Korolenkova M V, Poberezhnaya A A, Dmitrieva N A
Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia.
Moscow Regional Research Institute named after M.F. Vladimirskiy, Moscow, Russia.
Stomatologiia (Mosk). 2022;101(1):46-52. doi: 10.17116/stomat202210101146.
Was to assess bacterial load in oral wounds in children with recessive dystrophic epidermolysis bullosa (RDEB).
The study comprised 77 RDEB children aged 3-18 years (mean age 9.5±3.6 years) and 27 healthy children aged 4-18 years (mean age 9.8±4.1 years) who served as controls. Swabs for bacteriological study were taken from the oral wounds in RDEB patients and non-affected corresponding oral mucosa areas in controls. The microorganism growth was assessed after 24, 48 and 72 hours of incubation (37 °C and 30 °C) with subsequent identification in automatic bacteriological analyzer MicroScan Walk Away (Simens, USA). Results. The study revealed high prevalence and concentrations of Candida albicans (in 40.3% children), Staphilococcus aureus (23.4%), Enterobacter cloacae (9.1%), and Enterobacteria (10.4%) in RDEB children. From these species, only Candida albicans was present in controls (26%). The prevalence and concentration of commensal and pathogenic species correlated positively with age and significant difference was revealed between children at the age of 3-6 and 7-10 years (=0.001). Thus, bacterial load in oral wounds correlates with the RDEB natural history and fibrosis progression. Delayed oral wound healing was associated with microbiome shift towards biofilm-producing bacteria Staphilococcus aureus and Enterobacter cloacae.
Oral wounds microbiome may be an indicator of RDEB severity and tendency to oral fibrosis. The decrease of bacterial load in the oral wounds may remove one of the healing obstacles and serve as fibrosis prevention measure.
评估隐性营养不良型大疱性表皮松解症（RDEB）患儿口腔伤口中的细菌载量。
该研究纳入了77名3至18岁的RDEB患儿（平均年龄9.5±3.6岁）和27名4至18岁的健康儿童（平均年龄9.8±4.1岁）作为对照。从RDEB患者的口腔伤口以及对照者未受影响的相应口腔黏膜区域采集用于细菌学研究的拭子。在37°C和30°C孵育24、48和72小时后评估微生物生长情况，随后在自动细菌分析仪MicroScan Walk Away（美国西门子公司）中进行鉴定。结果：研究发现RDEB患儿中白色念珠菌（40.3%的患儿）、金黄色葡萄球菌（23.4%）、阴沟肠杆菌（9.1%）和肠杆菌（10.4%）的患病率和浓度较高。在这些菌种中，对照者中仅存在白色念珠菌（26%）。共生菌和病原菌的患病率及浓度与年龄呈正相关，3至6岁和7至10岁儿童之间存在显著差异（P = 0.001）。因此，口腔伤口中的细菌载量与RDEB的自然病程和纤维化进展相关。口腔伤口愈合延迟与微生物群落向产生物膜细菌金黄色葡萄球菌和阴沟肠杆菌的转变有关。
口腔伤口微生物群可能是RDEB严重程度和口腔纤维化倾向的一个指标。降低口腔伤口中的细菌载量可能消除愈合障碍之一，并作为预防纤维化的措施。
