Prevalência e sensibilidade aos antimicrobianos de microrganismos potencialmente superinfectantes na cavidade bucal de pacientes com espondilite anquilosante em uso de terapia anti TNF
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Data
2010-06-21
Autores
Pereira, Daniel Freitas Alves [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A espondilite anquilosante (EA) é uma doença inflamatória crônica de etiologia desconhecida, caracterizada pelo acometimento predominante do esqueleto axial. A terapia convencional inclui o uso de antiinflamatórios não hormonais e drogas anti-reumáticas modificadoras da evolução da doença (DMARDs). O uso de agentes imunobiológicos, como o anti-TNF, tem sido considerada uma excelente opção terapêutica em casos mais graves e refratários, porém estudos prévios demonstraram maior risco de infecções após o tratamento. Reservatórios bucais de microrganismos oportunistas podem causar infecções sistêmicas, uma vez que a cavidade bucal representa uma porta de entrada para patógenos, especialmente em pacientes imunocomprometidos. O objetivo do presente estudo foi avaliar a presença e a sensibilidade aos antimicrobianos de Candida spp., Staphylococcus spp., Enterobacteriaceae e Pseudomonas spp. na cavidade bucal de pacientes com EA em uso de anti-TNF comparando-os com indivíduos controle. Foram incluídos no estudo: grupo anti-TNF (35 indivíduos, diagnosticados portadores de EA com idade entre 17 a 63 anos e sob terapia anti-TNF); grupo Convencional (35 pacientes portadores de EA, com idade entre 21 e 74 anos sob tratamento convencional não imunobiológico; e respectivos grupos controle composto por indivíduos saudáveis pareados na idade, gênero e condições bucais aos grupos com EA. Foram realizados exame clínico, anamnese, bem como coleta de enxágüe bucal de cada indivíduo a qual foi semeada em meios de cultura específicos para cada microrganismo e posterior obtenção do número de unidades formadoras de colônia por militros (UFC/mL). Os isolados foram identificados pelo Sistema API, bem como fora realizados testes de sensibilidade aos antifúngicos dos isolados de leveduras, e, antibióticos dos isolados bacterianos...
The Ankylosing Spondylitis (AS) is a chronic inflammatory disease of unknown etiology, particularly characterized by a compromise of the axial skeleton. The conventional therapy includes the use of non-hormonal anti-inflammatory and Disease-modifying antirheumatic drugs (DMARDs). The use of immunobiological agents, such as anti-TNF, has been considered an excellent therapeutical option in more serious and refractory cases. However, previous studies demonstrated an increased risk of infections after the treatment is completed. Oral reservoirs of opportunist microorganisms can cause systemic infections, once that the oral cavity represents a door of entrance for pathogens, especially in immunocompromised patients. The aim of the present study was to evaluate the presence and antimicrobial susceptibility of Candida spp., Staphylococcus spp., Enterobacteriaceae and Pseudomonas spp. in the oral cavity of patients with AS treated with anti-TNF in comparison to healthy individuals. The following groups were included in the study: anti-TNF group (35 AS patients, aged between 17 and 63 years and under anti-TNF therapy); Conventional group (35 AS patients aged between 21 and 74 years under non-immunobiological conventional treatment); and respective Control groups (composed by healthy individuals paired in age, gender and oral conditions with AS groups). After clinical examination and anamnesis, oral rinses of each individual was collected. The rinses were plated in specific culture media for each microorganism. The number of colony-forming units per milliters (CFU/mL) was obtained. Isolates were identified by API system. Next, sensitivity tests to antifungicals agents were done for yeasts isolates and antibiotics for bacterial isolates. For Staphylococcus spp., the CFU counts for the anti-TNF group and Conventional group was statistically higher than the respective control groups... (Complete abstract click electronic access below)
The Ankylosing Spondylitis (AS) is a chronic inflammatory disease of unknown etiology, particularly characterized by a compromise of the axial skeleton. The conventional therapy includes the use of non-hormonal anti-inflammatory and Disease-modifying antirheumatic drugs (DMARDs). The use of immunobiological agents, such as anti-TNF, has been considered an excellent therapeutical option in more serious and refractory cases. However, previous studies demonstrated an increased risk of infections after the treatment is completed. Oral reservoirs of opportunist microorganisms can cause systemic infections, once that the oral cavity represents a door of entrance for pathogens, especially in immunocompromised patients. The aim of the present study was to evaluate the presence and antimicrobial susceptibility of Candida spp., Staphylococcus spp., Enterobacteriaceae and Pseudomonas spp. in the oral cavity of patients with AS treated with anti-TNF in comparison to healthy individuals. The following groups were included in the study: anti-TNF group (35 AS patients, aged between 17 and 63 years and under anti-TNF therapy); Conventional group (35 AS patients aged between 21 and 74 years under non-immunobiological conventional treatment); and respective Control groups (composed by healthy individuals paired in age, gender and oral conditions with AS groups). After clinical examination and anamnesis, oral rinses of each individual was collected. The rinses were plated in specific culture media for each microorganism. The number of colony-forming units per milliters (CFU/mL) was obtained. Isolates were identified by API system. Next, sensitivity tests to antifungicals agents were done for yeasts isolates and antibiotics for bacterial isolates. For Staphylococcus spp., the CFU counts for the anti-TNF group and Conventional group was statistically higher than the respective control groups... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Espondilite anquilosante, Infecções oportunistas, Antimicrobianos, Microbiota bucal, Ankylosing Spondylitis, Superinfection
Como citar
PEREIRA, Daniel Freitas Alves. Prevalência e sensibilidade aos antimicrobianos de microrganismos potencialmente superinfectantes na cavidade bucal de pacientes com espondilite anquilosante em uso de terapia anti TNF. 2010. 177 p. Dissertação (mestrado) – Universidade Estadual Paulista, Faculdade de Odontologia de São José dos Campos, 2010.