology in order to diagnose oral micro-
A note on emerging and
bial infections, which are intimately related to the overall
re-emerging infections
treatment plan for their patients. Moreover, the two major
oral disorders – caries and periodontal disease – that the
dental practitioner is frequently called upon to treat are due Infectious agents have been adversaries of humans for
to changes in the oral bacterial ecosystem, and a grasp of millennia. It has been postulated that diseases such as
these disease processes is essential for their appropriate plague have wiped out civilizations in ancient times while
management. humans in turn have won the battle against microbes
The impact of these infections on the health and welfare in more recent times (e.g. eradication of smallpox). Such
of the community is simply astonishing. It has been esti- new diseases are given the terms emerging infections or
mated, for instance, that caries and periodontal disease are re-emerging infections (Fig. 1.1), and they are broadly
the most costly diseases that the majority of the population categorized as:
has to contend with during their lifetime, and the number • new infections, caused by novel agents such as the
of working hours lost due to these infections and the related
coronavirus of severe acute respiratory syndrome
cost of dental treatment worldwide amount to billions of
(SARSCoV)
dollars per annum (e.g. more than 81 billion dollars in the • ‘old’ infections – known disease entities where the
USA in 2006). This is not surprising as it is generally accepted
aetiological agents have been recently identified
that periodontal disease is the most common affliction of
through advances in technology (e.g. Helicobacter pylori
the human kind.
causing gastric ulcer disease)
The advent of the human immunodeficiency virus (HIV) • re-emergent infections – diseases that have returned
infection in the early 1980s and the subsequent concerns on
with a vengeance due to genetic and structural
cross infection via contaminated blood and instruments
transformations and attendant increased virulence of
have resulted in an increased regimentation of infection
the organism (e.g. drug-resistant Mycobacterium
control practices in dentistry. Furthermore, many patients
tuberculosis with its ‘new bag of tricks’).
are acutely concerned about possible infection transmission
The reasons for their emergence are manifold and include:
in clinical settings because of the intense, and sometimes
unwarranted, publicity given to these matters by the media. • societal events – economic impoverishment (especially
The dental practitioner should therefore be conversant with in the developing world), war and civil conflicts, as
all aspects of infection control in the clinical environment, well as mass population migration
not only to implement infection control measures but also • health care – new medical devices, organ/tissue
to advise the dental team (dental surgery assistants, dental transplantation, immunosuppression, antibiotic abuse
hygienists and other ancillary personnel) and to allay and contaminated blood and blood products
patients’ unfounded fears. For all these and many other • human behaviour – increasing sexual promiscuity,
reasons, which the student will discover in the text, the injectable drug abuse
© 2012 Elsevier Ltd, Inc, BV
DOI: 10.1016/B978-0-7020-3484-8.00044-8