L Osakabe1, A Utsumi2, B Saito3, Y Okamatsu4, H Kinouchi5, T Nakamaki3, S Hironaka1. 1. Department of Special Needs Dentistry, Division of Hygiene and Oral Health, Showa University School of Dentistry, Tokyo, Japan. 2. Department of Special Needs Dentistry, Division of Hygiene and Oral Health, Showa University School of Dentistry, Tokyo, Japan. Electronic address: akemi@dent.showa-u.ac.jp. 3. Department of Medicine, Division of Hematology, Showa University School of Medicine, Tokyo, Japan. 4. Dentistry and Oral Surgery, Showa University Hospital, Tokyo, Japan; Division of Community Based Comprehensive Dentistry, Department of Special Needs Dentistry, Showa University School of Dentistry, Tokyo, Japan. 5. Dentistry and Oral Surgery, Showa University Hospital, Tokyo, Japan.
Abstract
OBJECTIVE: Oral mucositis (OM) caused by infection facilitated by myelosuppression and immunosuppression can be controlled through oral care. We investigated changes in oral anaerobic bacterial flora during the onset of OM with hematopoietic stem cell transplantation (HSCT). METHODS: This study included 19 patients who underwent HSCT. All received professional oral care before initiating the preparative regimen. We assessed OM, oral health and obtained microbial samples from the oral cavity during 5 assessment points: before initiating the preparative regimen; the day before HSCT (day 1); and at 7, 14, and 30 days after HSCT. Microbial species were identified by using a mass spectrometer. RESULTS: The number of patients with serious OM increased initially after HSCT and decreased thereafter. Many Streptococcus species were identified before HSCT, but these gradually decreased and were replaced by coagulase-negative staphylococci. An increase in Candida species after HSCT and the identification of Enterococcus species were significantly associated with OM. Nutritional status recovery and prognosis were significantly worse in patients who developed OM. CONCLUSIONS: To the best of our knowledge, this study is the first which shows that anaerobic bacteria were identified in patients' oral flora before and after HSCT by using a mass spectrometer. These results indicate that Enterococcus species and Candida species may have been associated with OM. OM affected the patients' improvement in nutritional status and their prognosis. We concluded that it is important to provide more complete oral care instructions and interventions to prevent these bacterial infections.
OBJECTIVE:Oral mucositis (OM) caused by infection facilitated by myelosuppression and immunosuppression can be controlled through oral care. We investigated changes in oral anaerobic bacterial flora during the onset of OM with hematopoietic stem cell transplantation (HSCT). METHODS: This study included 19 patients who underwent HSCT. All received professional oral care before initiating the preparative regimen. We assessed OM, oral health and obtained microbial samples from the oral cavity during 5 assessment points: before initiating the preparative regimen; the day before HSCT (day 1); and at 7, 14, and 30 days after HSCT. Microbial species were identified by using a mass spectrometer. RESULTS: The number of patients with serious OM increased initially after HSCT and decreased thereafter. Many Streptococcus species were identified before HSCT, but these gradually decreased and were replaced by coagulase-negative staphylococci. An increase in Candida species after HSCT and the identification of Enterococcus species were significantly associated with OM. Nutritional status recovery and prognosis were significantly worse in patients who developed OM. CONCLUSIONS: To the best of our knowledge, this study is the first which shows that anaerobic bacteria were identified in patients' oral flora before and after HSCT by using a mass spectrometer. These results indicate that Enterococcus species and Candida species may have been associated with OM. OM affected the patients' improvement in nutritional status and their prognosis. We concluded that it is important to provide more complete oral care instructions and interventions to prevent these bacterial infections.
Authors: Alexa M G A Laheij; Judith E Raber-Durlacher; Renée G A Koppelmans; Marie-Charlotte D N J M Huysmans; Carin Potting; Stephanie J M van Leeuwen; Mette D Hazenberg; Michael T Brennan; Inger von Bültzingslöwen; Jan-Erik Johansson; Johannes J de Soet; Thijs M Haverman; Mark J Buijs; Bernd W Brandt; Frederik R Rozema; Nicole M A Blijlevens; Egija Zaura Journal: Sci Rep Date: 2019-11-15 Impact factor: 4.379