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. 2019 Jun;276(6):1815-1822.
doi: 10.1007/s00405-019-05445-1. Epub 2019 Apr 26.

Bacterial biofilm in salivary stones

Ramón Perez-Tanoira  1   2 , Antti Aarnisalo  3 , Aaro Haapaniemi  3 , Riitta Saarinen  3 , Pentti Kuusela  4 , Teemu J Kinnari  3
Affiliations

Bacterial biofilm in salivary stones

Ramón Perez-Tanoira et al. Eur Arch Otorhinolaryngol. 2019 Jun.

Abstract

Purpose: To assess the susceptibility of salivary stones to bacterial biofilm formation, which may be involved in the development of salivary gland infection, and to investigate a relation between microbiological aspects and patient characteristics.

Methods: This prospective study comprises of 54 patients with sialolithiasis attended in Helsinki University Hospital during 2014-2016. A total of 55 salivary stones were removed, and studied for biofilm formation using fluorescence microscopy and sonication. The isolated organisms were quantified and identified using matrix-assisted laser desorption ionization time-of-flight mass spectrometry.

Results: Biofilm formation was confirmed on the surface of 39 (70.9%) stones. A total of 96 microorganisms were isolated from 45 salivary stones (81.8%). Two or more organisms were isolated in 33 (73.3%) cases. The main isolates were Streptococcus mitis/oralis (n = 27; 28.1%), followed by Streptococcus anginosus (n = 10; 9.6%), Rothia spp. (n = 8; 8.3%), Streptococcus constellatus (n = 7; 7.3%), and Streptococcus gordonii (n = 6; 6.2%). In all patients showing pre-operative (12 cases) or peri-operative (three cases) drainage of pus, the presence of biofilm was detected in microscopy (p = 0.004). Four patients showed post-operative infection, and in three of them (75.0%), the presence of biofilm was detected. Increased number of pus drainage was found among patients with reflux symptoms or use of proton-pump inhibitors.

Conclusions: Salivary stones are susceptible to bacterial biofilm formation, which could be related with the development and severity of the inflammation and the refractory nature of the disease. Sonication of salivary gland stones could be a useful method for finding the etiology of the chronic infection.

Keywords: Biofilm; Salivary stones; Sialadenitis; Sialendoscopy; Sialolithiasis.

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Conflict of interest statement

No conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Representative fluorescent microscope images of the salivary stone showing adherent bacteria/biofilm. The samples A and B were stained with Acridine Orange (BD Diagnostics, Sparks, MD, USA). 20× magnification. Scale bar represents 100 µm
Fig. 2
Fig. 2
Scheme of procedure of salivary stones analysis
See this image and copyright information in PMC

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