| Autor: |
Twigg JA; School of Dentistry, Cardiff University, Wales, UK.; Present address: School of Dentistry, University of Leeds, Leeds, UK., Smith A; Faculty of Health and Applied Science, University West of England, Bristol, UK., Haury C; School of Dentistry, Cardiff University, Wales, UK., Wilson MJ; School of Dentistry, Cardiff University, Wales, UK., Lees J; Centre for High Frequency Engineering, Cardiff University, Wales, UK., Waters M; School of Dentistry, Cardiff University, Wales, UK., Williams DW; School of Dentistry, Cardiff University, Wales, UK. |
| Abstrakt: |
Introduction. Bacterial pneumonia is a common cause of morbidity and mortality in elderly individuals. While the incidence of edentulism is falling, approximately 19 % of the UK population wear a full or partial removable denture. Despite advances in denture biomaterials, the majority of dentures are fabricated using polymethyl-methacrylate. Growing evidence suggests that colonization of the oral cavity by putative respiratory pathogens predisposes individuals to respiratory infection, by translocation of these microorganisms along the respiratory tract. Hypothesis/Gap Statement. We hypothesized that denture surfaces provide a susceptible colonization site for putative respiratory pathogens, and thus could increase pneumonia risk in susceptible individuals. Aim. This study aimed to characterize the bacterial community composition of denture-wearers in respiratory health compared with individuals with a confirmed diagnosis of pneumonia. Methodology. This was an analytical cross-sectional study, comparing frail elderly individuals without respiratory infection ( n =35) to hospitalized patients with pneumonia ( n =26). The primary outcome was the relative abundance of putative respiratory pathogens identified by 16S rRNA metataxonomic sequencing, with quantitative PCR used to identified Streptococcus pneumoniae . Results. There was a statistically significant increase in the overall relative abundance of putative respiratory pathogens ( P <0.0001), with a greater than 20-fold increase in the bioburden of these microorganisms. In keeping with these findings, there were significant shifts in bacterial community diversity (Chao index, P =0.0003) and richness (Inverse Simpson index P <0.0001) in the denture-associated microbiota of pneumonia patients compared with control subjects. Conclusion. Within the limitations of this study, our evidence supports the role of denture acrylic biomaterials as a potential colonization site for putative respiratory pathogens, which may lead to an increased risk of pneumonia in susceptible individuals. These findings support prior observational studies which have found denture-wearers to be at increased risk of respiratory infection. Further research is needed to confirm the sequence of colonization and translocation to examine potential causal relationships. |
