Journal of Medical Microbiology (J MED MICROBIOL)

Publisher: Pathological Society of Great Britain and Ireland, Society for General Microbiology

Journal description

The Journal of Medical Microbiology aims to maintain and enhance its high-quality comprehensive coverage of pathogenic micro-organisms and their diseases from research, clinical, and diagnostic points of view. Each issue contains up-to-the-minute editorials, in-depth review articles, original papers presenting research findings, and brief reports and technical notes.

Current impact factor: 2.25

Impact Factor Rankings

2016 Impact Factor Available summer 2017
2014 / 2015 Impact Factor 2.248
2013 Impact Factor 2.266
2012 Impact Factor 2.297
2011 Impact Factor 2.502
2010 Impact Factor 2.38
2009 Impact Factor 2.272
2008 Impact Factor 2.19
2007 Impact Factor 2.091
2006 Impact Factor 2.18
2005 Impact Factor 2.318
2004 Impact Factor 2.484
2003 Impact Factor 1.987
2002 Impact Factor 1.779
2001 Impact Factor 1.762
2000 Impact Factor 1.625
1999 Impact Factor 1.735
1998 Impact Factor 1.961
1997 Impact Factor 1.525
1996 Impact Factor 1.935
1995 Impact Factor 1.793
1994 Impact Factor 1.627
1993 Impact Factor 1.522
1992 Impact Factor 1.561

Impact factor over time

Impact factor

Additional details

5-year impact 2.51
Cited half-life 7.40
Immediacy index 0.46
Eigenfactor 0.02
Article influence 0.76
Website Journal of Medical Microbiology website
Other titles Journal of medical microbiology (Online)
ISSN 0022-2615
OCLC 37788051
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Society for General Microbiology

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • Author's pre-print on author's personal website, institutional repository or pre-print archive such as BioRxiv
    • Author's post-print on institutional repository or subject repository
    • Published source must be acknowledged
    • Version deposited must replicate that accepted for publication (authors version)
    • Set phrase to accompany archived copy (see policy)
    • Publisher's version/PDF cannot be used
    • Must link to publisher version with DOI
    • Non-commercial use
    • Publisher last contacted on 06/08/2015
  • Classification

