Oral Microflora: A Comparative Study in HIV and Normal Patients

Abstract

The study was designed to compare the oral microbiota in normal and HIV-infected individuals. The study tries to establish a significant shift in oral microflora in HIV-infected patients. Antibiotic sensitivity testing was performed to establish any rise in resistance against the antibiotics. It was a two and half year prospective study conducted in a tertiary care centre. The study group consisted of eighty subjects divided into two groups of control and HIV. The age range for this group was 9-75 years. The mean age in this group was 39.7 years. The male:female ratio was 2.75:1. Tuberculosis was the most common opportunistic infection in patients with HIV infection. The most common commensal micro organism isolated was the Viridans streptococci in 60% followed by Streptococcus pneumoniae in 23.33%. HIV Group: The most common commensal micro organism isolated was the Viridans streptococci in 42%; this was followed by the Micrococci spp. in 22% cases. S. pneumoniae was isolated in 6% of cases. The colony count for Viridans streptococci showed a heavy growth in 55.56% of cases in controls whereas the same in HIV group was 62.5%. Micrococcus spp. was isolated from 11 subjects in HIV group while it was not isolated from the controls. 50% subjects in the HIV group showed a heavy growth of Klebsiella spp. whereas controls showed only moderate and scanty growth. In patients with CD4? T cell count less than 50 cells/ll we found a heavy colonization of the oral cavity with Micrococcus spp., Acinetobacter and Klebsiella spp. Viridans streptococcus was not isolated in any of the patients with CD4? T cell count less than 50 cells/ll. As CD4? T cells counts improved to 51-100 cells/ll Viridans streptococcus colonies returned and 37.5% patients showed a heavy growth. Micrococcus spp. colonies were isolated till the CD4? T cells improved up to 300 cells/ll. At counts [ 300 cells/ll the oral microbiota became comparable to that of the controls. Many of the opportunistic infections in HIV are caused by commensal bacteria which are otherwise harmless in a normal individual. Our study is unique in that such a study of the oral commensals in HIV patients has never been reported. We found an increased colonization of the oral cavity by Micrococcus spp. which is a normal commensal of the skin.

Exploring salivary microbiota in AIDS patients with different periodontal statuses using 454 GS-FLX Titanium pyrosequencing

“…However, classic periodontal pathogens were not significantly different between these two groups. These results are supported by previous suggestions that uncommon species might affect the process of periodontitis in AIDS patients (Hegde et al, 2014 ). Forty-five unique OTUs that were found in HIV-related necrotic periodontitis, suggesting that they might play roles in the pathogenesis of necrotic lesion, but further analysis in future studies will be needed to test this.…”

“…A study also using the oral rinsing sampling method found that when compared with healthy controls there was a shift in oral microflora in HIV infected patients with a reduction in the isolation of Viridans streptococci and S. pneumoniae , but an increase in Micrococcus sp. (Hegde et al, 2014 ). While a comparison of those patients with HIV that had been treated with antiretroviral therapy, those who were antiretroviral naïve, and healthy controls using tongue samples and PCR/microarray methods showed that potential pathogenic Veillonella, Prevotella, Megasphaera , and Campylobacter were increased in antiretroviral naïve HIV infection while commensal Streptococcus and Veillonella species and Neisseria flavescens were lower (Dang et al, 2012 ).…”

“…Previous studies analyzed AIDS patients' saliva using conventional techniques (selective media and PCR techniques) (Hegde et al, 2014 ; Mukherjee et al, 2014 ). Using the 454 pyrosequencing technology, the present study was the first to identify the phylotypes at a 3% cutoff level to assess the bacteria present in the oral cavity of AIDS subjects in relation with their periodontal health.…”

“…A previous study compared the microbiota between healthy controls and patients with HIV, and showed that patients with HIV had an increased oral colonization by Micrococcus sp. (a normal commensal of the skin) (Hegde et al, 2014 ). Another study showed that Entamoeba gingivalis , an oral commensal, had pathogenic potentials in immunocompromised individuals (Cembranelli et al, 2013 ).…”

Common bacterial cultures from oral mucosa after hematopoietic stem cell transplantation: dependence on the patient characteristics and therapeutic factors

“…It comprises, mostly, saprophytic and oppor-tunistic bacteria. In particular, the microflora of normal oral mucosa is well known, and the most common bacterial species are identified [1,2]. Members of normal oral microbiota exist as com-mensal flora in a symbiotic state within host tissue, thus suppressing colonization with more path-ogenic bacterial species as presented in excellent review by Hull, Chow [1].…”