Isolation of Enterococcus faecalis in the saliva samples of patient candidates for liver transplantation

Abstract

Background: Liver transplantation has turn into a standard management for chronic liver
failure (CLF), and the number of recipients increased during the last few years. Enterococci are
progressively related to nosocomial and opportunistic infections. Oral cavity may act as a reservoir
for this species, especially in cases with oral infection. Immunocompromised patients are prone to
serious enterococci‑related disease. This study investigated the prevalence of Enterococcus faecalis
in the saliva samples of patient candidates for liver transplantation.
Materials and Methods: In this cross‑sectional study the saliva samples of 100 patient candidates
for liver transplantation and 100 age‑ and sex‑matched healthy control group were collected.
Bacterial DNA was extracted from the samples and E. faecalis was detected using polymerase chain
reaction test. Fisher’s exact test and Mann–Whitney test were used to correlate the positive and
negative cases with the disease. Statistically, a significant difference was considered when P < 0.05.
Results: There was no significant difference between both groups for the presence of E. faecalis.
This bacterium isolated from the saliva of two cases in the study group and only one healthy
control. The higher rate of carious teeth were detected in the oral cavity of CLF cases than control
group (P = 0.001).
Conclusion: Patients with chronic liver diseases assessed in this research showed a higher
incidence of poor oral health and caries compared with the healthy controls, but there was no
statistical difference in the presence of E. faecalis in saliva samples of each group. Complete oral
examination, dental treatment, and oral hygiene instruction are necessary for all these cases before
liver transplantation.
Key Words: Enterococcus faecalis, liver transplantation, saliva