Zuanazzi et al 7 reported that the most prevalent bacteria in th

Zuanazzi et al. 7 reported that the most prevalent bacteria in the saliva of hospitalized individuals were Staphylococcus spp. (85.7%), Pseudomonas spp. (83.8%), and Acinetobacter

spp. (53.3%). The results of another study suggested a possible peroral route for staphylococci, as the provision of microorganisms from the nasal cavity was shown. 8 Staphylococcus species are amongst the most frequent causes of bacteremia in mechanically ventilated patients.9 Further work in this area see more may lead to benefits such as improved decolonization regimens for eradication of MRSA and acknowledgement of the mouth as a source of bacteremia-causing staphylococci.10 Microorganisms of the Enterobacteriaceae and Pseudomonadaceae families have been thoroughly investigated by the medical field

and are known for their pathogenicity in humans; however, these bacteria have not been considered pathogenic in the oral cavity. Despite this, the presence of these bacteria in the oral cavity can serve as a reservoir, and can severely compromise the lives of immunocompromised individuals. 11, 12, 13 and 14 Some studies have reported an association between Enterobacteriaceae and oral ulcerations in HIV-positive patients, but this association may not find more necessarily be causal, as enterobacteria may be secondary invaders. 15 and 16 Local and systemic factors appear to be correlated with increased oral prevalence of Enterobacteriaceae and/or Pseudomonas. However, the percentage of oral isolates containing these species differs amongst reports from different groups and remains controversial. 3, 14, 17 and 18

Despite the importance of this subject, few studies of Enterobacteriaceae and/or Pseudomonas in the oral cavities of HIV-positive patients have been performed in Brazil. Most of the published studies have focused on Candida spp. Because oral reservoirs of potential pathogens such as enterobacteria and staphylococci may also cause local or systemic infections and compromise the lives of immunosuppressed individuals, the aim of this study was to evaluate the presence of Staphylococcus spp., Enterobacteriaceae and Pseudomonadaceae in the oral cavities Fossariinae of HIV-positive patients. This study was approved by the Local Ethics Committee (protocol number 012-PH/CEP) and was undertaken with the informed written consent of each subject. Forty-five individuals (23 female and 22 male), aged 22–66 years, HIV-positive as diagnosed by ELISA and confirmed by Western blot, undergoing treatment at the Day Hospital of Taubaté Medical School or Medical Specialties Center (São Paulo State; ARE), and having undergone anti-retroviral therapy for at least 1 year were included in the study. Of the total, 43% of the patients were undergoing highly active antiretroviral therapy (HAART), and the remaining patients were treated only with a protease inhibitor.

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