Colonización oral y orofaríngea por Enterobacteriaceae: una revisión narrativa sobre su epidemiología e impacto clínico

Abstract

The Enterobacteriaceae family encompasses a broad group of Gram-negative bacteria of the order Enterobacteriaceae, usual residents of the intestinal and urinary tracts, behaving only as allochthonous in the oral cavity. There is no consensus regarding prevalence, determinants and consequences of upper aero-digestive colonization by this family of bacteria. In view of this, a narrative review was made on the epidemiology and clinical impact of oral and oropharyngeal colonization by Enterobacteriaceae, differentiating by age groups. An organized bibliographic search was carried out in digital databases: PubMed/MEDLINE, Scielo, Google Scholar and Cochrane library of clinical and preclinical studies published in the last twenty years. Oral and oropharyngeal colonization by Enterobacteriaceae was 38.24 and 39%, respectively. The genera Enterobacter spp. (68.75%), Klebsiella spp. (68.75%), Escherichia spp. (43.75%), Citrobacter spp. (25%), Pantoea spp. (25%) were the most prevalent taxonomic groups in the oral cavity, especially in children and adolescents, while Klebsiella spp. (22.5%), Escherichia spp. (15.5%) and Enterobacter spp. (8%) were the most prevalent in the oropharyngeal area of elderly subjects. This colonization is associated with an increased risk of infectious and inflammatory episodes such as pneumonia, inflammatory bowel disease, periodontal disease, and progression of renal failure; with determinants that differ according to age, with periodontal disease being a shared risk factor for senile and nonsenile groups. The presence of enterobacteria in the upper aerodigestive tract is significant, dominating in infant-adolescents, promoted by various factors that differ according to age and with systemic consequences of an infectious or inflammatory nature in certain types of hosts.