Management of Streptococcus mutans-Candida spp. Oral Biofilms’ Infections: Paving the Way for Effective Clinical Interventions

Abstract

Oral diseases are considered the most common noncommunicable diseases and are related to serious local and systemic disorders. Oral pathogens can grow and spread in the oral mucosae and frequently in biomaterials (e.g., dentures or prostheses) under polymicrobial biofilms, leading to several disorders such as dental caries and periodontal disease. Biofilms harbor a complex array of interacting microbes, increasingly unapproachable to antimicrobials and with dynamic processes key to disease pathogenicity, which partially explain the gradual loss of response towards conventional therapeutic regimens. New drugs (synthesized and natural) and other therapies that have revealed promising results for the treatment or control of these mixed biofilms are presented and discussed here. A structured search of bibliographic databases was applied to include recent research. There are several promising new approaches in the treatment of Candida spp.–Streptococcus mutans oral mixed biofilms that could be clinically applied in the near future. These findings confirm the importance of developing effective therapies for oral Candida–bacterial infections.

Candida albicans—The Virulence Factors and Clinical Manifestations of Infection

“…are present on all tooth surfaces–enamel, dentin, and cementum. C. albicans grows in enamel cracks and grooves and can penetrate through open dentin tubules [ 75 , 76 ]. Several Candida spp.…”

Fascial space odontogenic infections: Ultrasonography as an alternative to magnetic resonance imaging

“…Pathogens can also be introduced into deeper oral tissues by trauma during dental procedures. The treatment consists of removal of the source of infection, systemic antibiotics, and area drainage[ 4 , 7 , 8 ].…”

Sorting out the Superbugs: Potential of Sortase A Inhibitors among Other Antimicrobial Strategies to Tackle the Problem of Antibiotic Resistance

“…These include (however are not restricted to): The notoriously known multidrug-resistant (MDRSA) and methicillin-resistant (MRSA) Staphylococcus aureus strains [ 6 ]; Staphylococcus epidermidis —for long thought to be a mere opportunistic microorganism, but recently shown to be implicated in medical device-related infections, keratitis, and bacteremia [ 7 ]; Clostridium difficile, which is considered one of the most frequent causes of hospital-acquired gastrointestinal tract infections [ 8 , 9 ]; different enterococci, some of which (e.g., Enterococcus faecalis and E. faecium ) can be responsible for bacteremia and endocarditis in addition to urinary tract, intra-abdominal, pelvic, and soft tissue infections [ 10 ]. Whereas some other (non-nosocomial) relevant Gram-positive pathogens worth a mention are Streptococcus mutans —associated with oral diseases and infective endocarditis [ 11 , 12 ]; Streptococcus pneumoniae —capable of causing pneumonia, meningitis, sepsis, bacteremia, and otitis [ 13 ]; Listeria monocytogenes —a significant cause of foodborne listeriosis outbreaks with a fatality rate of up to 30% [ 14 , 15 ]; causative agent of zoonotic anthrax— Bacillus anthracis , for which antibiotic resistance may not yet be an urgent matter, but potentially relevant [ 16 , 17 ].…”