Introduction

The human microbiome is a key player in the balance between health and disease. Insights into the diversity and organization of the complex microbial ecosystem that inhabits the human oral cavity are crucial to understand possible impacts on health and disease, at the oral or systemic levels (Wade 2013; Tuganbaev et al. 2022). Oral microbiomes are characterized by high richness and diversity. About 800 bacterial species have been reported in the human mouth and aerodigestive tract (i.e. pharynx, nasal passages, sinuses, and esophagus), most of which (76%) are culturable, although only 58% are officially named (The Human Microbiome Oral Database, http://www.homd.org – HOMD V3, accessed at 23 November 2022). More than half of these taxa (481 out of 789) are specifically associated with a nasal/oral or oral body site and observed to belong to 12 Bacteria and one Archaea phyla (HOMD V3).

In healthy humans, the core oral microbiome is dominated by members of six phyla, which account for more than 90% of the taxa identified (HOMD V3): Bacillota (formerly Firmicutes), Actinobacteriota (Actinobacteria), Pseudomonadota (formerly Proteobacteria), Fusobacteriota (formerly Fusobacteria), Bacteroidota (formerly Bacteroidetes), and Spirochaetota (formerly Spirochaetes) (Deo and Deshmukh 2019; Zhang et al. 2018). Nonetheless, the structure of the core microbiota, i.e. the relative proportions of each taxon, is supposed to vary. Determinant factors include the geography and diet, the anatomic and physiologic characteristics of the host, as well as the oral cavity site, and consequent biofilm formation, oxygen and nutrient availability, exposure to host immunological factors, among others (Zhigang Ren et al. 2021; Sampaio-Maia et al. 2016; Zhang et al. 2018; Wang et al. 2022b). The broad diversity of oral microbiomes was evidenced by Tierney et al. (2019) who, based on the analysis of 1473 oral metagenomes, identified 23 961 508 genes, half of which were unique in each metagenome. Such a uniqueness has led some authors to propose the oral microbiome profile as a valuable tool for biogeography investigations or forensic personal discrimination (Wang et al. 2022a, 2022b).

The interconnections between phylogenetic diversity and ecology of the microbiota inhabiting the oral cavity, and the possible relationship with host conditions (e.g. age, diet, physical condition), are supposed to have important implications in human health (Burcham et al. 2020; Sampaio-Maia et al. 2016; Tang et al. 2019; Hayes et al. 2018; Dashper et al. 2019). Indeed, the nexus between the oral and gut microbiome is a topic of interest in the exploitation of the oral microbiota (Teil Espina et al. 2019; Iwauchi et al. 2019). Considering that a milliliter of saliva may contain 8–9 log-units of microbial cells, some of which can multiply every 3–4 h, it can be estimated that 1–3 g of microbial biomass can be ingested per day (Edgar et al. 2012). Given the capacity of some of these microbial cells to survive and colonize the host’s gut, a balanced and stable oral microbiota is an essential barrier to prevent pathogen colonization and infection and, therefore, oral and/or systemic infections and/or inflammatory symptoms (Albuquerque-Souza and Sahingur 2022; Ren et al. 2021; Sampaio-Maia et al. 2016; Willis et al. 2020). The interface environment-human has received a renewed attention under the One Health perspective that considers a continuum between humans, animals, and the natural environment (Cunningham et al. 2017; Osterhaus et al. 2020). Accordingly, the human microbiome is affected by the surrounding environment, with the geography, diet, and lifestyle shaping its structure (Cunningham et al. 2017; Osterhaus et al. 2020). In particular, the oral microbiome is expected to be influenced by external conditions that include not only the range of microorganisms to which humans are exposed, for instance, via food products, but also by lifestyle and hygiene habits (Freire et al. 2020; Peters et al. 2018; Tang et al. 2019; Wang et al. 2022a, 2022b).

Pseudomonadota are reported among the predominant phyla in the natural environments, which frequently are under anthropic impacts (Chen et al. 2019; Ferro et al. 2019; Higgins et al. 2018; Nazareno Scaccia et al. 2021; Vaz-Moreira et al. 2014; 2017). In turn, Pseudomonadota include some of the most ubiquitous bacterial groups, as well as a vast array of opportunistic pathogens, for which existing antibacterial drugs may be ineffective (e.g. Acinetobacter, Pseudomonas, Enterobacteriaceae) (Ferro et al. 2019; Jordi Rello et al. 2019; Vaz-Moreira et al. 2014; Rizzatti et al. 2017; Theuretzbacher et al. 2020). Curiously, in spite of these clinically relevant features and although Pseudomonadota are the second most abundant phylum in the mouth (Wang et al. 2022b), not much attention has been given to its presence. Indeed, in discussions about the oral microbiome and its relevance, Pseudomonadota are frequently underexplored when compared with other groups (Radaic and Kapila 2021; Zhang et al. 2018). This review aims at addressing this topic by making, for the first time, an overview of the diversity and ecology of Pseudomonadota in the oral cavity.

