{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:51:30Z","timestamp":1790833890909,"version":"4.1.0"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T00:00:00Z","timestamp":1666915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:p>Potential interactions between the SARS-CoV-2 virus and the human oral microbiota are currently investigated widely. Patients with COVID-19 requiring mechanical ventilation in an intensive care unit (ICU) setting are at high risk of developing severe complications, including ventilator-associated pneumonia, thus making oral health management important. The aim of this study was to evaluate the oral health status and assess the dysbiosis of cultivable oral bacteriota in COVID-19 patients hospitalized in an ICU with acute respiratory distress within 36\u2009h following intubation. In this prospective cohort study, we recruited 56 adult COVID-19 patients that qualified for mechanical ventilation in the Temporary ICU for COVID-19 Patients of the University Hospital in Krakow. On admission to the ICU, oral health of patients was assessed using the modified Beck Oral Assessment Score (BOAS). Four oral habitats were sampled, namely the buccal mucosa, tongue, buccal dental surface and gingival pocket. Microorganisms were identified by MALDI\/TOF mass spectrometry. The mean age of the study population was 66.5\u2009\u00b1\u200912.7\u2009years, there were 24 (42.9%) females. All patients included in this study were intubated and ventilated in the ICU, with a corresponding high mortality rate (76.8%). On admission to ICU, 76.8% subjects scored 11\u201320 on the BOAS scale (median 12 [IQR 10\u201314]), indicating moderate or severe dysfunction of oral health. Potentially pathogenic bacteria were identified in the oral microbiota samples, including <jats:italic>Acinetobacter baumannii, Enterococcus faecalis, Escherichia coli and Klebsiella pneumoniae<\/jats:italic> in 23.2%, 39.3%, 17.9%, and 19.6% of patients, respectively. Lactobacillus spp. were present in 57.1% subjects. The mean CFU counts of all bacteria strains in dental brushes were 9.3E+5 (1.4E+6) and in gingival pockets 7.6E+5 (1.4E+6). The highest CFU counts were observed for <jats:italic>Enterococcus<\/jats:italic> spp. and, <jats:italic>Lactobacillus<\/jats:italic> spp., although these did not differ significantly from CFU counts of <jats:italic>Streptococcus<\/jats:italic> spp. and <jats:italic>Staphylococcus<\/jats:italic> spp. In this report we comprehensively characterized the oral health condition and cultivable oral bacteriota in COVID-19 patients hospitalized in an ICU with acute respiratory distress within 36\u2009h following intubation. The oral bacteriota showed significant qualitative and quantitative dysbiosis. Hospitalization in an ICU and mechanical ventilation are important factors leading to oral dysbiosis in SARS-CoV-2 patients.<\/jats:p>","DOI":"10.3389\/fmicb.2022.1013559","type":"journal-article","created":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T13:39:46Z","timestamp":1666964386000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Cultivable oral bacteriota dysbiosis in mechanically ventilated COVID-19 patients"],"prefix":"10.3389","volume":"13","author":[{"given":"Iwona","family":"Gregorczyk-Maga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateusz","family":"Fiema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Kania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanta","family":"K\u0119dzierska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estera","family":"Jachowicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorota","family":"Romaniszyn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jadwiga","family":"W\u00f3jkowska-Mach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e103","DOI":"10.4037\/ajcc2011359","article-title":"Effects of systematic Oral Care in Critically ill Patients: a multicenter study","volume":"20","author":"Ames","year":"2011","journal-title":"Am. J. Crit. Care"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1423","DOI":"10.3389\/fmed.2021.726753","article-title":"Oral manifestations of COVID-19: updated systematic review with meta-analysis","volume":"8","author":"Aragoneses","year":"2021","journal-title":"Front. Med."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1840","DOI":"10.3389\/fmicb.2020.01840","article-title":"Oral microbiome and SARS-CoV-2: beware of lung co-infection","volume":"11","author":"Bao","year":"2020","journal-title":"Front. Microbiol."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1097\/00002820-197906000-00002","article-title":"Impact of a systematic oral care protocol on stomatitis after chemotherapy","volume":"2","author":"Beck","year":"1979","journal-title":"Cancer Nurs."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12866-020-01801-y","article-title":"Defining the oral microbiome by whole-genome sequencing and resistome analysis: the complexity of the healthy picture","volume":"20","author":"Caselli","year":"2020","journal-title":"BMC Microbiol."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/j.mimet.2017.11.009","article-title":"Extensive evaluation of fastidious anaerobic bacteria recovery from the Copan eSwab\u00ae transport system","volume":"144","author":"Demuyser","year":"2018","journal-title":"J. Microbiol. Methods"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"5002","DOI":"10.1128\/JB.00542-10","article-title":"The human oral microbiome","volume":"192","author":"Dewhirst","year":"2010","journal-title":"J. Bacteriol."},{"key":"ref8","year":"2022"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1111\/scd.12705","article-title":"Oral lesions and saliva alterations of COVID-19 patients in an intensive care unit: a retrospective study","author":"Eduardo","year":"2022","journal-title":"Spec. Care Dentist."