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.