Influence of TNF-α blockers on the oral prevalence of opportunistic microorganisms in ankylosing spondylitis patients
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Objectives: To compare the oral prevalence and antimicrobial susceptibility of Candida spp., staphylococci, enterobacteriaceae, and pseudomonas spp.from ankylosing spondylitis (AS) patients receiving conventional and anti-TNF-α therapy. Methods: The study included 70 AS patients, diagnosed according to the modified New York criteria (1984). The volunteers were divided into 2 groups: a biological group (AS BioG) (n=35) (on anti-TNF-α therapy) and a conventional group (AS ConvG) (n=35). The control group (ContG) (n=70) was made up of healthy individuals matched for age, gender, and oral conditions. After clinical examination, oral rinse samples were collected and plated in specific culture media. The number of colony-forming units per milliliter (cfu/ml) was obtained, and isolates were identified using the API system. Antimicrobial susceptibility tests were performed according to the NCCLS guidelines. Prevalence and counts of microorganisms were statistically compared between the 3 groups, using the Mann-Whitney and Chi-square tests. Significance level was set at 5%. Results: In both the AS BioG and the AS ConvG, staphylococci counts were higher than that in the ContG (p<0.0001). Candida albicans and staphylococcus epidermidis were the most commonly found species in all the groups. Serratia marcescens and klebsiella oxytoca were more prevalent in the AS BioG and the AS ConvG, respectively. Two Candida isolates (2.8%) from the AS BioG and 5 (10.8%) from the AS ConvG were resistant to amphotericin B and 5-fluorocytosine. A low percentage of staphylococci isolates was resistant to amoxicillin, ciprofloxacin, and doxycycline. Conclusion: Higher counts of staphylococci were observed in both AS groups, regardless of the current therapy, age, sex, and oral conditions. Anti-TNF-α therapy could not be correlated with increased counts of microorganisms. © Copyright CLINICAL AND EXPERIMENTAL RHEUMATOLOGY 2012.
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Ankylosing spondylitis Candida Infection Oral microbiology Staphylococcus Super-infection TNF-α blockers amoxicillin amphotericin B ampicillin antibiotic agent antifungal agent antiinfective agent azithromycin carbapenem cefalexin cephalosporin ciprofloxacin clindamycin doxycycline erythromycin fluconazole flucytosine ketoconazole methotrexate metronidazole nonsteroid antiinflammatory agent norfloxacin penicillin derivative quinoline derived antiinfective agent salazosulfapyridine tetracycline tumor necrosis factor alpha inhibitor adult ankylosing spondylitis antibiotic sensitivity Candida albicans colony forming unit controlled study culture medium disease duration Enterobacteriaceae female human infection risk Klebsiella oxytoca major clinical study male mouth cavity mouth disease nonhuman opportunistic infection prevalence priority journal Pseudomonas salivation Serratia marcescens Staphylococcus aureus Staphylococcus epidermidis superinfection Adult Anti-Infective Agents Bacterial Infections Brazil Chi-Square Distribution Colony Count, Microbial Cross-Sectional Studies Female Humans Immunologic Factors Male Microbial Sensitivity Tests Middle Aged Mouth Mouth Diseases Opportunistic Infections Predictive Value of Tests Prevalence Spondylitis, Ankylosing Tumor Necrosis Factor-alpha
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Clinical and Experimental Rheumatology, v. 30, n. 5, p. 679-685, 2012.