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Biofilms plays an important role in medical device-related infections. This study aimed to determine the factors that influence adherence and biofilm production, as well as the relationship between strong biofilm production and genetic determinants in clinical isolates of MRSA. Fifteen strains carrying different chromosomal cassettes, recovered from patients hospitalized were selected: five SCCmecII, five SCCmecIII and five SCCmecIV. The SCCmec type, agr group and the presence of the virulence genes (bbp, clfA, icaA, icaD, fnbB, bap, sasC and IS256) were assessed by PCR. Pulsed field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) techniques also were performed. The initial adhesion and biofilm formation were examined by quantitative assays. The surface tension and hydrophobicity of the strains were measured by contact angle technique to evaluate the association between these parameters and adhesion ability. SCCmecIII and IV strains were less hydrophilic, with a high value for the electron acceptor parameter and higher adhesion in comparison with SCCmecII strains. Only SCCmecIII strains could be characterized as strong biofilm producers. The PFGE showed five major pulsotypes (A-E) however, biofilm production was related to the dissemination of one specific PFGE clone (C) belonging to MLST ST239 (BECC, Brazilian epidemic clonal complex). The genes agrI, fnbB and IS256 in SCCmecIII strains, were considered as genetic determinants associated with strong biofilm-formation by an ica-independent biofilm pathway. This study contributes to the understanding of biofilm production as an aggravating factor potentially involved in the persistence and severity of infections caused by multidrug-resistant MRSA belonging to this genotype.
    No preview · Article · Feb 2016 · Journal of Medical Microbiology
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    ABSTRACT: Respiratory infections are common causes of morbidity and mortality worldwide. We sought to assess the multiple antibiotic resistance (MAR) index, fitness, and virulence potential in Pseudomonas aeruginosa from patients with lower respiratory tract infections. Isolates were assessed for antimicrobial susceptibility, in vitro competitive fitness, pigment, elastase and rhamnolipid production. Oxidative stress tolerance was determined on both planktonic and biofilm cells and virulence potential was tested in a plant model. Mean MAR index for isolates was 0.34 (range, 0.17 - 0.50). While isolates exhibited good biofilm formation in the presence of ciprofloxacin, there was no significant difference in biofilm production over the concentration range assessed. Several drug-resistant strains were out-competed by a sensitive strain in the presence of antibiotic.H2O2 exerted a greater oxidative stress than tert-butyl hydroperoxide, and as expected, biofilms were more resistant than planktonic cells. While most (81%) isolates were pigmented there was no significant difference between pigmented and non-pigmented isolates when elastolytic activity was compared (p>0.05). More than half of the isolates produced the quorum sensing mediator, rhamnolipid, and infection of the plant model by bacteria occurred whether elastase or rhamnolipid was present or absent. These data suggest that non-pigmented strains of P. aeruginosa might pose an equally significant microbiological threat as pigmented strains even though pigment production appeared to be strongly associated with elastase expression. While dual expression of elastase and rhamnolipid by these bacteria would cause severe tissue damage (as seen in the plant model), non-production of either does not prevent bacteria from causing serious infection.
    No preview · Article · Feb 2016 · Journal of Medical Microbiology
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    ABSTRACT: Accurate diagnosis of Clostridium difficile infection is essential for disease management. A clinical and molecular analysis of C. difficile isolated from symptomatic patients at Groote Schuur Hospital, South Africa, was conducted to establish the most suitable clinical test for the diagnosis and characterisation of locally prevalent strains. C. difficile was detected in stool samples using enzyme-based immunoassays (EIA) and nucleic acid amplification methods, and their performance was compared to C. difficile isolation using direct selective culture combined with specific PCR to detect the C. difficile tpi gene, toxin A and B genes and binary toxin genes. Toxigenic isolates were characterised further by ribotyping. Selective culture isolated 32 C. difficile strains from 145 patients (22%). Of these, the most prevalent (50%) were of ribotype 017 (toxin A-B+) while 15.6% were ribotype 001 (toxin A+B+). No ribotype 027 strains or binary toxin genes (cdtA and cdtB) were detected. The test sensitivities and specificities, respectively, of the four commercial clinical diagnostic methods were as follows: ImmunoCard Toxins A & B (40% and 99.1%), VIDAS C. difficile Toxin A & B (50% and 99.1%), GenoType CDiff (86.7% and 88.3%) and Xpert C. difficile (90% and 97.3%). Ribotype 001 and 017 strains had a 100% detection rate by Xpert C. difficile, 100% and 93.3% by GenoType CDiff, 75% and 53.3% by ImmunoCard and 75% and 60% by VIDAS respectively. The poor performance of EIA suggests that a change to PCR-based testing would assist diagnosis and ensure reliable detection of locally prevalent C. difficile 017 strains.
    No preview · Article · Feb 2016 · Journal of Medical Microbiology

