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Cultivable oral bacteriota dysbiosis in mechanically ventilated COVID-19 patients

Potential interactions between the SARS-CoV-2 virus and the human oral microbiota are currently investigated widely. Patients with COVID-19 requiring mechanical ventilation in an intensive care unit (ICU) setting are at high risk of developing severe complications, including ventilator-associated pn...

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Autores principales: Gregorczyk-Maga, Iwona, Fiema, Mateusz, Kania, Michal, Kędzierska, Jolanta, Jachowicz, Estera, Romaniszyn, Dorota, Wójkowska-Mach, Jadwiga
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9651008/
https://www.ncbi.nlm.nih.gov/pubmed/36386658
http://dx.doi.org/10.3389/fmicb.2022.1013559
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author Gregorczyk-Maga, Iwona
Fiema, Mateusz
Kania, Michal
Kędzierska, Jolanta
Jachowicz, Estera
Romaniszyn, Dorota
Wójkowska-Mach, Jadwiga
author_facet Gregorczyk-Maga, Iwona
Fiema, Mateusz
Kania, Michal
Kędzierska, Jolanta
Jachowicz, Estera
Romaniszyn, Dorota
Wójkowska-Mach, Jadwiga
author_sort Gregorczyk-Maga, Iwona
collection PubMed
description Potential interactions between the SARS-CoV-2 virus and the human oral microbiota are currently investigated widely. Patients with COVID-19 requiring mechanical ventilation in an intensive care unit (ICU) setting are at high risk of developing severe complications, including ventilator-associated pneumonia, thus making oral health management important. The aim of this study was to evaluate the oral health status and assess the dysbiosis of cultivable oral bacteriota in COVID-19 patients hospitalized in an ICU with acute respiratory distress within 36 h following intubation. In this prospective cohort study, we recruited 56 adult COVID-19 patients that qualified for mechanical ventilation in the Temporary ICU for COVID-19 Patients of the University Hospital in Krakow. On admission to the ICU, oral health of patients was assessed using the modified Beck Oral Assessment Score (BOAS). Four oral habitats were sampled, namely the buccal mucosa, tongue, buccal dental surface and gingival pocket. Microorganisms were identified by MALDI/TOF mass spectrometry. The mean age of the study population was 66.5 ± 12.7 years, there were 24 (42.9%) females. All patients included in this study were intubated and ventilated in the ICU, with a corresponding high mortality rate (76.8%). On admission to ICU, 76.8% subjects scored 11–20 on the BOAS scale (median 12 [IQR 10–14]), indicating moderate or severe dysfunction of oral health. Potentially pathogenic bacteria were identified in the oral microbiota samples, including Acinetobacter baumannii, Enterococcus faecalis, Escherichia coli and Klebsiella pneumoniae in 23.2%, 39.3%, 17.9%, and 19.6% of patients, respectively. Lactobacillus spp. were present in 57.1% subjects. The mean CFU counts of all bacteria strains in dental brushes were 9.3E+5 (1.4E+6) and in gingival pockets 7.6E+5 (1.4E+6). The highest CFU counts were observed for Enterococcus spp. and, Lactobacillus spp., although these did not differ significantly from CFU counts of Streptococcus spp. and Staphylococcus spp. In this report we comprehensively characterized the oral health condition and cultivable oral bacteriota in COVID-19 patients hospitalized in an ICU with acute respiratory distress within 36 h following intubation. The oral bacteriota showed significant qualitative and quantitative dysbiosis. Hospitalization in an ICU and mechanical ventilation are important factors leading to oral dysbiosis in SARS-CoV-2 patients.
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spelling pubmed-96510082022-11-15 Cultivable oral bacteriota dysbiosis in mechanically ventilated COVID-19 patients Gregorczyk-Maga, Iwona Fiema, Mateusz Kania, Michal Kędzierska, Jolanta Jachowicz, Estera Romaniszyn, Dorota Wójkowska-Mach, Jadwiga Front Microbiol Microbiology Potential interactions between the SARS-CoV-2 virus and the human oral microbiota are currently investigated widely. Patients with COVID-19 requiring mechanical ventilation in an intensive care unit (ICU) setting are at high risk of developing severe complications, including ventilator-associated pneumonia, thus making oral health management important. The aim of this study was to evaluate the oral health status and assess the dysbiosis of cultivable oral bacteriota in COVID-19 patients hospitalized in an ICU with acute respiratory distress within 36 h following intubation. In this prospective cohort study, we recruited 56 adult COVID-19 patients that qualified for mechanical ventilation in the Temporary ICU for COVID-19 Patients of the University Hospital in Krakow. On admission to the ICU, oral health of patients was assessed using the modified Beck Oral Assessment Score (BOAS). Four oral habitats were sampled, namely the buccal mucosa, tongue, buccal dental surface and gingival pocket. Microorganisms were identified by MALDI/TOF mass spectrometry. The mean age of the study population was 66.5 ± 12.7 years, there were 24 (42.9%) females. All patients included in this study were intubated and ventilated in the ICU, with a corresponding high mortality rate (76.8%). On admission to ICU, 76.8% subjects scored 11–20 on the BOAS scale (median 12 [IQR 10–14]), indicating moderate or severe dysfunction of oral health. Potentially pathogenic bacteria were identified in the oral microbiota samples, including Acinetobacter baumannii, Enterococcus faecalis, Escherichia coli and Klebsiella pneumoniae in 23.2%, 39.3%, 17.9%, and 19.6% of patients, respectively. Lactobacillus spp. were present in 57.1% subjects. The mean CFU counts of all bacteria strains in dental brushes were 9.3E+5 (1.4E+6) and in gingival pockets 7.6E+5 (1.4E+6). The highest CFU counts were observed for Enterococcus spp. and, Lactobacillus spp., although these did not differ significantly from CFU counts of Streptococcus spp. and Staphylococcus spp. In this report we comprehensively characterized the oral health condition and cultivable oral bacteriota in COVID-19 patients hospitalized in an ICU with acute respiratory distress within 36 h following intubation. The oral bacteriota showed significant qualitative and quantitative dysbiosis. Hospitalization in an ICU and mechanical ventilation are important factors leading to oral dysbiosis in SARS-CoV-2 patients. Frontiers Media S.A. 2022-10-28 /pmc/articles/PMC9651008/ /pubmed/36386658 http://dx.doi.org/10.3389/fmicb.2022.1013559 Text en Copyright © 2022 Gregorczyk-Maga, Fiema, Kania, Kędzierska, Jachowicz, Romaniszyn and Wójkowska-Mach. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Microbiology
Gregorczyk-Maga, Iwona
Fiema, Mateusz
Kania, Michal
Kędzierska, Jolanta
Jachowicz, Estera
Romaniszyn, Dorota
Wójkowska-Mach, Jadwiga
Cultivable oral bacteriota dysbiosis in mechanically ventilated COVID-19 patients
title Cultivable oral bacteriota dysbiosis in mechanically ventilated COVID-19 patients
title_full Cultivable oral bacteriota dysbiosis in mechanically ventilated COVID-19 patients
title_fullStr Cultivable oral bacteriota dysbiosis in mechanically ventilated COVID-19 patients
title_full_unstemmed Cultivable oral bacteriota dysbiosis in mechanically ventilated COVID-19 patients
title_short Cultivable oral bacteriota dysbiosis in mechanically ventilated COVID-19 patients
title_sort cultivable oral bacteriota dysbiosis in mechanically ventilated covid-19 patients
topic Microbiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9651008/
https://www.ncbi.nlm.nih.gov/pubmed/36386658
http://dx.doi.org/10.3389/fmicb.2022.1013559
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