To date, the most comprehensive data on the bacteriology of this form of actinomycosis come from a study conducted in two reference laboratories in Germany (12). It is notable that, already in the early 1980s, A. israelii was suggested to be an associated organism on the basis of immunocytological findings (153), but this was ignored at that time. These findings suggest an oral source of these polymicrobial brain abscesses. – show that methotrexate, an anti-inflammatory drug designed to target human cells, has off-target effects on the growth, transcription, and metabolic activity of diverse human gut bacteria with downstream consequences for host immunity. Later, the impact of Actinomyces as an infectious organism under this condition was reinforced when Actinomyces, identified as A. israelii, was found prominently colonizing necrotic bone in the majority of 31 patients with osteoradionecrosis (53). Previously, A. israelii had been identified as the main Actinomyces species recovered in bronchial secretions (13). In a study using sequencing of the 16S rRNA gene, however, only one A. israelii-positive specimen from osteoradionecrotic bone was found among six specimens examined (155), whereas the use of a DNA-DNA checkerboard method with targeted probes revealed the presence of Actinomyces species in all 12 resected jaw bone specimens examined (156). Bisphosphonate-related osteonecrosis of the jaw.Bisphosphonates are commonly used drugs in oncology. Indeed, at the age of 2 months, one-third of infants in one study were already colonized with Actinomyces (28). Radiographic imaging techniques, such as computed tomography, and magnetic resonance imaging are valuable diagnostic tools for recognizing the location and size of the lesion(s) (61 Oral infections in tissues surrounding teeth/implants. Notably, the patient's poor dentition was seen as a predisposing factor. Enter multiple addresses on separate lines or separate them with commas. Moreover, some actinomycosis cases have been linked to specific conditions, such as osteoradionecrosis or bisphosphonate-related osteonecrosis of the jaws (53, 54), the use of anti-inflammatory drugs (55, 56), or some hereditary diseases (57, 58). Nipple piercing was suggested to be a predisposing factor for Actinomyces infection of the breast in two patients, one due to A. radingae (204) and another due to A. turicensis together with a Gram-positive anaerobic coccus, Peptoniphilus harei (206). Interestingly, A. odontolyticus colonized all 20 subjects, and A. naeslundii colonized half of the subjects regardless of age or disease status, whereas A. cardiffensis and A. massiliensis were recovered mainly from healthy children (36). Primary cutaneous actinomycosis with multiple lesions has been described to be a first sign of a patient's HIV infection (133). Hilt et al. An appropriate diagnosis is the cornerstone to be able to choose a proper treatment modality and, conceivably, to have a successful treatment outcome. They are early colonizers and produce fimbriae that bind to saliva proline-rich proteins and statherin, which adsorb onto the tooth surface (279, 280). Therefore, the first reports on their involvement in infections of the urinary tract came from laboratories with a special interest in unusual organisms and expertise in molecular detection methods. Concomitant/coinfecting organisms in 12 brain abscess cases with an involvement of Actinomyces meyeri 252). Volume 8, Issue 1 - 2021. – Their detection and identification in clinical microbiology laboratories and recognition as pathogens in clinical settings can be challenging. A. gerencseriae in particular is among the most active species in dental plaque of children suffering from severe early childhood caries, which is a chronic disease causing extensive destruction of the primary dentition (181). The clinically relevant Gram-positive anaerobic bacilli are found in two phyla: Actinobacteria and Firmicutes. Inside the tissue, these bacteria form masses consisting of aggregates of branching, filamentous bacilli (7 As Gram-positive organisms, they are also susceptible to vancomycin. Among 15 clinical strains collected from eye infections (infection not specified) and sent to a reference laboratory in the United Kingdom for identification, A. gerencseriae, A. israelii, A. odontolyticus, A. naeslundii, and A. georgiae, in descending order, were detected (64). Bioenergy is renewable energy from biomass. Rates of detection of Actinomyces in clinical endodontic samples varied from 9% among 53 specimens examined by DNA-DNA checkerboard analysis (185) to 56% among 129 specimens examined by PCR (187). neuii, seems to be the most frequently detected Actinomyces species in infected tissues around different types of prostheses, including mammary prostheses (225), penile prostheses (226), prosthetic valves (227), and hip prostheses (228), but also in connection to medical devices such as ventriculoperitoneal shunts (229, 230) and peritoneal dialysis catheters (231). 