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Infection and Immunity, July 2000, p. 4018-4023, Vol. 68, No. 7
0019-9567/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Natural History of Streptococcus
sanguinis in the Oral Cavity of Infants: Evidence for a Discrete
Window of Infectivity
Page W.
Caufield,*
Ananda P.
Dasanayake,
Yihong
Li,
Yaping
Pan,
Jay
Hsu, and
J. Michael
Hardin
School of Dentistry, University of Alabama,
Birmingham, Alabama
Received 20 December 1999/Returned for modification 8 March
2000/Accepted 24 April 2000
The heterogeneous group of oral bacteria within the sanguinis
(sanguis) streptococci comprise members of the indigenous biota of the
human oral cavity. While the association of Streptococcus sanguinis with bacterial endocarditis is well described in the literature, S. sanguinis is thought to play a benign, if
not a beneficial, role in the oral cavity. Little is known, however, about the natural history of S. sanguinis and its specific
relationship with other oral bacteria. As part of a longitudinal study
concerning the transmission and acquisition of oral bacteria within
mother-infant pairs, we examined the initial acquisition of S. sanguinis and described its colonization relative to tooth
emergence and its proportions in plaque and saliva as a function of
other biological events, including subsequent colonization with mutans
streptococci. A second cohort of infants was recruited to define
the taxonomic affiliation of S. sanguinis. We found that
the colonization of the S. sanguinis occurs during a
discrete "window of infectivity" at a median age of 9 months in the
infants. Its colonization is tooth dependent and correlated to the time
of tooth emergence; its proportions in saliva increase as new teeth
emerge. In addition, early colonization of S. sanguinis and its elevated levels in the oral cavity were
correlated to a significant delay in the colonization of mutans
streptococci. Underpinning this apparent antagonism between S. sanguinis and mutans streptococci is the observation that after
mutans streptococci colonize the infant, the levels of S. sanguinis decrease. Children who do not harbor detectable levels
of mutans streptococci have significantly higher levels of S. sanguinis in their saliva than do children colonized with mutans
streptococci. Collectively, these findings suggest that the
colonization of S. sanguinis may influence the subsequent colonization of mutans streptococci, and this in turn may suggest several ecological approaches toward controlling dental caries.
*
Corresponding author. Mailing address: Page W. Caufield, D.D.S., Ph.D., University of Alabama at Birmingham, School of
Dentistry, Box 13, 1919 7th Avenue South, Birmingham, AL 35294. Phone:
(205) 934-4327. Fax: (205) 975-6773. E-mail: page{at}uab.edu.
Infection and Immunity, July 2000, p. 4018-4023, Vol. 68, No. 7
0019-9567/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
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