  • No preview · Article · Feb 2016 · Journal of Medical Microbiology
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    ABSTRACT: Many clinically relevant biofilms are polymicrobial. Examining the effect of antimicrobials in a multi-species biofilm consortium is of great clinical importance. The goal of this study was to investigate the effect of different honey types against bacterial wound pathogens grown in multi-species biofilm and to test the antibiofilm activity of honey defensin-1 in its recombinant form. Modified Lubbock chronic wound biofilm formed by four bacterial species (Staphylococcus aureus, Streptococcus agalactiae, Pseudomonas aeruginosa, Enterococcus faecalis) was used for evaluation of honey and recombinant bee-derived defensin-1 antibiofilm efficacy. Defensin-1 was prepared by heterologous expression in Escherichia coli. We showed that different types of honey (manuka and honeydew) were able to significantly reduced cell viability of wound pathogens (S. aureus, S. agalactiae and P. aeruginosa) in polymicrobial biofilm. None of the tested honeys showed the ability to eradicate E. faecalis in biofilm. In addition, recombinant defensin-1 successfully reduced the viability of S. aureus and P. aeruginosa cells within established polymicrobial biofilm after 24 and 48 hours of treatment. Interestingly, recombinant defensin-1 did not affect the viability of S. agalactiae cells within the biofilm whereas both natural honeys significantly reduced the viable bacteria. Although E. faecalis was highly resistant to defensin-1, defensin-1 significantly affected biofilm formation of E. faecalis and S. agalactiae after 24 hours of treatment, most likely through the inhibiting its extracellular polymeric substances production. In conclusion, our study reveals that honey and defensin-1 are effective against established multi-species biofilm; however, E. faecalis grown in multi-species biofilm was resistant to both antimicrobials.
    No preview · Article · Feb 2016 · Journal of Medical Microbiology
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    ABSTRACT: Oral candidiasis is a disease caused by opportunistic species of Candida that normally reside on human mucosal surfaces. The transition of Candida from budding yeast to filamentous hyphae allows for covalent attachment to oral epithelial cells, followed by biofilm formation, invasion and tissue damage. In this study, combinations of Lactobacillus plantarum SD5870, L. helveticus CBS N116411, and Streptococcus salivarius DSM 14685 were assessed for their ability to inhibit the formation of, and disrupt C. albicans biofilms. Co-incubation with probiotic supernatants under hyphae-inducing conditions reduced C. albicans biofilm formation by over 75% in all treatment groups. Likewise, combinations of live probiotics reduced biofilm formation of C. albicans by over 67%. When live probiotics or their supernatants were overlaid on preformed C. albicans biofilms, biofilm size was reduced by over 63% and 65% respectively. Quantitative RT-PCR results indicated that the combined supernatants of SD5870 and CBS N116411 significantly reduced the expression of several C. albicans genes involved in the yeast-hyphae transition: the ALS3 adhesin/invasin by 70% (p<0.0001); the EFG1 hyphae-specific gene activator by 47% (p=0.0061); the SAP5 secreted protease by 49% (p<0.0001); and the HWP1 hyphal wall protein critical to biofilm formation by over 99% (p<0.0001). These findings suggest the combination of L. plantarum SD5870, L. helveticus CBS N116411, and S. salivarius DSM 14685 is effective at both preventing the formation of, and removing preformed C. albicans biofilms. Our novel results point to the downregulation of several Candida genes critical to the yeast-hyphae transition, biofilm formation, tissue invasion, and cellular damage.
    No preview · Article · Feb 2016 · Journal of Medical Microbiology

