Evaluation of the dynamics of oral pathogenic microbiota in COVID-19 patients by genomic sequencing after application of foam with antimicrobial action

Relevance. The COVID-19 pandemic caused by the SARS-CoV-2 virus has demonstrated the critical importance of understanding the mechanisms of transmission and finding effective methods of prevention. Particular attention has been paid to the role of oral hygiene, as the oral cavity serves as a major route of transmission. Studies show that the composition of the oral microbiota can influence the course and outcome of COVID-19 disease. Therefore, there is a need to study the effects of oral antiseptics on the microbiome, which may offer new opportunities for the prevention and treatment of this disease.

Objective. The aim of this study is to evaluate the effectiveness of the oral cleansing foam «Parodontol PROF» in reducing the pathogenic microflora of the oral cavity in patients with COVID-19 and to assess its effect on the risk of secondary infections.

Materials and methods. The study was conducted on the basis of the Clinical Medical Centre «Kuskovo» of Russian University of Medicine. It included 450 patients with a confirmed diagnosis of COVID-19. The participants were divided into two groups: the test group used oral cleansing foam, while the control group used no additional oral hygiene. Comparative analyses of the taxonomic composition of the oropharyngeal microbiota and dental plaque before and after the use of the cleansing foam were performed.

Results. The study showed that patients who regularly used the cleansing foam «Parodontol PROF» had a significant decrease in the representation of pathogens, including Mycoplasma, and an increase in the number of beneficial commensals such as Lactococcus and Lactobacillus. These changes indicate the potential efficacy of this product to improve oral hygiene and reduce the risk of secondary infections.

Conclusion. The study supports the hypothesis that improving oral hygiene with specialised antiseptic agents, such as a cleansing foam, may help to reduce pathogenic microflora in the oral cavity in patients with COVID-19. This, in turn, may reduce the risk of pathogen migration into the lower respiratory tract and the development of secondary infections. The findings emphasise the importance of further research in this area and the development of comprehensive approaches to oral hygiene management in the context of infectious diseases.

1. Hoffmann D. The role of the oral cavity in SARS-CoV-2- and other viral infections / D. Hoffmann // Clinical Oral Investigations. – 2023. – Vol. 27. – № Suppl 1. – P. 15–22.

2. Dysbiosis of Oral and Gut Microbiomes in SARS-CoV-2 Infected Patients in Bangladesh: Elucidating the Role of Opportunistic Gut Microbes / S.M.R. Islam, M.J. Foysal, M. N. Hoque [и др.]. – Текстs: электронный // Frontiers in Medicine. – 2022. – Т. 9. – Dysbiosis of Oral and Gut Microbiomes in SARS-CoV-2 Infected Patients in Bangladesh. – URL: https://www.frontiersin.org/articles/10.3389/fmed.2022.821777/full (дата обращения: 16.01.2024).

3. Oral Microbiome and SARS-CoV-2: Beware of Lung Co-infection / L. Bao, C. Zhang, J. Dong [и др.]. – Текстs: электронный // Frontiers in Microbiology. – 2020. – Т. 11. – Oral Microbiome and SARS-CoV-2. – URL: https://www.frontiersin.org/articles/10.3389/fmicb.2020.01840/full (дата обращения: 16.01.2024).

4. 104 Inflammation-Type Dysbiosis of the Oral Microbiome Associates With the Duration of Coronavirus Disease 2019 (COVID-19) and Long COVID Disease States / J. Haran, E. Bradley, A. Zeamer [и др.]. – Текстs: электронный // Annals of Emergency Medicine. – 2021. – Т. 78. – С. 47-47. – URL: https://www.sciencedirect.com/science/article/pii/S019606442100665X?via%3Dihub (дата обращения: 16.01.2024).

5. Emerging role of bacteria in oral carcinogenesis: a review with special reference to perio-pathogenic bacteria / M. Perera, N. N. Al-Hebshi, D. J. Speicher [и др.] // Journal of Oral Microbiology. – 2016. – Т. 8. – Emerging role of bacteria in oral carcinogenesis. – С. 32762.

