Effect of Probiotics on Oral Candidiasis: A Systematic Review and Meta-Analysis.

Tiziana Mundula,Beatrice Barbetta,Michela Baccini,Amedeo Amedei,Federica Ricci

doi:10.3390/nu11102449

Tiziana Mundula, Beatrice Barbetta + Show 3 more

Open Access

https://doi.org/10.3390/nu11102449

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Abstract

Oral candidiasis (OC) is an increasing health problem due to the introduction of new drugs, population aging, and increasing prevalence of chronic illness. This study systematically reviews the effects of the oral intake of probiotics, prebiotics, and synbiotics on Candida spp. counts (colony-forming units (CFU)/mL) in oral and palatal samples. A literature search was conducted. Twelve studies, eight randomized clinical trials (RCTs), and four pre-post studies, resulted as eligible for the meta-analysis, which was performed through a Bayesian random-effects model. All studies analyzed probiotics, and none of them analyzed prebiotics or synbiotics. The treatments effects were measured in terms of odds ratio (OR) of OC (CFU/mL >102, 103, or 104). The meta-analytic OR was 0.71 (95% credibility interval (CrI): 0.37, 1.32), indicating a beneficial effect of treatment; the I2 index was 56.3%. Focusing only on RCTs, the OR was larger and more precise at 0.53 (95% CrI: 0.27, 0.93). The effect of treatment appeared to be larger on denture wearers. Our findings indicate that the intake of probiotics can have a beneficial effect on OC and that the effects could vary according to the patients’ characteristics. Due to the presence of medium–high-risk studies, the results should be interpreted with caution.

Highlights

IntroductionCandida spp. represent a commensal yeast belonging to the normal microbiota localized on the surface of different body sites (skin, oral cavity, and the gastro-intestinal, uro-genital, and respiratory tracts) of human beings [1]
Candida spp. represent a commensal yeast belonging to the normal microbiota localized on the surface of different body sites of human beings [1]
In the mouth; when there is a detection of a salivary Candida spp. count >400 colony-forming units (CFU) per mL, an infection occurs called “oral candidiasis” (OC) [4]

Summary

Introduction

Candida spp. represent a commensal yeast belonging to the normal microbiota localized on the surface of different body sites (skin, oral cavity, and the gastro-intestinal, uro-genital, and respiratory tracts) of human beings [1]. Candida spp. colonization of the mucus membranes occurs very early in life, usually at birth [2]. The fungus can switch from a harmless form into a pathogenic form that can lead to infections [3]. About 75% of healthy adults carry Candida spp. in the mouth; when there is a detection of a salivary Candida spp. count >400 colony-forming units (CFU) per mL, an infection occurs called “oral candidiasis” (OC) [4]. OC is predominantly caused by Candida albicans and by other species like Candida parapsilosis, Candida metapsilosis, Candida tropicalis, Candida khmerensis [5], Candida glabrata [6], and Candida dubliniensis [7].

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