Evaluation of Staphylococcus Aureus and Pseudomonas Aeruginosa in Saliva of Patients with Acute Myeloid Leukemia.

​Statement of the Problem: Patients with leukemia are prone to infectious and often life-threatening complications. Evidence suggests that a specific oral microbiota may contribute to septicemia, which can delay antineoplastic treatment, compromise treatment efficacy, or even endanger patients' lives. Purpose: This study investigated the prevalence of Staphylococcus aureus and Pseudomonas aeruginosa in the saliva of patients with acute myeloid leukemia who were candidates for bone marrow transplantation. Materials and Method: This cross-sectional study was conducted in 2019 in the Hematology-Oncology Department of Namazi Hospital, Shiraz University of Medical Sciences. The study included 28 patients with acute myeloid leukemia eligible for bone marrow transplantation as the case group and age- and sex-matched healthy individuals as the control group. Unstimulated saliva samples were collected to determine the frequency of Staphylococcus aureus and Pseudomonas aeruginosa. Data were analyzed using SPSS version 18, the chi-square test, and the independent t-test. Results: In the patients with acute myeloid leukemia, 26 (86%) were positive for Staph-ylococcus aureus and 18 (60%) were positive for Pseudomonas aeruginosa. In the healthy group, 11 (22.9%) were positive for Staphylococcus aureus and 3 (6.2%) were positive for Pseudomonas aeruginosa. The frequency of Pseudomonas aeruginosa and Staphylococcus aureus in the saliva samples of patients with acute myeloid leukemia was significantly higher than in the healthy control subjects (p value < 0.05). Chi-square test showed no significant association between age and the frequency of bacteria (p value= 0.27). Conclusion: In the current study, the frequency of Staphylococcus aureus and Pseudomonas aeruginosa in the saliva of patients with acute myeloid leukemia was higher than in the healthy control group.

Co-Infection Rates between SARS-CoV-2 and RSV in Oropharyngeal, Nasopharyngeal Aspirate and Saliva Samples of COVID-19 Patients, Shiraz, South of Iran.

Statement of the Problem: Determining the prevalence of respiratory viruses' coinfection with coronavirus disease 2019 (COVID-19) is essential to defining its true clinical influence. Purpose: This study aimed to evaluate co-infection rates between severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) and respiratory syncytial virus (RSV) in infected patients in Shiraz, south of Iran. Materials and Method: In a cross-sectional descriptive study, oropharyngeal, nasopharyngeal aspirate (NPA), and saliva samples of 50 COVID-19 patients who were referred to Ali-Asghar hospital (Shiraz, Iran) from March to August 2020, were collected. A control group consisted of age and sex-matched healthy participants. The nasopharyngeal and oropharyngeal aspirates were collected by sterile swabs. All cases were hospitalized, and all SARS-CoV-2 patients had a fever and respiratory symptoms. The samples were packed in a vial with 1 mL of transport medium and transported to the Valfagre specialty laboratory, where they were tested for RSV using a real-time polymerase chain reaction (PCR). Results: 100 nasopharyngeal/oropharyngeal aspirates and saliva samples including 50 healthy controls (24 females, 26 males) and 50 COVID-19 patients' samples (27 males and 23 females) were studied. There was no significant difference regarding age as well as gender between both groups (p> 0.05). None of the healthy subjects was infected with RSV; however, 5(10%) patients from COVID-19 group were infected with the RSV virus. Chi-square test did not show a significant difference between RSV infection in COVID-19 patients and healthy subjects. Conclusion: The outcome of present research showed that concurrent RSV with COVID 19 infection might be seen in hospitalized patients in Shiraz Southwest of Iran. For more reliable findings, further research on bigger populations, including more pathogens in several places around the country, and considering the severity of symptoms is required.

Isolation and Identification of Non- Commensal Pathogenic Bacteria in the Saliva of Patients Candidate for Liver Transplant: A Cross Sectional Study in Shiraz, South of Iran.

STATEMENT OF THE PROBLEM: Liver cirrhosis is the end stage of liver failure. It is mentioned as one of the main etiologies of morbidity and mortality in the world. The human salivary bacteria may induce oral disorders and interact with other body microbiota. PURPOSE: The aim of the present study is to identify the pathogenic bacteria of non-oral origin from the saliva samples of patients with end stage liver failure. MATERIALS AND METHOD: In this cross-sectional study, the saliva samples of 88 end stage liver disease cases and 84 age- and sex-matched healthy subjects were collected. The samples were cultured using gram staining and API20E Kit. RESULTS: According to the statistical analysis, the total amount of the non-commensal bacteria was significantly higher in chronic liver failure (CLF) group than controls (p= 0.001). There was no significant difference between both groups for the presence of other bacteria (p= 0.001) except for Escherichia coli (E. coli). E. coli was isolated from the saliva of 15 cases and only 2 controls. CONCLUSION: Oral cavity may act as a reservoir for enteric bacteria such as E. coli in liver failure patients. Adequate oral and general hygiene might reduce the risk of systemic infection especially in immunocompromised cases.

