Summary: Previous research has linked oral bacteria to poor dental hygiene and an increased risk of Alzheimer’s disease. Now researchers have found a link between Streptococcus anginosus, a bacteria found in oral abscesses, and an increased risk of brain abscesses.
Source: Plymouth University
Bacteria known to cause oral infections may also be a contributing factor in patients developing life-threatening brain abscesses, new research suggests.
The study, published in the journal of dentistry, studied brain abscesses and their association with bacteria present in the oral cavity. Although this type of abscess is relatively rare, it can cause significant mortality and morbidity.
The researchers reviewed the records of 87 patients admitted to hospital with brain abscesses and used microbiological data obtained from abscess swabs and peripheral cultures.
This allowed them to study the presence of oral bacteria in the brain abscesses of patients where a cause for the abscess had either been found, as was the case in only 35 patients, or not found.
Their results showed that the 52 patients for whom no cause had been found were about three times more likely to have oral bacteria present in their samples.
These patients also carried a significantly higher number of Streptococcus angina, a bacterium that can cause pharyngitis, bacteremia and infections in internal organs such as the brain, lungs and liver. This bacterium is often found in dental abscesses.
Writing in the study, the researchers say the findings suggest the oral cavity could be considered a source of infection in cases of brain abscess where no clear cause has been identified.
The University of Plymouth and Plymouth NHS Trust University Hospitals carried out the research.
Dr Holly Roy, NIHR Clinical Lecturer in Neurosurgery based at the University of Plymouth and Plymouth NHS Trust Teaching Hospitals, is the study’s senior author.
She said: “Although many potential causes of brain abscesses are recognised, the origin of the infection often remains clinically unidentified. However, it was still surprising to frequently find oral bacteria in brain abscesses of unexplained origin.
“This highlights the importance of using more sensitive techniques to assess the oral cavity as a potential bacterial source in patients with brain abscess. It also highlights the importance of improving dental care and oral hygiene. -dental more generally.
The study is part of ongoing research within the University’s Oral Microbiome Research Group, led by Dr. Raul Bescos and Dr. Zoe Brookes, to explore the links between the oral microbiome and a range of cardiovascular and neurological conditions.
Further clinical trials are underway to investigate the links between gum health and Alzheimer’s disease and identify patients at high cardiovascular risk in primary care dental clinics, as an altered balance of oral bacteria (microbiome) during gum disease can lead to high blood pressure and strokes.
These clinical studies are conducted in primary care dental facilities operated by Peninsula Dental Social Enterprise, where research is primarily focused on improving clinical outcomes for patients.
About this brain abscess and the latest in oral health research
Author: Alain Williams
Source: Plymouth University
Contact: Alan Williams – University of Plymouth
Image: Image is in public domain
See also
Original research: Free access.
“Oral microbes and brain abscess formation: a retrospective single-center study” by Holly Roy et al. journal of dentistry
Summary
Oral microbes and brain abscess formation: a single-center retrospective study
Objective
Intracranial abscesses are relatively rare, but can cause significant mortality and morbidity. While many potential causes of brain abscesses are recognized, in many cases the origin of the infection remains clinically unidentified. Our objective was to study the role of bacteria present in the oral cavity in the development of brain abscesses.
Methods
A retrospective analysis was performed using data from 87 patients admitted to a single UK neurosurgery unit with brain abscesses over a 16-year period. Using microbiological data obtained from abscess swabs and peripheral cultures, bacterial species were categorized in patients with no identified primary source of infection (INS) for their brain abscess. (not = 52), or when an infectious source (ISI) has been identified. Microbiological data were then reviewed to identify common oral bacteria in each group.
Results
ISI group brain abscesses (not = 35) demonstrated a significantly lower preponderance of oral bacteria (not = 8), that the NSI group (not = 29) (p < 0.05). Brain abscesses in the NSI group also had a significantly higher number of Streptococcus angina compared to ISI (p < 0.05), brain abscesses being most frequent in the frontal and parietal lobes for ISI and NSI.
conclusion
These results suggest that the oral cavity could be considered a source of occult infection in cases of brain abscess where no clear cause has been identified. Future studies should include oral screening and microbiome analysis to better understand the mechanisms involved and develop prevention approaches.
Clinical Significance Statement
Oral bacteria may be an underrecognized cause of brain abscesses. Careful examination of oral health in patients with brain abscess can help establish causation, especially in patients whose cause of the abscess has not been identified. Good levels of oral health can help prevent the development of brain abscesses in some people.
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