In healthy individuals, oral Pseudomonadota are mostly represented by members of the families Neisseriaceae, Pasteulleraceae, and Campylobacteraceae, although the distribution of bacteria may be site- and subject-specific (Aas et al. 2005; Jiang et al. 2019; Zaura et al. 2009). It has been also reported that Pseudomonadota tend to increase in the oral cavity with the age and are frequently associated with inflammatory diseases (Iwauchi et al. 2019; Singh et al. 2019) and other non-infectious disorders (Costa et al. 2021; Rizzatti et al. 2017). However, further insights about Pseudomonadota diversity in the oral cavity will better elucidate the role of the oral cavity as an entry portal for environmental clinically relevant bacteria. With the increasing capacity to have holistic insights across the One Health microbiomes, new opportunities to explore the environment-oral-gut microbiome nexus emerge. This perspective not only will shed additional light into beneficial interactions and how they can promote health, but also will contribute to better understand how some antibiotic resistance or virulence determinants may have access into the human oral microbiome, or how the oral microbiome may be related with health impairment.

This review addresses the hypothesis that the human oral cavity is exposed to different groups of Pseudomonadota, some of which can also thrive in the external environment. It is also hypothesized that given their specific physiological and biochemical, intrinsic or acquired, properties some of these Pseudomonadota may be able to colonize other parts of the human body, and act as vectors of antibiotic resistance or as opportunistic infections. The approach to test the abovementioned hypotheses was to review the literature and databases available, list the most commonly reported Pseudomonadota in the oral cavity and, based on this information, infer about their ecology and distribution, presence of potential clinically relevant properties, and discuss possible implications for the human oral microbiome.

Oral Pseudomonadota in the scientific literature and in public databases

A total of eighty-seven publications surveying the microbiota in the human oral cavity, and reporting target populations, samples’ characteristics, and identification methods (Tables S1 and S2), were screened for the presence of Pseudomonadota. In addition, Pseudomonadota taxa reports in the oral cavity were searched in the databases NIH Human Microbiome Project (https://www.hmpdacc.org/) (n = 24) and expanded Human Oral Microbiome Database (http://www.homd.org/) (n = 53) (Table S1 and S2). The bacterial groups were listed and categorized according to the number of reports (number of times that a taxonomic group was identified) and frequency (quotient between the total number of identifications of a specific taxonomic group and the total number of taxa reported) (Table S3). The data was organized at the genus level, meaning that each name referred to the sum of all taxa within that genus, regardless the identification to the species level. In studies based on the 16S rRNA gene amplicon sequencing, the absence/presence of a given taxon was considered, disregarding relative abundance values.

Genera that were reported more than five times were characterized for their environmental distribution, and possible carriage of antibiotic resistance and/or virulence determinants. Common habitats were compiled based on the section of ecology and habitats of Bergey’s Manual (Garrity et al. 2005) and Nørskov-Lauritsen and Kilian (2006) for the genus Aggregatibacter. Antibiotic resistance and virulence genetic determinants were searched based on whole genome sequences available in the Pathosystems Resource Integration Center (PATRIC, https://www.patricbrc.org, accessed January 2021), through the Specialty Genes tab—The Antibiotic Resistance Database (ARDB) (Liu and Pop 2009) and the Comprehensive Antibiotic Resistance Database (CARD) (McArthur et al. 2013), and Victors virulence factors database (Sayers et al. 2019) and the Virulence Factor Database (VFDB) (Chen et al. 2016), respectively. The results were filtered for 100% sequence identity and subject/query coverage, and duplicates were deleted. The genes or gene-product designations were browsed in CARD and VFDB databases for verification of the antibiotic resistance and virulence mechanisms, respectively. The phylogenetic relationship between taxa reported in the oral cavity and human gut microbiota was assessed based on the 16S rRNA gene sequences available for the type strains of the species (https://lpsn.dsmz.de; Parte et al. 2020), used as query for mega BLAST search using the filter human gut microbiome containing 9759 16S ribosomal RNA gene sequences (https://blast.ncbi.nlm.nih.gov/Blast.cgi; (Zhang et al. 2000) (accessed at 7th May 2022).

