[Oral microbiome in children with dystrophic recessive epidermolysis bullosa]

Area of Science:

• Oral microbiology
• Pediatric dermatology
• Wound healing

Background:

• Recessive dystrophic epidermolysis bullosa (RDEB) is a severe genetic skin disorder.
• Oral manifestations, including wounds and fibrosis, are common in RDEB patients.
• The role of oral microbiome in RDEB wound healing and fibrosis progression is not well understood.

Purpose of the Study:

• To assess the bacterial load in oral wounds of children with RDEB.
• To identify specific microorganisms present in RDEB oral wounds.
• To correlate bacterial load with RDEB severity, age, and fibrosis progression.

Main Methods:

• Bacteriological swabs were collected from oral wounds of 77 RDEB children and oral mucosa of 27 healthy controls.
• Microorganism growth was assessed after incubation at 37°C and 30°C for 24, 48, and 72 hours.
• Bacterial identification was performed using the MicroScan Walk Away system.

Main Results:

• High prevalence of Candida albicans (40.3%), Staphylococcus aureus (23.4%), Enterobacter cloacae (9.1%), and Enterobacteria (10.4%) was found in RDEB children's oral wounds.
• Candida albicans was also present in 26% of controls.
• Bacterial load correlated positively with age, with significant differences observed between age groups (3-6 vs. 7-10 years).
• Delayed oral wound healing was linked to a shift towards biofilm-producing bacteria like S. aureus and E. cloacae.

Conclusions:

• The oral wound microbiome in RDEB patients may indicate disease severity and fibrosis risk.
• Reducing bacterial load in oral wounds could be a strategy to prevent fibrosis and improve healing in RDEB.
• Targeting specific bacterial species may be crucial for managing oral complications in RDEB.