6. Acquiring and maintaining a normal oral microbiome: current perspective / E. Zaura, E. A. Nicu, B. P. Krom, B. J. F. Keijser // Frontiers in Cellular and Infection Microbiology. – 2014. – Т. 4. – Acquiring and maintaining a normal oral microbiome. – С. 85.

7. Deo P. N. Oral microbiome: Unveiling the fundamentals / P. N. Deo, R. Deshmukh. – Texts: electronic // Journal of Oral and Maxillofacial Pathologys: JOMFP. – 2019. – Vol. 23. – Oral microbiome. – № 1. – P. 122–128. – URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6503789/ (date accessed: 02.02.2024).

8. COVID-19 and Its Effect on Dentistry / A. Sharma, R. Balpande, A. Shrivastava [и др.] // Journal of Advances in Medicine and Medical Research. – 2020. – С. 14–24.

9. Oral Microbiome Dysbiosis Is Associated With Symptoms Severity and Local Immune/Inflammatory Response in COVID-19 Patients: A Cross-Sectional Study / I. Soffritti, M. D’Accolti, C. Fabbri [и др.]. – Текстs: электронный // Frontiers in Microbiology. – 2021. – Т. 12. – Oral Microbiome Dysbiosis Is Associated With Symptoms Severity and Local Immune/Inflammatory Response in COVID-19 Patients. – URL: https://www.frontiersin.org/articles/10.3389/fmicb.2021.687513 (дата обращения: 11.11.2023).

10. Use of an antiviral mouthwash as a barrier measure in the SARS-CoV-2 transmission in adults with asymptomatic to mild COVID-19: a multicentre, randomized, double-blind controlled trial / F. Carrouel, M. Valette, E. Gadea [et al.]. – Texts: electronic // Clinical Microbiology and Infection. – 2021. – Vol. 27. – Use of an antiviral mouthwash as a barrier measure in the SARS-CoV-2 transmission in adults with asymptomatic to mild COVID-19. – № 10. – P. 1494–1501. – URL: https://linkinghub.elsevier.com/retrieve/pii/S1198743X21002688 (date accessed: 26.09.2023).

11. Efficacy of commercial mouth-rinses on SARS-CoV-2 viral load in saliva: randomized control trial in Singapore. / C.J. Seneviratne, P. Balan, K.K.K. Ko [и др.] // Infection. – 2020. – Т. 49. – № 2. – С. 305-311.

12. Antiviral Activity of Reagents in Mouth Rinses against SARS-CoV-2 / F. Carrouel, L.S. Gonçalves, M. P. Conte [и др.] // Journal of Dental Research. – 2021. – Т. 100. – № 2. – С. 124–132.

13. Evaluation of Current Evidence on the Use of Oral Antiseptics Against SARS-CoV-2: A Narrative Review / V. Chumpitaz-Cerrate, L. Chávez-Rimache, E. Ruiz-Ramirez [и др.] // Journal of International Society of Preventive and Community Dentistry. – 2022. – Т. 12. – Evaluation of Current Evidence on the Use of Oral Antiseptics Against SARS-CoV-2. – № 5. – С. 488–499.

14. Oral antiseptics against coronavirus: in-vitro and clinical evidence / M.V. Mateos Moreno, A.M. Obrador, V.A. Márquez, M.D. Ferrer García // Journal of Hospital Infection. – 2021. – Т. 113. – Oral antiseptics against coronavirus. – С. 30–43.

15. Antimicrobial mouthwashes (gargling) and nasal sprays administered to patients with suspected or confirmed COVID-19 infection to improve patient outcomes and to protect healthcare workers treating them / M.J. Burton, J.E. Clarkson, B. Goulao [et al.]. – Texts: electronic // Cochrane Database of Systematic Reviews. – 2020. – № 9. – URL: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013627.pub2/full/ru (date accessed: 31.01.2024).