Pseudomonadota in the oral cavity

The literature reviewed was published between 2005 and 2020 and relied on 16S rRNA gene amplicon sequencing (n = 76), mainly based on Illumina or 454 pyrosequencing, and on culture-based methods (n = 6) or targeted methods based on PCR or probe hybridization (n = 7) (Table S1). Most of the studies used samples of saliva or mouth washes, tooth or dental plaques, or soft tissues such as gingiva, cheek, tongue, or tonsils (Table S2). The number of individuals analysed per study ranged between 2 and 2338, with ages between 18 and 80 years, although the information about the studied group was not clearly provided in 12 publications. Some studies included individuals with specific conditions, such as cancer patients (6 articles) or smoker groups (6 articles), or an indigenous tribe (1 article). Based on this search, it was possible to list 1328 observations that corresponded to a total of 313 genera, of which 77 were reported three or more times (i.e. n = 27 three times, n = 10 four times, and n = 40 five times or more) (Table S2, S3). The remaining were reported only once (n = 191) or twice (n = 45) (Table S3a). The fact that distinct analytical and identification methods were used in different studies might have led to distinct identifications at the species level, a bias that we believe was considerably reduced at the genus or higher taxonomic ranks, as we used in this study (Table S3).

Most of the 1328 observations of Pseudomonadota in the oral cavity (Fig. 1; Table S3a) belonged to the classes Gammaproteobacteria (n = 558) and Betaproteobacteria (n = 452). Members of the classes Alphaproteobacteria (n = 139), Epsilonproteobacteria (n = 119), and Deltaproteobacteria (n = 57) were reported fewer times, and the classes Acidithiobacillia and Oligoflexia were mentioned only three times. More than half of the 1328 observations were included in four families, specifically Neisseriaceae (n = 263, class Betaproteobacteria), represented by 10 genera, Pasteurellaceae (n = 243, class Gammaproteobacteria) distributed by 13 genera, Enterobacteriaceae (n = 100, class Gammaproteobacteria) that included 12 genera, and Campylobacteraceae (n = 99, class Epsilonproteobacteria) that although represented by two genera, most (n = 98) referred to the genus Campylobacter (Table S3a). These observations agree with previous studies that refer to Neisseriaceae, Pasteurellaceae, and Campylobacteraceae as the most common Pseudomonadota of the oral microbiome (Zaura et al. 2009). However, among the genera that were reported five times or more (Table S3c) (n = 926), it noteworthy the occurrence of other Pseudomonadota, such as members of the families Enterobacteriaceae (n = 48, 5%), Burkholderiaceae (n = 43; 5%), Comamonadaceae (n = 9, 1%), Moraxellaceae (n = 31, 3%), and Pseudomonadaceae (n = 29, 3%) that include bacteria with potential clinical relevance, recurrently reported in the oral cavity (Table S3c, Table 1). For example, members of the family Enterobacteriaceae were reported in 25 distinct publications (Table S2, S3). The occurrence of taxa that do not belong to the core oral microbiome may be favoured in some conditions. For example, a recent study suggested that when compared to healthy controls, chronic kidney disease patients presented the proliferation of clinically relevant Enterobacteriaceae in the oral cavity, potentially harbouring acquired antibiotic resistance genes (Costa et al. 2021). Another example was provided by a mice model study, which showed that periodontitis was associated with the accumulation in the oral cavity of Enterobacteriaceae, specifically of the genera Klebsiella and Enterobacter (Kitamoto et al. 2020).

Fig. 1
figure 1

Pseudomonadota in the oral cavity number of reports identified at the class or family levels

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Table 1 Diversity and characteristics of the genera of bacteria belonging to the phylum Pseudomonadota, whose occurrence in the oral cavity was reported more than five times in the examined literature. In a total of 1328 genera of Pseudomonadota, 583 were reported more than five times and were affiliated to (class, number of genera, number of observations) the following: Alphaproteobacteria, 4, 27; Betaproteobacteria, 11, 327; Deltaproteobacteria, 3, 24; Epsilonproteobacteria, 2, 109; Gammaproteobacteria 20, 439. Virulence and antibiotic resistance characteristics of members of these genera were collected from the public database PATRIC (https://www.patricbrc.org/) and the following sources: ARDB, CARD, Victors, VFDB. Ecology and habitats were reviewed from the Bergey’s Manual (Garrity et al. 2005) and (Nørskov-Lauritsen and Kilian 2006) for Aggregatibacter. Additional information is provided as a supplementary file
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The oral cavity as primary or transient Pseudomonadota habitat