  • No preview · Article · Feb 2016 · Journal of Medical Microbiology
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    ABSTRACT: Metallo-beta-lactamases (MBLs), porin OprD, integrons, virulence factors, and the clonal relationship have been characterized in imipenem-resistant Pseudomonas aeruginosa (IRPA) isolates. Fifty-six IRPA strains were recovered from blood samples of different patients at Toulouse teaching hospital (period 2011-2013). Susceptibility testing to 14 antibiotics was performed by the disc diffusion method. Detection and characterization of MBLs, oprD gene, and integrons were studied by PCR and sequencing. Thirteen genes involved in virulence of P. aeruginosa were analyzed. Molecular typing of IRPA was performed by PFGE and MLST. In this study, 61% of the IRPA isolates showed a multi-resistance phenotype. The MBL phenotype, detected in 3 isolates (5.4%), was linked to blaVIM-2 gene. The oprD gene was amplified in 55 IRPA (98.2%), and variations were observed in 54 of them. Insertion sequences (IS) truncating oprD was detected in 8 IRPA, being the new ISPa56 (GenBank KR258747) identified in two strains. Class 1 integrons were detected in 24 IRPA (42.9%). The blaVIM-2 gene was found inside the class 1 integron arrangements. The new integrons In1054 (intI1-aacA56-qacEΔ1-sul1) and In1160 (intI1-aacA4-aacC1d-ISKpn4-gcuE-qacEΔ1-sul1) were firstly described in this study (GenBank KM201605 and KR184824). A high clonal diversity was found in our strains. Among the variety of STs found, ST175, ST233, ST235, ST244 and ST654 were noteworthy as epidemic clones. To sum up 5.4% of IRPA showed a MBL phenotype, linked to blaVIM-2 gene. The identified oprD high polymorphism could be implicated in the variable resistance to carbapenems in IRPA. The high-risk clones dissemination is a cause of concern.
    No preview · Article · Feb 2016 · Journal of Medical Microbiology
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    ABSTRACT: Bloodstream infections caused by E. coli ST131 and ST131 H30-Rx subclones have emerged worldwide. This study was carried out to evaluate the prevalence of ST131-Rx subclone and characterize the virulence properties of the Rx among the bloodstream E. coli isolates. A total of 297 non-duplicated E.coli bloodstream isolates were studied. Antibiotic susceptibilities were tested using the disk diffusion method. PCR amplification and sequencing was used to identify ST131 and H30-Rx, the virulence gene, the betalactamase, and virotype. Quinolone resistance among bacteremic E.coli strains was 51%, and it was 98% among E.coli ST131. The ST131 accounted for 16% (49) of all isolates and all ST131 isolates belonged to the ExpEC. The proportion of H30 subclone among the ST131 isolates was 98% and 75% of H30 isolates belonged to the H30-Rx. The prevalence of ST131 increased from 13% to 23% in 4 years; however, there was a decrease in the ratio of H30-Rx infections. CTX-M-15 was detected in 85% of ST131 and all of H30-Rx isolates. The virulence genes associated with adhesion, cell protection, iron uptake, and toxins (papA, iha , KpsmtII, iut, and sat) were more common in ST131 than in non-ST131. Most of the ST131 and H30-Rx isolates were of the C virotype. All papA positive isolates were in virotype C. The E. coli ST131 clone has increased rapidly among bloodstream isolates. However, decrease in the ratio of H30-Rx subclone in the quinolone resistant population suggests the possibility of dissemination of other virulent and quinolone resistant subclones in hospital settings.
    No preview · Article · Jan 2016 · Journal of Medical Microbiology
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    ABSTRACT: A. baumannii is an important opportunistic bacterial pathogen responsible for serious infections in hospitalized patients. From a total of 78 consecutive non-repetitive Acinetobacter spp. isolates from patients with blood infections, 61 were carbapenem resistant which were positive for blaOXA-51-like (96.7%), blaOXA-23-like (77%), blaOXA-58-like (8.1%), and blaOXA-40-like (32.8%) by multiplex PCR. The isolates were identified as A. baumannii (n=59), and A. nosocomialis (n=2). Also, we found a case of A. junii causing bacteraemia, that possesses IMP. High levels of resistance were observed to fluoroquinolones, aminoglycosides, tigecycline and to the beta-lactam antibiotics, including piperacillin/tazobactam and ampicillin/sulbactam. ISAba1 was present in 96.7% of all Acb isolates. Also, 33(54.1%) and 23(37.7%) isolates were harboring the ISAba1 upstream of blaOXA-23-like and blaOXA-51-like genes, respectively, though not observed in A. nosocomialis isolates. No relationship was observed between the presence of the ISAba1 upstream oxacillinase genes and the level of carbapenem resistance in all Acb isolates. Only 2 genes encoding metallo-beta-lactamase (VIM, SPM) were detected in all Acb isolates. It suggests that carbapenem resistance in blood isolate Acb is mostly due to the presence of acquired carbapenemases. This is the first report from Iran on the identification of A. nosocomialis isolates that possess multiple oxacillinase genes and lack upstream ISAba1.
    No preview · Article · Jan 2016 · Journal of Medical Microbiology
