AUTHOR=Pasman Raymond , Krom Bastiaan P. , Zaat Sebastian A. J. , Brul Stanley 

TITLE=The Role of the Oral Immune System in Oropharyngeal Candidiasis-Facilitated Invasion and Dissemination of Staphylococcus aureus

JOURNAL=Frontiers in Oral Health

VOLUME=3

YEAR=2022

URL=https://www.frontiersin.org/journals/oral-health/articles/10.3389/froh.2022.851786

DOI=10.3389/froh.2022.851786

ISSN=2673-4842

ABSTRACT=<p><italic>Candida albicans</italic> and <italic>Staphylococcus aureus</italic> account for most invasive fungal and bacterial bloodstream infections (BSIs), respectively. However, the initial point of invasion responsible for <italic>S. aureus</italic> BSIs is often unclear. Recently, <italic>C. albicans</italic> has been proposed to mediate <italic>S. aureus</italic> invasion of immunocompromised hosts during co-colonization of oral mucosal surfaces. The status of the oral immune system crucially contributes to this process in two distinct ways: firstly, by allowing invasive <italic>C. albicans</italic> growth during dysfunction of extra-epithelial immunity, and secondly following invasion by some remaining function of intra-epithelial immunity. Immunocompromised individuals at risk of developing invasive oral <italic>C. albicans</italic> infections could, therefore, also be at risk of contracting concordant <italic>S. aureus</italic> BSIs. Considering the crucial contribution of both oral immune function and dysfunction, the aim of this review is to provide an overview of relevant aspects of intra and extra-epithelial oral immunity and discuss predominant immune deficiencies expected to facilitate <italic>C. albicans</italic> induced <italic>S. aureus</italic> BSIs.</p>