To avoid situations of misidentification or of sporadic episodes of occurrence, the further discussion is focused at genus level identifications and on situations where consistent reports were available, i.e. genera that were reported more than five times. This procedure resulted in a list of 40 genera of the classes Gammaproteobacteria (n = 20), Betaproteobacteria (n = 11), Epsilonproteobacteria (n = 2), Deltaproteobacteria (n = 3), and Alphaproteobacteria (n = 4). For sake of simplicity, the 40 genera were ranked according to their frequency of occurrence, resulting in 19 categories designated from Top1 to Top19 (Table S3c, Table 1). In addition, the ecology and habitats, clinically relevant features (virulence and antibiotic resistance), and hypothetical horizontal gene transfer, suggested by the occurrence of identical genetic elements in other bacterial groups, are summarized in the five right-hand columns of Table 1. The association of members of almost all these genera (n = 36) to infectious disease has been demonstrated (Table 2), suggesting that specific host conditions may facilitate the opportunistic character of these bacteria.

Table 2 Examples of infectious diseases associated with Pseudomonadota reported in the oral cavity.
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The assessment of the information compiled in Table 1 highlights three profiles—bacteria mainly associated with humans and other animals, environmental bacteria, and ubiquitous bacteria. Bacteria mainly associated with humans and other animals were represented mainly in the Top1–6 groups, composed of genera whose major habitat includes mucosa of oral cavity and sometimes also of the gastrointestinal and/or genital tract. Environmental bacteria were found in the Top7–19 groups, which include also genera associated with animals and humans (e.g. Top8, 13, some Top16, 17; Table 1) and others, whose natural environment (water, soils, plants) is the primary habitat. Genera such as Rhizobium, Herbaspirillum, Shewanella, or Methylobacterium are good examples of bacteria that typically thrive in the natural environment, and which presence in the oral cavity may be explained based on diet, lifestyle, or familiar context, with unknown potential clinical relevance (Table 1) (Hisham Altayb et al. 2022; Nasidze et al. 2011). Other groups, typically of environmental nature, like the strict anaerobic sulphate-reducing Deltaproteobacteria, such as members of the genera Desulfovibrio, Desulfomicrobium, and Desulfobulbus, have been reported in the oral microbiota of healthy people (Deo and Deshmukh 2019), although may be also associated with pathologies such as periodontal disease, dental plaques, or gastrointestinal inflammation (Colombo et al. 2009; Khor et al. 2021). The group of ubiquitous bacteria, with a wide distribution that span from pristine to heavily contaminated environments, and also the human and animal body, are those of major concern in the environment-human oral cavity interface. These bacterial genera, such as Pseudomonas, Escherichia, Citrobacter, Klebsiella, or Burkholderia, were in the groups Top7, 9, 11, 12, 16 (Table 1), include opportunistic pathogens, and frequently harbour acquired antibiotic resistance. The presence of these groups in the oral cavity may be associated with poor hygiene conditions, oral dysbiosis, deficient host defences, systemic diseases, or other factors; for example, chronic nail-biting habit and chronic kidney disease promote the oral carriage of Enterobacteriaceae (Baydaş et al. 2007; Costa et al. 2021). The ecology and genome plasticity of these ubiquitous bacteria may also explain the diverse array of antibiotic resistance and virulence mechanisms that characterize these groups (Table 1). The facts that members of these genera can thrive in soil, water, and plants, where human and animal excreta can be also present, and have typically highly dynamic genomes, suggest that these bacteria can serve as vectors of clinically relevant features (e.g. antibiotic resistance, virulence) from the environment to humans (Sanz-García et al. 2021; Wang et al. 2022a, 2022b). Indeed, the summary provided in Table 1 shows that bacteria of some of these genera hold a broad set of antibiotic resistance genes, generically included in the categories efflux, inactivation, target modification, reduced permeability, among others, that are shared by other Pseudomonadota. Also, virulence genes, related with factors such as adherence, invasion, transport, iron transport, secretion systems, motility/chemotaxis, toxins, host response evasion, among others are reported in bacteria of these genera. Virulence and antibiotic resistance determinants may contribute to enhance the capacity for colonizing, which can also be favoured by charity processes among the microbial community members, e.g. through extracellular antibiotic degradation. In some cases, identical gene sequences (100% sequence identity and coverage) were found in other taxa, suggesting the potential for dynamic horizontal gene transfer. Remarkably, bacteria of genera, such as Achromobacter, Acinetobacter, Aeromonas, Bordetella, Burkholderia, Campylobacter, Citrobacter, Comamonas, Enterobacter, Escherichia, Haemophilus, Klebsiella, Pantoea, Pasteurella, Proteus, Serratia, and Shewanella, harbour antibiotic resistance and/or virulence genes that are 100% identical to others reported in other taxa, whose habitats include the transition between animals, humans, soil, water, and plants. Although horizontal gene transfer is probably rare in the oral cavity (Tierney et al. 2019), the colonization by bacteria with a rich accessory genome comprised by antibiotic resistance or virulence genes, acquired somewhere else, is of concern, mainly in elderly, immune-depressed, and individuals with oral dysbiosis (Radaic and Kapila 2021). It is suggested that some Pseudomonadota with opportunistic pathogenic character and able to harbour acquired genes can reach the oral cavity and, eventually, can colonize it as well as the gut or other body habitats and ultimately cause disease. Moreover, it is noteworthy that some of these bacteria are probably able to cross the distinct One Health compartments and may represent important vectors of transmission of antibiotic resistance between the natural environment and the humans (Osterhaus et al. 2020). For some genera, specifically Aggregatibacter, Cardiobacterium, Desulfobulbus, Desulfomicrobium, Desulfovibrio, Eikenella, Herbaspirillum, Lautropia, Methylobacterium, Ralstonia, and Simonsiella, the data available on virulence or antibiotic resistance was scant. Although most of these genera have been associated with the oral cavity and human body and reported to thrive in natural environments with low anthropogenic impacts, further information about their genome plasticity and physiology may be relevant to better understand their role in the oral cavity.