2. Anti-tumor necrosis factor alpha drugs.Anti-tumor necrosis factor alpha (TNF-α) drugs, which are increasingly used in the treatment of inflammatory diseases such as rheumatoid arthritis and Crohn's disease, have been linked to an increased susceptibility to bacterial infections. Although this method is extremely powerful and can be relied upon for genus-level identification, some validly published species have highly similar 16S rRNA sequences, and there has been extensive recombination in the genomes, including the 16S rRNA gene, among certain groups of organisms, notably those that are naturally competent, such as the genus Neisseria (293). NOTE: We request your email address only to inform the recipient that it was you who recommended this article, and that it is not junk mail. A large number of Actinomyces species have been described since the description of A. israelii, A. naeslundii, A. odontolyticus, and A. viscosus. Numbers represent bootstrap values for each branch based on data for 1,000 trees. Similar to infections with Actinomyces, those with P. propionicum and A. schaalii are often polymicrobial (13, 257). In one A. israelii case, no signs of osteomyelitis in the spinal column were observed; the organism was detected in cerebrospinal fluid, and the entire spinal cord was involved, leaving the patient with severe neurological symptoms (138). Among 14 thoracic actinomycosis cases involving children, Aggregatibacter actinomycetemcomitans and Fusobacterium nucleatum were the most commonly detected organisms, being detected in 9 and 5 cases, respectively (95). A. meyeri was also implicated in splenic abscesses in a young girl with autoimmune hepatitis (108). Disseminated actinomycosis.Disseminated actinomycosis exhibits multiorgan involvement (9) and usually also has a polymicrobial nature; Aggregatibacter (formerly Actinobacillus) actinomycetemcomitans is often among the coinfecting organisms (89, 146, 147). ASM journals are the most prominent publications in the field, delivering up-to-date and authoritative coverage of both basic and clinical microbiology. Breast tissue is a site commonly affected by actinomycosis, with A. neuii especially being identified as a causative organism (11, 64, 119, 175, 199 Other Actinomyces organisms found in the urinary tract include A. urogenitalis from urethra and urine (45), A. neuii in urinary tract infection (118), and A. europaeus in patients with cystitis or purulent urethritis (178). Biologic productivity is high and the nutrient load is also high. Besides A. meyeri, A. odontolyticus, A. turicensis, A. cardiffensis, and A. funkei were among thorax specimens that were identified in a reference laboratory in the United Kingdom (64); due to the lack of other information, it was not possible to estimate whether they were associated with thoracic actinomycosis or other pulmonary infections. Results of microscopy of samples from superficial infections at mucosal surfaces where Actinomyces and other Gram-positive bacilli are commonly found should be interpreted with caution. (n = 1), and two cases specified as “actinomycosis,” were suggested to be causative organisms of chronic granulomatous disease-related actinomycosis (58). A wide range of Actinomyces species are being increasingly associated with infections at many body sites (11, 13, 14). Actinomycosis is generally considered an uncommon disease; however, current prevalence rates are not available, and furthermore, data from developing countries are incomplete (8). viscosus” and A. odontolyticus being represented (42). 