16. Sampson V. Oral hygiene risk factor / V. Sampson. – Texts: electronic // British Dental Journal. – 2020. – Vol. 228. – № 8. – P. 569-569. – URL: https://www.nature.com/articles/s41415-020-1545-3 (date accessed: 31.01.2024).

17. Mani K. Role of oral health during COVID-19 / K. Mani, J. Karini. – Texts: electronic // International Journal of Research in Medical Sciences. – 2021. – Vol. 9. – № 1. – P. 324–324. – URL: https://www.msjonline.org/index.php/ijrms/article/view/9024 (date accessed: 31.01.2024).

18. Effects of xylitol-containing chewing gum on the oral microbiota / K. Takeuchi, M. Asakawa, T. Hashiba [и др.] // Journal of Oral Science. – 2018. – Т. 60. – № 4. – С. 588–594.

19. Exploration of singular and synergistic effect of xylitol and erythritol on causative agents of dental caries / S. Kõljalg, I. Smidt, A. Chakrabarti [и др.] // Scientific Reports. – 2020. – Т. 10. – № 1. – С. 6297.

20. Xylitol, a Promising Allied for Oral Heath / E.G D. Siqueira Fraga, F. M. Teófilo Campos, M.P.D. Silva Cavalcante [и др.]. – Текстs: электронный // Journal of Young Pharmacists. – 2020. – Т. 12. – № 3. – С. 197-200. – URL: http://www.jyoungpharm.org/article/1499 (дата обращения: 31.01.2024).

21. Marquis R. E. Antimicrobial actions of fluoride for oral bacteria / R.E. Marquis // Canadian Journal of Microbiology. – 1995. – Т. 41. – № 11. – С. 955–964.

22. Bacterial viability in oral biofilm after tooth brushing with amine fluoride or sodium fluoride / E.A. Naumova, L. Weber, V. Pankratz [и др.]. – Текст: электронный // Archives of Oral Biology. – 2019. – Т. 97. – С. 91–96. – URL: https://www.sciencedirect.com/science/article/pii/S0003996918303042 (дата обращения: 31.01.2024).

23. Killing of Gram-positive cocci by fatty acids and monoglycerides / G. Bergsson, J. Arnfinnsson, O. Steingrímsson, H. Thormar // APMIS: acta pathologica, microbiologica, et immunologica Scandinavica. – 2001. – Т. 109. – № 10. – С. 670–678.

24. Vergara-Buenaventura A. Use of mouthwashes against COVID-19 in dentistry / A. Vergara-Buenaventura, C. Castro-Ruiz. – Текстs: электронный // British Journal of Oral and Maxillofacial Surgery. – 2020. – Т. 58. – № 8. – С. 924–927. URL: https://www.bjoms.com/article/S0266-4356(20)30403-4/fulltext (дата обращения: 02.02.2024).

25. Shklair I. L. The Inhibitory Effect of Sodium N-Lauroyl Sarcosinate On Oral Lactobacilli When Grown On Various Media / I.L. Shklair, K.C. Hoerman, H.R. Englander. – Texts: electronic // Journal of Dental Research. – 1957. – Vol. 36. – № 1. – P. 129–131. – URL: https://doi.org/10.1177/00220345570360010701 (date accessed: 31.01.2024).

26. Mouthrinses against SARS-CoV-2: anti-inflammatory effectivity and a clinical pilot study / M. Schürmann, M. Aljubeh, C. Tiemann, H. Sudhoff // European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. – 2021. – Vol. 278. – Mouthrinses against SARS-CoV-2. – № 12. – P. 5059–5067.

27. Emerging technologies and potential applications of algae in dentistry – A critical review / A. Balasubramaniam, M. Arumugham I, S. Nathan P [и др.]. – Текстs: электронный // Journal of Biotechnology. – 2022. – Т. 360. – С. 1–10. – URL: https://www.sciencedirect.com/science/article/pii/S0168165622002309 (дата обращения: 31.01.2024).