Pseudomonadota: from the oral cavity to the gut microbiome

An interconnection between the oral and gut microbiomes has been demonstrated in the literature (Khor et al. 2021; Kitamoto et al. 2020; Kitamoto and Kamada 2022). According to Kitamoto et al. (2020), bacteria can be transmitted from the oral cavity to the gut through hematogenous or enteral routes. In the hematogenous route, the bacteria have access to a systemic circulation through oral mechanical injuries (induced by, e.g. hard mastication, brushing, orthodontics, extractions, or unhealthy periodontium) with the subsequent gut colonization. In the enteral route, bacteria migrate through the gastrointestinal tract till colonizing the intestine. It is generally assumed that only part of the swallowed oral bacteria reaches and colonizes the healthy gut due to the gastric acidity. Indeed, the gut-resident- and oral microbiota are represented by distinct bacterial groups identified based on 16S rRNA gene sequence amplicon analysis (Wang et al. 2022b). Comparatively, Pseudomonadota are present at much lower proportions in the gut than in the oral cavity (< 5% vs. > 30%) (Wang et al. 2022b). However, when members of the oral bacterial community reach the gut, they may induce a considerably change in the gut microbiome composition, with systemic repercussions. For example, Nakajima et al. (2015) showed that the oral administration to mice of Porphyromonas gingivalis (phylum Bacteroidota) led to a decrease of Bacillota in the gut, while increased serum endotoxin levels were observed, suggesting the impairment of the barrier leading to the dissemination of enteric bacteria into the liver.

