Viral-bacterial associations in acute apical abscesses

Dennis C. Ferreira, Isabela N. Ras, Simone S.M. Paiva, Flávia L. Carmo, Fernanda S. Cavalcante, Alexandre S. Rosado, Kátia R.N. Santos, José F. Siqueira

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Objective: Viral-bacterial and bacterial synergism have been suggested to contribute to the pathogenesis of several human diseases. This study sought to investigate the possible associations between 9 candidate endodontic bacterial pathogens and 9 human viruses in samples from acute apical abscesses. Study design: DNA extracts from purulent exudate aspirates of 33 cases of acute apical abscess were surveyed for the presence of 9 selected bacterial species using a 16S ribosomal RNA gene-based nested polymerase chain reaction (PCR) approach. Single or nested PCR assays were used for detection of the human papillomavirus (HPV) and herpesviruses types 1 to 8. Results: Two-thirds of the abscess samples were positive for at least one of the target viruses. Specifically, the most frequently detected viruses were HHV-8 (54.5%); HPV (9%); and varicella zoster virus (VZV), EpsteinBarr virus (EBV), and HHV-6 (6%). Bacterial DNA was present in all cases and the most prevalent bacterial species were Treponema denticola (70%), Tannerella forsythia (67%), Porphyromonas endodontalis (67%), Dialister invisus (61%), and Dialister pneumosintes (57.5%). HHV-8 was positively associated with 7 of the target bacterial species and HPV with 4, but all these associations were weak. Several bacterial pairs showed a moderate positive association. Viral coinfection was found in 6 abscess cases, but no significant viral association could be determined. Conclusions: Findings demonstrated that bacterial and viral DNA occurred concomitantly in two-thirds of the samples from endodontic abscesses. Although this may suggest a role for viruses in the etiology of apical abscesses, the possibility also exists that the presence of viruses in abscess samples is merely a consequence of the bacterially induced disease process. Further studies are necessary to clarify the role of these viral-bacterial interactions, if any, in the pathogenesis of acute apical abscesses. © 2011 Mosby, Inc. All rights reserved.
Original languageEnglish (US)
Pages (from-to)264-271
Number of pages8
JournalOral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology
Issue number2
StatePublished - Aug 1 2011
Externally publishedYes


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