PCR Detection of HHV8 DNA in the Saliva of Removable Denture Wearers Compared to Dentate Cases in Shiraz, South of Iran.

RESULT: In the denture wearers, HHV8 DNA was detected in 11 cases. Two of the controls amplified HHV8 DNA. Fisher's exact test demonstrates a significant difference between virus infection and using removable dentures (p = 0.015). CONCLUSION: Our findings suggested that HHV8 detection could be associated with use of denture.

The LncRNA H19 rs217727 Polymorphism Is Associated with Oral Squamous Cell Carcinoma Susceptibility in Iranian Population.

Lack of protein-coding capacity is a main characteristic of long noncoding RNAs (lncRNAs) which, as molecular biomarkers, have found a novel pharmacological application in cancer and are reported to be important regulators of gene expression. H19 is reportedly involved in cancer progression and tumorigenesis. One of the most common types of head and neck cancers is oral squamous cell carcinoma (OSCC). The main objective of the present study was to evaluate the correlation of OSCC susceptibility with H19 gene in an Iranian population. This research was performed on 400 subjects of both sexes referred to the Namazi Hospital affiliated with the Shiraz University of Medical Sciences (SUMS). Individuals aged 15-88 years were divided into two groups: pathologically diagnosed patients with new-onset OSCC and healthy controls. After written and informed consent was obtained from the individuals, genomic DNA was extracted. The tetra-primer ARMS-PCR technique was performed for DNA genotyping by the use of specific primer pairs. The susceptibility of OSCC and H19 gene polymorphism sites was further analyzed (rs217727 and rs2107425). The allele and genotype frequencies of H19 rs2107425 polymorphism were similar between OSCC cases and controls. The H19 rs217727T allele frequency was significantly higher in OSCC cases (P = 0.002), and the polymorphism of H19 rs217727 was associated with OSCC susceptibility in the codominant (OR = 6.04, 95%CI = 1.70 - 21.42, P = 0.001 for TT genotype), dominant (OR = 1.62, 95%CI = 1.08 - 2.43, P = 0.01), and recessive (OR = 5.32, 95%CI = 1.51 - 18.69, P = 0.003) models. This study showed that rs217727 and OSCC susceptibility were statistically correlated in the Iranian population.

Isolation of Enterococcus faecalis in the saliva samples of patient candidates for liver transplantation.

BACKGROUND: Liver transplantation has turn into a standard management for chronic liver failure (CLF), and the number of recipients increased during the last few years. Enterococci are progressively related to nosocomial and opportunistic infections. Oral cavity may act as a reservoir for this species, especially in cases with oral infection. Immunocompromised patients are prone to serious enterococci-related disease. This study investigated the prevalence of Enterococcus faecalis in the saliva samples of patient candidates for liver transplantation. MATERIALS AND METHODS: In this cross-sectional study the saliva samples of 100 patient candidates for liver transplantation and 100 age- and sex-matched healthy control group were collected. Bacterial DNA was extracted from the samples and E. faecalis was detected using polymerase chain reaction test. Fisher's exact test and Mann-Whitney test were used to correlate the positive and negative cases with the disease. Statistically, a significant difference was considered when P < 0.05. RESULTS: There was no significant difference between both groups for the presence of E. faecalis. This bacterium isolated from the saliva of two cases in the study group and only one healthy control. The higher rate of carious teeth were detected in the oral cavity of CLF cases than control group (P = 0.001). CONCLUSION: Patients with chronic liver diseases assessed in this research showed a higher incidence of poor oral health and caries compared with the healthy controls, but there was no statistical difference in the presence of E. faecalis in saliva samples of each group. Complete oral examination, dental treatment, and oral hygiene instruction are necessary for all these cases before liver transplantation.

A Radiographic Evaluation of Missing of Permanent First Molars in a Group of Iranian Children and Adults: A Retrospective Study.

The missing of permanent first molars influences the occlusal status and dental health. The purpose of this study was to determine the prevalence of missing first molar teeth in a selected population of Shiraz, Iran. Methods. A total of 2206 panoramic views of patients aged from 7 to 75 years old were inspected for missing of permanent first molars. Patients were categorized into five age groups: from 7 to 15, 16 to 30, 31 to 45, 46 to 60, and more than 60 years old. Data were categorized according to sex, age, and number of lost teeth using SPSS software. Results. No first molar was missing in 59.9% of the cases, 17.05% had lost one, 10.4% had lost two, 7.2% had lost three, and 5% were missing all four of their permanent first molars. The mandibular first molar was the most commonly lost tooth, and the left side in both jaws was more affected than the right side. There was a positive relation between age and missing first molar. Conclusions. A missing first molar is a common finding in southern Iran population. Due to the important role of permanent first molars in occlusion, more education and dental care is recommended to preserve these teeth.

