Toothbrushes may convey bacteria to the cystic fibrosis lower airways

Rebeca Passarelli Mantovani,Angela Sandri,Marzia Boaretti,Alessandra Grilli,Sonia Volpi,Paola Melotti,Gloria Burlacchini,Maria M Lleò,Caterina Signoretto

doi:10.1080/20002297.2019.1647036

Rebeca Passarelli Mantovani, Angela Sandri + Show 7 more

Open Access

https://doi.org/10.1080/20002297.2019.1647036

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Abstract

ABSTRACTRecent findings indicate that the oral cavity acts as a bacterial reservoir and might contribute to the transmission of bacteria to the lower airways. Control of a potentially pathogenic microbiota might contribute to prevent the establishment of chronic infection in cystic fibrosis. We evaluated the presence of CF microorganisms in saliva and toothbrushes of CF patients and verify their possible transmission to lower airways.Methods: We assessed the presence of P. aeruginosa, S. aureus, S. maltophilia, A. xylosoxidans, S. marcescens, and yeasts in saliva, toothbrushes and sputum of 38 CF patients and assessed the clonal identity of the strains occurring contemporary in multiple sites by PFGE.Results: At least one of the investigated species was isolated from 60 saliva samples and 23 toothbrushes. S. aureus was the most abundant species, followed by Candida spp. 31 patients contemporary had the same species in sputum and saliva/toothbrush: in most cases, clonal identity of the strains among the different sites was confirmed.Conclusion: Toothbrushes may be sources of oral contamination and might act as reservoirs favoring transmission of potentially pathogenic microorganisms from the environment to the oral cavity and eventually to the LAW. Oral hygiene and toothbrush care are important strategies to prevent CF lung infections.

Highlights

S. aureus was the most abundant species, followed by Candida spp. 31 patients contemporary had the same species in sputum and saliva/toothbrush: in most cases, clonal identity of the strains among the different sites was confirmed
In this study we aimed at evaluating the presence of classical Cystic fibrosis (CF) bacterial species, namely P. aeruginosa and S. aureus, as well as other potentially pathogenic microorganisms recently isolated more and more frequently such as S. maltophilia, A. xylosoxidans, Serratia marcescens and Candida spp., in saliva, toothbrushes and sputum of CF patients
At least one of the investigated species was contemporary present in sputum and saliva of 31 patients; among these, 10 presented with a positive toothbrush in the same period. These data suggested the occurrence of bacteria transmission between airways and mouth/toothbrush, we must consider that during the expectoration procedure cross-contamination between sputum and saliva might happen

Summary

Objectives

In this study we aimed at evaluating the presence of classical CF bacterial species, namely P. aeruginosa and S. aureus, as well as other potentially pathogenic microorganisms recently isolated more and more frequently such as S. maltophilia, A. xylosoxidans, Serratia marcescens and Candida spp., in saliva, toothbrushes and sputum of CF patients. We aimed to evaluate the presence of typical and emerging CF bacterial species, namely P. aeruginosa, S. aureus, S. maltophilia, A. xylosoxidans and S. marcescens in saliva and in toothbrushes of CF patients, both adults and pediatrics

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Results

Conclusion