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    ABSTRACT: The reported incidence of Legionnaires' disease caused by Legionella longbeachae has increased since 2008 in Scotland. While microbiological and epidemiological studies have identified exposure to growing media as a risk factor for infection, little is known about the differences regarding disease risk factors, clinical features and outcomes of infection with L. longbeachae when compared with L. pneumophila. A nested case-case study was performed comparing 12 L. longbeachae cases with 25 confirmed L. pneumophila cases. Fewer L. longbeachae infected patients reported being smokers (27 % [95 % CI 2 %-52 %] vs. 68 % [95 % CI 50 %-86 %], p=0.034) but more L. longbeachae patients experienced breathlessness (67 % [95 % CI 40 %-94 %] vs. 28 % [95 % CI 10 %-46 %]), p=0.036). Significantly more L. longbeachae infected patients received treatment in intensive care (50 % [95 % CI 22 %-78 %] vs. 12 % [95 % CI 0 %-25 %], p=0.036). However, the differences in diagnostic methods between the two groups may have led to only the most severe cases of L. longbeachae being captured by the surveillance system. No differences were observed in any of the other pre-hospital symptoms assessed. Our results highlight the similarity of Legionnaires' disease caused by L. pneumophila and L. longbeachae and reinforce the importance of diagnostic tools other than the urinary antigen assays for the detection of non-L. pneumophila species. Unfortunately cases of community acquired pneumonia caused by Legionella species will continue to be under-diagnosed unless routine testing criteria changes.
    No preview · Article · Dec 2015 · Journal of Medical Microbiology
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    ABSTRACT: A piperacillin/tazobactam (PT) restriction was initiated at our institution on 15 July 2012 requiring clinical pharmacy or infectious diseases approval for durations exceeding 72 hours. A retrospective review was undertaken to determine if this restriction decreased PT usage and/or rates of acute renal failure (ARF) (defined as a 50% increase or 0.5 mg/dL increase in serum creatinine from baseline). Patients prescribed at least 1 day of PT with a creatinine clearance (CrCl) >39 mL/min at the time of initiation in the 3 months prior to the restriction were compared to patients in the 5 months after restriction implementation. Overall, 115 unique patients were included in the pre-implementation group and compared to 117 unique patients in the post-implementation group. The pre-implementation group received an average of 5.22 days of PT, compared to 4.71 days in the post-implementation group (P=0.224). Ten percent (12/115) of patients in the pre-implementation group developed ARF compared to 9.16% (11/120) of patients in the post-implementation group (P=0.0309). Ninety five patients in the pre-implementation group and 91 in the post-implementation group received combination therapy with vancomycin. ARF occurred in 11.6% (11/95) of those in the pre-implementation group and 12.1% (11/91) in the post-implementation (P>0.05). Overall, 11.8% (22/186) of patients who received therapy with PT and vancomycin developed ARF, compared to 1.7% (1/56) who received PT monotherapy (P<0.0001). This restriction resulted in a numeric reduction in the number of PT days in the post-implementation group, and a significant reduction in the rate of ARF.
    No preview · Article · Dec 2015 · Journal of Medical Microbiology
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    ABSTRACT: Over a period of 3 years' study (2012-2014), a total of 518 fecal samples were collected and cultured to isolate E. coli. Of these, 338 (65.3%) E. coli isolates were recovered from infants, and 142/338 (42 %) were multidrug resistance (MDR) to ≥ 3 drug classes using antimicrobial susceptibility disc diffusion method. A total of 125/142 ( 88%) of E. coli isolates were ESBL-producers. blaCTX-M-15 types were observed in 80 /125 (64%) of the isolates, and 60/80 (75%) were positive for blaCTX-M-15. Out of 338 E. coli isolates, 9 (2.6%) were positive for ST131/O25b clone and each isolate was associated with several plasmids of different sizes (1-21.2 Kb). The identities of these 9 isolates were confirmed by sequencing for presence of pabB (347bp) and trpA (427bp) genes. This study demonstrates low prevalence rate of the highly virulent E. coli ST131 clone producing blaCTX-M-15 in the intestine of Jordanian infants.
    No preview · Article · Dec 2015 · Journal of Medical Microbiology
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    ABSTRACT: Microorganisms isolated from the oral cavity may translocate to the lower airways during mechanical ventilation leading to ventilator-associated pneumonia (VAP). Changes within the dental plaque microbiome during mechanical ventilation (MV) have been documented previously, primarily using culture-based techniques. The aim of this study was to use community profiling by high throughput sequencing to comprehensively analyse suggested microbial changes within dental plaque during MV. 16S rDNA gene sequences were obtained from 38 samples of dental plaque sampled from 13 mechanically ventilated patients and sequenced using the Illumina platform. Sequences were processed using Mothur, applying a 97% gene similarity cut-off for bacterial species level identifications. A significant 'microbial shift' occurred in the microbial community of dental plaque during MV for 9 out of 13 patients. Following extubation, or removal of the endotracheal tube (ETT) that facilitates ventilation, sampling revealed a decrease in the relative abundance of potential respiratory pathogens and a compositional change towards a more predominantly (in terms of abundance) oral microbiota including Prevotella spp., and streptococci. The results highlight the need to better understand microbial shifts in the oral microbiome in the development of strategies to reduce VAP, and may have implications for the development of other forms of pneumonia such as community acquired infection.