Isolation and Identification of Nonoral Pathogenic Bacteria in the Oral Cavity of Patients with Removable Dentures.

AIMS AND OBJECTIVES: Dentures in the oral cavity may act as a reservoir of microorganisms, which may be related to systemic infections. The aim of this study was to investigate the nonoral pathogenic bacteria in the oral cavity of patients with removable dentures in Shiraz, Southern Iran. MATERIALS AND METHODS: The bacterial flora of saliva samples from 50 men and 50 women with removable dentures and 100 age- and sex-matched controls with normal dentate were compared using culture, Gram staining, and API20E Kit methods. All data were analyzed using SPSS software. RESULTS: Except for Enterobacter cloacae isolate (P = 0.03), there was no significant difference between both groups for the presence of Escherichia coli, Klebsiella pneumoniae, nonfermenting Gram-negative bacilli, Raoultella ornithinolytica, Raoultella planticola, Kluyvera spp., and Enterobacter aerogenes. No significant correlation was noticed between age and presence of bacteria in the oral cavity. The Gram-negative rod bacteria were more in males, but the difference was not significant. When a total of Gram-negative rods were considered, there was a significant difference between case and control groups (P = 0.004). CONCLUSIONS: Based on our findings that nonoral pathogenic bacteria are detected from the saliva of the denture wearers, general and oral health measures in patients with removable dentures should be adopted to decrease the risk of cross infection.

In vitro comparison of cytotoxic and antibacterial effects of 16 commercial toothpastes.

BACKGROUND: Toothpastes are considered as one of the most common and usable cosmetic and hygienic materials. Such materials contain chemicals which may have an adverse effect on oral tissue in humans. The present study aimed to compare the toxic effect of current commercial toothpastes including Iranian products and imported types which are consumed globally on oral epithelial- and HeLa cells as well as to evaluate their antibacterial effect on Streptococcus mutans in Shiraz, Iran. MATERIALS AND METHODS: In this experimental study, 16 types of commercial toothpastes were prepared, and their effect was determined on primer epithelial cells of the oral cavity and HeLa cells. Toothpastes anti streptococcal property and toxicity were examined in vitro in different intervals of 1, 2, and 5 min. Data collection and analysis were done using one-way analysis of variance. RESULTS: All experimented toothpastes revealed variable toxic effects on cultured cells. Through an increase in the time of exposure with toothpastes, the toxicity of these materials substantially increased (P = 0.005). On the other hand, all tested toothpastes showed varying degrees of anti-streptococcal effect in the laboratory (P = 0.005). CONCLUSIONS: The most cytotoxic effect on primer epithelial cells of oral mucosa and HeLa cells, respectively, belongs to Bath, Daroogar2, Latifeh2, Crend, Sehat, Nasim and Aqua fresh toothpastes; however, the least cytotoxic effect on primer epithelial cells of oral mucosa and HeLa cells, respectively, belongs to Pronamel followed by Crest (sensitive), Close-up, Oral-B, Signal, Colgate, Paradent, and AME.

Ctla-4 gene polymorphism in +49 a/g position: a case control study on patients with oral lichen planus.

BACKGROUND: Oral lichen planus (OLP) is a premalignant mucocutaneous disease in which genetic factors and immune responses play a major role. Cytotoxic T Lymphocyte Antigen-4 (CTLA-4) is a co-inhibitory molecule that down-regulates immune responses to prevent autoimmunity. This study aimed to investigate the relationship between polymorphism of the CTLA-4 gene in +49 A/G position and OLP. MATERIALS AND METHODS: Thirty-five patients with OLP (16 males, 19 females, with a mean age of [± standard deviation (SD)] 55.92 [± 12.83]) and 105 sex- and aged-matched healthy subjects (48 males, 57 females, with a mean age of [± SD] 56.82 [± 14.71]) were recruited in this study. Genomic DNA of both groups was extracted from white blood cells and then CTLA-4 genotypes and allele frequencies were investigated using polymerase chain reaction-restriction fragment length polymorphism methods. The data were collected and examined using Pearson's Chi square test (SPSS version 11.5). RESULTS: In the patient group, AA, AG, and GG genotypes occurred in position 49 A/G in the CTLA-4 gene with the frequency of 19 (55.9%), 11 (31.4%), and 3 (8.8%), respectively. With respect to the control group, they occurred with the frequency of 58 (55.2%), 39 (37.1%), and 8 (7.6%), respectively. As far as the frequency of A and G alleles in this position was concerned, we had, respectively, 49 (74.24%) and 17 (25.75%) for patients and, respectively, 155 (73.80%) and 55 (26.19%) for the control group. The calculated values were not significantly different between these groups (P > 0.05). CONCLUSION: Polymorphisms of CTLA-4 genes in position +49 A/G did not show any significant relationship with each other in OLP patients in Shiraz, Iran.