1) shows that there are three principal clusters albeit not particularly strongly supported by bootstrap analysis. The type species is Actinomyces bovis. Actinomyces is one of the predominant genera in the oral cavity. Musculoskeletal actinomycosis, Actinomycosis of the central nervous system, Actinomycosis: an ancient disease difficult to diagnose, Cerebral actinomycosis before adolescence, Pericarditis, pneumonia and brain abscess due to a combined, Bisphosphonate-related osteonecrosis of the jaw: the role of, Opportunistic actinomycosis in osteoradionecrosis of the jaws in patients affected by head and neck cancer: incidence and clinical significance, Bisphosphonate-related osteonecrosis of the jaws: a review of 34 cases and evaluation of risk, Microbial biofilms in osteomyelitis of the jaw and osteonecrosis of the jaw secondary to bisphosphonate therapy, Infected osteoradionecrosis of the mandible: follow-up study suggests deterioration in outcome for patients with, Osteoradionecrosis contains a wide variety of cultivable and non-cultivable bacteria, DNA-DNA hybridization demonstrates multiple bacteria in osteoradionecrosis, Risk of hospitalized bacterial infections associated with biologic treatment among US veterans with rheumatoid arthritis, Brain abscess as an initial presentation in a patient of hereditary haemorrhagic telangiectasia caused by a novel ENG mutation, Hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber disease) presenting with polymicrobial brain abscess Case report, Photo quiz I. Elevated levels of A. neuii in subgingival sites of women with gingivitis were reported in a study where the DNA-DNA checkerboard technique was used as a detection method (193). The following is a title guide to the Health Sciences Libraries eBook library. Actinomyces species isolated from cerebrospinal fluid include A. israelii, from a patient with meningitis (107), and A. naeslundii (sensu stricto) (10). Despite the severity of disseminated infection, it can have clinically mild manifestations. Sequences can be submitted via the Internet to databases such as the Ribosomal Database Project (292) for identification. He qualified in Microbiology in 1978 at the University of East Anglia. According to recent reports, A. neuii, especially A. neuii subsp. Actinomyces species are rarely involved in early stages of endodontic infections but are typically found in persistent infections and extraradicular lesions (183 Despite improved techniques and targeted searches for Actinotignum (formerly Actinobaculum) species in urine specimens, only single findings of A. massiliense and A. urinale in urine or blood have been made (256, 261, 266), differing from the obvious involvement of A. schaalii in infections in, and occasionally outside, the urogenital tract. A somewhat more distant location is the esophagus, from where actinomycotic lesions have also been recovered in both immunocompetent and immunocompromised individuals (83, 84). viscosus,” A. israelii, A. georgiae, A. gerencseriae, and A. graevenitzii, in descending order, were recovered from 33 failed dental implant fixtures, which had been removed due to infection (195). A. schaalii is thus considered a uropathogen in the elderly, but the significance of this species in children is receiving attention (258, 259). Amphiphilic molecules undergo a geometry-dependent rearrangement when aqueous phase is added, in order to mask the hydrophobic moieties from the polar aqueous environment [2,7].If an amphiphilic molecule has a cylindrical geometry (i.e., the cross-sectional area of polar and nonpolar moieties are approximately equal), adjacent molecules align parallel to each other to … Recently, A. meyeri was found to be the cause of a disseminated infection resulting in fatal mediastinitis after an esophageal stent operation (236). and 3.0 in Sonalika. 94), A. israelii (95, 96), A. odontolyticus (97, 98), and A. cardiffensis (99) have been recovered from actinomycotic lesions at pulmonary sites. Urinary tract.In both males and females, A. turicensis has been detected in connection with urethritis and cystitis (25, 107, 178). Altogether, 12,253 specimens, collected between 1972 and 1999 from patients having cervicofacial inflammatory processes, were examined thoroughly by using culture-based techniques with a wide variety of growth media and incubation times of up to 14 days. In a case report of a polybacterial brain abscess, Capnocytophaga spp. Bio Basic 20 Konrad Cres. A. turicensis has been detected in chronic otitis media and mastoiditis cases (47, 178), while one A. cardiffensis strain was found in pus collected from temporal, large, and small parietal and ear abscesses in a patient after