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1630","DOI":"10.3390\/microorganisms10081630","article-title":"Atypical presentation of aspergillus Niger infection in the oral cavity as a prediction of invasive pulmonary aspergillosis in a patient with COVID-19: case report and literature review","volume":"10","author":"Fiema","year":"2022","journal-title":"Microorg"},{"key":"ref11","author":"Flisiak","year":"2022"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1902\/jop.2011.100565","article-title":"Comparison of gingival Crevicular fluid sampling methods in patients with severe chronic periodontitis","volume":"82","author":"Guentsch","year":"2011","journal-title":"J. Periodontol."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e152346","DOI":"10.1172\/jci.insight.152346","article-title":"Inflammation-type dysbiosis of the oral microbiome associates with the duration of COVID-19 symptoms and long COVID","volume":"6","author":"Haran","year":"2021","journal-title":"JCI Insight"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1093\/ehjqcco\/qcab029","article-title":"Cardiovascular risk factors, cardiovascular disease, and COVID-19: an umbrella review of systematic reviews","volume":"7","author":"Harrison","year":"2021","journal-title":"Eur. Hear J. \u2013 Qual. Care Clin. Outcomes"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/jcm10040581","article-title":"Oral complications of ICU patients with COVID-19: case-series and review of two hundred ten cases","volume":"10","author":"Hockov\u00e1","year":"2021","journal-title":"J. Clin. Med."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1603","DOI":"10.3389\/fmicb.2021.671813","article-title":"Profiling of oral microbiota and cytokines in COVID-19 patients","volume":"12","author":"Iebba","year":"2021","journal-title":"Front. Microbiol."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41415-021-2656-1","article-title":"The impact of oral health status on COVID-19 severity, recovery period and C-reactive protein values","volume":"2021","author":"Kamel","year":"2021","journal-title":"Br. Dent. J."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1111\/cid.12357","article-title":"Antimicrobial effect of a single dose of amoxicillin on the oral microbiota","volume":"18","author":"Larsson Wexell","year":"2016","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1491","DOI":"10.3389\/fmicb.2022.895537","article-title":"The oral microbiota: community composition, influencing factors, pathogenesis, and interventions","volume":"13","author":"Li","year":"2022","journal-title":"Front. Microbiol."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1101\/2020.12.23.20248425","article-title":"Mechanical ventilation affects respiratory microbiome of COVID-19 patients and its 1 interactions with the host 2 3 chronic diseases and metabolism","volume":"10","author":"Llor\u00e9ns-Rico","year":"","journal-title":"Contag. Collab."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1186\/s13613-020-00775-4","article-title":"Ventilator-associated pneumonia in patients with SARS-CoV-2-associated acute respiratory distress syndrome requiring ECMO: a retrospective cohort study","volume":"10","author":"Luyt","year":"2020","journal-title":"Ann. Intensive Care"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12877-021-02716-7","article-title":"The impact of socioeconomic status, general health and oral health on health-related quality of life, oral health-related quality of life and mental health among polish older adults","volume":"22","author":"Malicka","year":"2022","journal-title":"BMC Geriatr."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1111\/jcpe.13435","article-title":"Association between periodontitis and severity of COVID-19 infection: a case\u2013control study","volume":"48","author":"Marouf","year":"2021","journal-title":"J. Clin. Periodontol."},{"key":"ref24","first-page":"e192","article-title":"A minimal common outcome measure set for COVID-19 clinical research","volume-title":"Lancet Infectious Diseases","author":"Marshall","year":"2020"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-019-55056-3","article-title":"Long-term impact of oral surgery with or without amoxicillin on the oral microbiome-a prospective cohort study","volume":"9","author":"Menon","year":"2019","journal-title":"Sci. Rep."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e0005521","DOI":"10.1128\/Spectrum.00055-21","article-title":"Oral microbiome alterations and SARS-CoV-2 saliva viral load in patients with COVID-19","volume":"9","author":"Miller","year":"2021","journal-title":"Microbiol. Spectr."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"104436","DOI":"10.1016\/j.micpath.2020.104436","article-title":"Marked virulence and azole resistance in Candida albicans isolated from patients with periodontal disease","volume":"148","author":"Monroy-P\u00e9rez","year":"2020","journal-title":"Microb. Pathog."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1603","DOI":"10.1111\/iej.13389","article-title":"Microbial ecology and predicted metabolic pathways in various oral environments from patients with acute endodontic infections","volume":"53","author":"Moraes","year":"2020","journal-title":"Int. Endod. J."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"106502","DOI":"10.1016\/j.ijantimicag.2021.106502","article-title":"Effect of antibiotics on the human microbiome: a systematic review","volume":"59","author":"Nel Van Zyl","year":"2022","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1177\/0022034514542468","article-title":"Newly identified pathogens associated with periodontitis: a systematic review","volume":"93","author":"P\u00e9rez-Chaparro","year":"2014","journal-title":"J. Dent. Res."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"163","DOI":"10.3389\/fmed.2022.821777","article-title":"Dysbiosis of oral and gut microbiomes in SARS-CoV-2 infected patients in Bangladesh: elucidating the role of opportunistic gut microbes","volume":"9","author":"Rafiqul Islam","year":"2022","journal-title":"Front. Med."