Staphylococcal flora of the oral cavity and dental prostheses before and after kidney transplantation. Part
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Katedra Protetyki Stomatologicznej, Warszawski Uniwersytet Medyczny Department of Prosthodontics, Medical University of Warsaw
Katedra Mikrobiologii Lekarskiej, Warszawski Uniwersytet Medyczny Department of Medical Microbiology, Medical University of Warsaw
Publication date: 2019-03-12
Prosthodontics 2019;69(1):7-30
Background Introduction. Staphylococcal bacteria through their ability to create biofilms and adhere to plastic surfaces easily inhabit foreign objects introduced into the body. Dentures, often used 24 hours a day, create conditions for the development and multiplication of microorganisms, being a convenient site for their accumulation. Patients with renal insufficiency and those who receive kidney transplants constitute a group at high risk of exposure to bacterial infections, and dental prostheses may be their potential source. Aim Objective. To analyse the structure of colonization of dental prostheses and pharyngeal mucosa with Staphylococci in patients treated with kidney organ transplantation, and to assess the impact of prosthesis use and hygiene pattern on the species composition of the bacterial flora at the studied sites. Material and methodsThe material consisted of 278 samples of clinical material from patients using prostheses, which in the form of direct swabs were collected from the mucosal surface of the pharynx and the mucosal side of the prosthesis plate from 57 patients treated with kidney organ transplantation (the study group) and 27 generally healthy people (the control group). In the study group, 28 patients were distinguished, in whom the swabs were taken three times in the period between 0 and 12 months after surgery. For isolated strains, identification and drug resistance examination were carried out. The results were subjected to statistical analysis. Results Staphylococci were isolated from the surface of the pharyngeal mucosa and prostheses with similar frequency in both groups, and the most common species was S. epidermidis, whose isolation rate reached 50%. Among patients in the study group subjected to one-year follow-up, the incidence of S. epidermidis was progressively decreasing from 48.84% to 18.6%. The S. aureus species was isolated from the surface of the prosthesis only in the case of the study group subjects. In the study group only the duration of denture use did affect the number of Staphylococcal strains on dentures, not prosthesis hygiene or the 24-hour period of use. Conclusions The Staphylococcal flora of the renal transplant recipients does not show significant differences in the colonization structure of denture surfaces and pharynx mucous membrane surfaces in comparison with the generally healthy people. The surface of the prosthesis plate promotes the accumulation and development of bacteria, conditioning a more stable microbiota than the surface of the pharyngeal mucosa. Improper use of prostheses may lead to an increase in colonization with Staphylococcus species.
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