The search for closely related Pseudomonadota taxa in the oral cavity and of human gut suggested evidence for this nexus. The sequence identity between the 16S rRNA gene of the type strain of species reported in the oral cavity and human gut microbiome revealed values ranging from 78.1 to 98.6% (Table S4). Identity values above 97%, a threshold below which it is assumed that two organisms belong to different species (Stackebrandt and Goebel 1994), were observed for the species Enterobacter cloacae, Enterobacter sakazakii (valid name Kosakonia sacchari), Enterobacter hormaechei, Klebsilela pneumoniae, Citrobacter koseri, Citrobacter amalonaticus, and Desulfovibrio desulfuricans. In addition, although with lower sequence identity values (91.2–90.4%), significant alignments (e-values ranging from e−87 to e−179) were observed for species of the genera Neisseria, Haemophilus, Campylobacter, Kingella, Pseudomonas, Eikenella, Actinobacillus, Acinetobacter, Moraxella, and Comamonas (Table S4). The finding of significant sequence identities may be limited by multiple factors, specifically, the use of type strains 16S rRNA gene sequences, the incapacity to detect minor populations, as is the case of Pseudomonadota, due to low DNA sequencing depth of the human microbiomes, and the fact that the DNA sequences being compared do not belong to the same human microbiome (gut and oral). It must be noted that that nexus oral-gut is probably established based on minor populations. Indeed, Tierney et al. (2019) observed that although gut and oral microbiota genes are shared, that is observed to < 2.5% of the microbiome genes; i.e. considering 95% of sequence identity, only 549 610 genes were common to the oral (23 411 898 genes) and gut (21 704 828 genes) microbiomes. While the low depth of sequencing is a major limitation to reliably compare metagenomes, Tierney et al. (2019) argued that each individual holds a unique microbiome, which can be fingerprinted based on rare microbial strains. Clearly, some Pseudomonadota genera are particularly suitable candidates for such fingerprinting approach, for epidemiological and health condition evaluations. As suggested, even if in low numbers, some oral Pseudomonadota genera are likely to reach and colonize the human gut. Eventually, this situation may be favored or triggered by dysbiosis conditions, frequently associated with the increased relative abundance of Pseudomonadota in the oral or gut microbiome (Khor et al. 2021; Weiss and Hennet 2017). Indeed, the study of Atarashi et al. (2017) showed based on gnotobiotic models that Klebsiella spp. isolated from the salivary microbiota tend to colonize the gut when the intestinal microbiota is under dysbiosis, eliciting a severe gut inflammation by strongly inducing T helper 1 cells. These findings have been confirmed in subsequent studies (Kitamoto et al. 2020), who showed that the periodontitis-driven accumulation of Klebsiella spp. and Enterobacter spp. in the oral cavity might result in a consequent increase in the gut, possibly inducing colitis. Curiously, such effects were only observed in susceptible hosts, as that oral bacteria did not colonize the gastrointestinal tract of healthy animals (Kitamoto et al. 2020). These studies suggest that species of the phylum Pseudomonadota, despite constituting a small fraction of the oral microbiota, can colonize the gut, and contribute to maintain gut dysbiosis and chronic inflammation (Khor et al. 2021; Kitamoto and Kamada 2022).

Final considerations

Pseudomonadota may include oral pathobionts, some of which constitute a reservoir of virulence and antibiotic resistance genes (Table 1, Table 2). In addition to the regularly found groups, others comprising the accessory, variable, or “non-core” microbiome (Deo and Deshmukh 2019) may be of interest, as indicators of specific health conditions or of an unbalanced microbiota. By default, the non-core microbiome is highly diverse and vast, probably influenced by the individual health conditions, dietary and lifestyle choices, hygiene practices, geography, and even ethnicity (Hisham Altayb et al. 2022; Wang et al. 2022b). In our review, we reported more than 250 bacterial genera that have not been listed as part of the core microbiota of the oral cavity, and which occurrence is probably minor in abundance and shaped by external variables. However, by highlighting a short list of 40 genera that were recurrently reported in the literature, this review suggests that non-core Pseudomonadota may be more diverse and frequent in the oral cavity than formerly believed, stressing the need of further investigation.

The increasing potential of anthropogenic bacteria to colonize, invade, and persist in environment-human interfaces, mainly when subjected to strong disinfection or antimicrobial actions, deserves attention (Becerra-Castro et al. 2016; Blaustein et al. 2021; Alexander Mahnert et al. 2019; Osterhaus et al. 2020). This review supports the hypothesis that humans exposed to food products and environments where increasingly anthropogenic microbiomes pullulate may have increased probability of acquiring antibiotic-resistant and virulent bacteria. These colonization events may only manifest under a host debilitation situation. The relationship between oral dysbiosis and oral (e.g. periodontal disease or dental caries) or systemic diseases (e.g. diabetes, cancer, endocarditis, systemic infections), where the unbalanced microbiome may be the trigger for the pathology, has been demonstrated (Albuquerque-Souza and Sahingur 2022; Al-Qadami et al. 2022; Khor et al. 2021). The interplay between the external factors and the colonization or proliferation in the oral cavity of some bacterial groups may be the key to prevent and control some pathologies. In addition, this is a crucial interface to better understand the environment-humans continuum that is implicitly assumed by the One Health concept.