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1177\/17571774211012448","article-title":"Healthcare-associated infections over an eight year period in a large university hospital in Sicily (Italy, 2011\u20132018)","volume":"22","author":"Russo Fiorino","year":"2021","journal-title":"J. Infect. Prev."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1397","DOI":"10.3389\/fmicb.2021.687513","article-title":"Oral microbiome Dysbiosis is associated with symptoms severity and local immune\/inflammatory response in COVID-19 patients: a cross-sectional study","volume":"12","author":"Soffritti","year":"2021","journal-title":"Front. Microbiol."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1111\/j.1600-051X.2011.01727.x","article-title":"The impact of hospitalization on oral health: a systematic review","volume":"38","author":"Terezakis","year":"2011","journal-title":"J. Clin. Periodontol."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"773","DOI":"10.33963\/KP.15990","article-title":"Association between cardiovascular disease, cardiovascular drug therapy, and in-hospital outcomes in patients with COVID-19: data from a large single-center registry in Poland","volume":"79","author":"Terlecki","year":"2021","journal-title":"Kardiol. Pol."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"258","DOI":"10.4161\/215055942014967608","article-title":"Integration of non-oral bacteria into in vitro oral biofilms","volume":"6","author":"Thurnheer","year":"2014","journal-title":"Virulence"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12903-022-02093-6","article-title":"Alterations in the oral microbiome of individuals with a healthy oral environment following COVID-19 vaccination","volume":"22","author":"Uehara","year":"2022","journal-title":"BMC Oral Health"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1016\/S0140-6736(20)30633-4","article-title":"Clinical course and mortality risk of severe COVID-19","volume":"395","author":"Weiss","year":"2020","journal-title":"Lancet"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1093\/femspd\/ftx031","article-title":"Neisseria models of infection and persistence in the upper respiratory tract","volume":"75","author":"Weyand","year":"2017","journal-title":"Pathog Dis."},{"key":"ref40","article-title":"WHO COVID-19 dashboard. [online] World Health Organization","year":"2022"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"370","DOI":"10.5603\/CJ.2013.0095","article-title":"Oral health status and the occurrence and clinical course of myocardial infarction in hospital phase: a case-control study","volume":"20","author":"Wozakowska-Kap\u0142on","year":"2013","journal-title":"Cardiol. J."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41522-021-00232-5","article-title":"Altered oral and gut microbiota and its association with SARS-CoV-2 viral load in COVID-19 patients during hospitalization","volume":"7","author":"Wu","year":"2021","journal-title":"NPJ Biofilms Microbiomes"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1111\/1462-2920.12502","article-title":"Oral cavity contains distinct niches with dynamic microbial communities","volume":"17","author":"Xu","year":"2015","journal-title":"Environ. Microbiol."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"42","DOI":"10.3390\/jcm11010042","article-title":"Oral health of COVID-19 patients using extracorporeal membrane oxygenation: a clinical study of 19 cases","volume":"11","author":"Yoshino","year":"2022","journal-title":"J. Clin. Med."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"e01693-15","DOI":"10.1128\/mBio.01693-15","article-title":"Same exposure but two radically different responses to antibiotics: resilience of the salivary microbiome versus long-term microbial shifts in feces","volume":"6","author":"Zaura","year":"2015","journal-title":"MBio"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1111\/prd.12359","article-title":"Optimizing the quality of clinical studies on oral microbiome: a practical guide for planning, performing, and reporting","volume":"85","author":"Zaura","year":"2001","journal-title":"Periodontol 2000"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2017\/8106491","article-title":"Examination of Oral microbiota diversity in adults and older adults as an approach to prevent spread of risk factors for human infections","volume":"2017","author":"Zawadzki","year":"2017","journal-title":"Biomed. Res. Int."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1016\/j.biopha.2018.01.146","article-title":"Human oral microbiota and its modulation for oral health","volume":"99","author":"Zhang","year":"2018","journal-title":"Biomed. Pharmacother."},{"key":"ref49","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1056\/NEJMoa2001017","article-title":"A novel coronavirus from patients with pneumonia in China, 2019","volume":"382","author":"Zhu","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref50","doi-asserted-by":"publisher","first-page":"3288","DOI":"10.1002\/jmv.26746","article-title":"Respiratory syndrome coronavirus-2 response: microbiota as lactobacilli could make the difference","volume":"93","author":"Zrelli","year":"2021","journal-title":"J. Med. Virol."}],"container-title":["Frontiers in Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2022.1013559\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T13:39:50Z","timestamp":1666964390000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2022.1013559\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,28]]},"references-count":50,"alternative-id":["10.3389\/fmicb.2022.1013559"],"URL":"https:\/\/doi.org\/10.3389\/fmicb.2022.1013559","relation":{},"ISSN":["1664-302X"],"issn-type":[{"value":"1664-302X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,28]]},"article-number":"1013559"}}