mastoidectomy (65). (51) used a combination of standard and expanded quantitative urine cultures and 16S rRNA gene sequencing to identify bacteria in urine specimens collected from 65 women (41 with overactive bladder and 24 controls). The first case of pelvic actinomycosis caused by P. propionicum was that of a woman who had long-term use of an IUCD as a predisposing factor (274). Many of these titles are included in full-text collections such as AccessMedicine, Books@Ovid, ClinicalKey, NCBI Bookshelf, R2 Library and STAT!Ref. (37.7%); Propionibacterium spp. Bone/Joint Infections During this 2-year longitudinal study, despite the appearance of A. naeslundii, “A. Recent taxonomic changes have compounded these problems. Subsequently, two novel Actinobaculum strains were detected in urine samples from women with urinary tract infections, namely, A. massiliae (A. massiliense) and A. urinale (21, 22). The authors of that report underlined the importance of prolonged incubation in detection of these fastidious organisms. viscosus” (107). Actinomyces species play a central role in the initial stages of biofilm formation on teeth (i.e., dental plaque) both above (supragingival) and below (subgingival) the gumline (29). After the detection of Actinobaculum schaalii (currently Actinotignum schaalii), a taxon closely related to the members of the genus Actinomyces, in urine, groin swabs, and vaginal swabs (18), it was recently suggested that this organism might be a relatively frequent commensal residing on the skin and mucosae of urogenital sites, but not in the colon, since no detection from feces was made (48). There were also obvious differences in the species distribution: A. gerencseriae and A. israelii (185) on the one hand and “A. Another report described an ulcer-type actinomycotic lesion with A. odontolyticus on the oral mucosa of a patient with diabetes (69). When considering the frequency of use of IUCDs, the recovery of <100 actinomycotic specimens, most of those being tubo-ovarian abscesses, between 1926 and 1995 indicated that the risk of pelvic actinomycosis in relation to the use of IUCDs is very low (122). They also interact with a range of other dental plaque bacteria, including representatives of the genera Fusobacterium, Prevotella, and Veillonella, by coaggregation (281), which provides structural integrity to the plaque (282). Based on data reported recently by Kommedal et al. Manifestations with a single or multiple draining sinuses can occur at various body sites, including the face, chest, midriff, hip, as well as upper and lower extremities. There are reports of cases where thoracic actinomycosis was found together with tuberculosis (85). In addition, A. naeslundii/“A. Both A. naeslundii genospecies 1 (A. naeslundii sensu stricto) and genospecies 2 (now A. oris) colonize active root caries lesions (182). These observations are credible due to the possibility of aspiration, since A. graevenitzii colonizes the oral cavity in particular (28). Characteristic features of actinomycosis include chronic manifestations, abscess formation with sinus tracts, and purulent discharge (9). A study using a nested-PCR assay targeted to P. propionicum and A. radicidentis revealed high rates of detection of P. propionicum in primary endodontic infections: 50% in teeth with acute apical periodontitis, 37% in teeth with periradicular abscesses, and 29% in teeth with chronic periradicular lesions (184). (25.1% and 21%, respectively); corroding Gram-negative rods (18.5%), including Campylobacter gracilis, Capnocytophaga spp., and Eikenella corrodens; and Aggregatibacter actinomycetemcomitans (14.2%) (12). Far more precise identifications can be obtained by 16S rRNA gene sequence analysis (290). Varibaculum cambriense as a Soft Tissue PathogenFifteen Actinomyces-like strains from infections at a variety of body sites in 14 subjects were characterized and described as belonging to the genus Varibaculum, including one species, V. cambriensis (later corrected to V. cambriense) (24). The role of concomitant organisms is considered to synergistically enhance the infectious process. Founded by Elisabeth Bik, microbiome and science integrity consultant. In the case of actinomycosis, it has been considered that a long duration of antimicrobial therapy with high doses is necessary, with treatment extending up to 1 year (or even longer). 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