    No preview · Article · Dec 2015 · Journal of Medical Microbiology
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    ABSTRACT: To determine the predominant genotype of the varicella-zoster virus (VZV) in suburban Shanghai Municipal Province, specimens were collected from the lesions of 95 outpatients clinically diagnosed with varicella or herpes zoster. Of these, 69 patients (72.6%) were positive for VZV DNA. The 69 isolates were all genotyped as the genotype J1/clade 2 according to the method of Barrett-Muir et al. Based on sequencing of the 447-bp sequence in ORF22, 66 isolates were identified as genotype J/clade 2 strains and three were identified as type M2/clade 4 strains. To confirm the classification of these three strains, we determined the presence of the 27 single-nucleotide polymorphisms (SNPs) proposed by Breuer et al. and found that isolates 1270/450 shared seven SNPs that differed from those of clade 2, in which three SNPs were unique to clade 3 and another three were unique to clade 4. Isolate 1456 had two markers of clade 4 that differed from clade 2. The phylogenetic tree showed that our isolates clustered primarily with clade 2 and that the three M2/J1 strains clustered between clades 2 and 4. It is likely that isolates 1270/1450/1446 may represent a new subclade of either clade 2 or 4, or some recombinant events. In addition, our isolates were wild-type strains. We also observed significant interstrain variations.
    No preview · Article · Dec 2015 · Journal of Medical Microbiology
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    ABSTRACT: The role of quorum sensing (QS) on the regulation of virulence factor production in Pseudomonas aeruginosa is well established. Increased antibiotic resistance in this bacterium has led to the search for new treatment options, and inhibition of the QS system has been explored for potential therapeutic benefits. If the use of QS inhibitory agents were to lead to a reduction in bacterial virulence, new approaches in the treatment of P. aeruginosa infections could be further developed. Accordingly, we examined whether human serum paraoxonase 1 (hPON1), which uses lactonase activity to hydrolyze acyl homoserine lactones (AHLs), could cleave P. aeruginosa-derived signaling molecules. hPON1 was purified using ammonium sulfate precipitation and hydrophobic interaction chromatography (Sepharose 4B-L-tyrosine-1-naphthylamine). Different concentrations of hPON1 have been found to reduce various virulence factors including pyocyanin, rhamnolipid, elastase, staphylolytic LasA protease and alkaline protease. Although treatment with 0,1-10 mg∙mL-1 hPON1 did not show a highly inhibitory effect on elastase and staphylolytic LasA protease production, it resulted in good inhibitory effects on alkaline protease production at concentrations as low as 0,1 mg∙mL-1. hPON1 also reduced the production of pyocyanin and rhamnolipid at a concentration of 1,25 mg∙mL-1 (within a range of 0,312-5 mg∙mL-1). In addition, rhamnolipid, an effective biosurfactant reported to stimulate the biodegradation of hydrocarbons, was able to degrade oil only in the absence of hPON1.
    No preview · Article · Dec 2015 · Journal of Medical Microbiology
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    ABSTRACT: This study evaluated the bactericidal effect of Er:YAG laser combined with sodium hypochlorite (NaOCl) irrigation in treatment of Enterococcus faecalis deep inside dentinal tubules. Er:YAG laser was activated respectively at 0.3, 0.5, and 1.0 W for either 20 or 30 seconds; 52.5 g L-1 NaOCl and normal saline were considered as the control groups. Root canals before and after treatments were examined using scanning electron microscopy (SEM). Bacterial reductions both on the root canal walls and at 100, 200, 300, 400, and 500 μm inside the dentinal tubules were analyzed using a one-way analysis of variance. SEM results showed that Er:YAG laser combined with NaOCl disinfected the dentinal tubules from 200 to over 500 μm as irradiation power and time increased. They killed significantly more bacteria than both the negative control group at each level tested and the positive control group at 300, 400, and 500 μm inside the dentinal tubules. It reached 100% in all experimental groups both on the root canal walls and at 100 and 200 μm inside the dentinal tubules. However, at 300, 400, and 500 μm inside the dentinal tubules only the groups with 0.5 W/30s and 1.0 W/30s exhibited no bacterial growth. Between the two groups in which no bacteria was detected at all tested depths, Er:YAG laser irradiation at 0.5 W for 30 seconds combined with NaOCl irrigation was preferable because of the lower emission power and shorter irradiation time, which may serve as a new option for effective root canal disinfection.
    No preview · Article · Dec 2015 · Journal of Medical Microbiology
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    Preview · Article · Dec 2015 · Journal of Medical Microbiology