Periodontal status and bacteremia with oral viridans streptococci and coagulase negative staphylococci in allogeneic hematopoietic stem cell transplantation recipients: a prospective observational study

被引：47

作者：

Raber-Durlacher, Judith E. ^{[1
,2
,3
]}

Laheij, Alexa M. G. A. ^{[4
]}

Epstein, Joel B.

Epstein, Matthew ^{[5
,6
]}

Geerligs, Gerard M. ^{[7
]}

Wolffe, Gordon N.

Blijlevens, Nicole M. A. ^{[8
]}

Donnelly, J. Peter ^{[8
]}

机构：

[1] Univ Amsterdam, Dept Periodontol, Acad Ctr Dent Amsterdam ACTA, NL-1081 LA Amsterdam, Netherlands

[2] Vrije Univ Amsterdam, NL-1081 LA Amsterdam, Netherlands

[3] Univ Amsterdam, Acad Med Ctr Amsterdam, Dept Oral & Maxillofacial Surg, Amsterdam, Netherlands

[4] ACTA, Dept Prevent Dent, NL-1081 LA Amsterdam, Netherlands

[5] City Hope Natl Med Ctr, Div Otolaryngol & Head & Neck Surg, Duarte, CA 91010 USA

[6] St Josephs Reg Med Ctr, Dept Oral & Maxillofacial Surg, Paterson, NJ USA

[7] Royal Netherlands Army, Minist Def, Mil Dent Ctr Amersfoort, Dept Periodontol & Implantol, Amersfoort, Netherlands

[8] Radboud Univ Nijmegen Med Ctr, Dept Haematol, Nijmegen, Netherlands

来源：

SUPPORTIVE CARE IN CANCER | 2013年 / 21卷 / 06期

关键词：

Periodontal disease; Gingivitis; Bacteremia; Hematopoietic stem cell transplantation; Coagulase negative staphylococci; Viridans streptococci; BONE-MARROW-TRANSPLANTATION; HEMATOLOGIC MALIGNANCIES; FUSOBACTERIUM-NUCLEATUM; INFECTIVE ENDOCARDITIS; NEUTROPENIC PATIENTS; FEBRILE NEUTROPENIA; CANCER-PATIENTS; ACUTE-LEUKEMIA; RISK-FACTOR; DISEASE;

D O I：

10.1007/s00520-012-1706-2

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

This study was aimed to investigate whether any association could be found between the presence of an inflamed and infected periodontium (e.g., gingivitis and periodontitis) and the development of bacteremia during neutropenia following allogeneic hematopoietic stem cell transplantation (HSCT). Eighteen patients underwent a periodontal examination before HSCT. Patients were classified as periodontally healthy [all periodontal pocket depths (PPD) a parts per thousand currency signaEuro parts per thousand 4 mm and bleeding on probing (BOP) a parts per thousand currency signaEuro parts per thousand 10 %) or as having gingivitis/periodontitis (PPD a parts per thousand yenaEuro parts per thousand 4 mm and BOP > 10 %]. Oral mucositis (OM) was scored using the daily mucositis score. Blood cultures were taken at least twice weekly. Five patients were periodontally healthy, while 13 patients had gingivitis or periodontitis. Twelve patients (67 %) developed bacteremia during neutropenia, of which 11 patients (61 %) had one or more episodes of bacteremia due to coagulase-negative staphylococci (CONS, most often Staphylococcus epidermidis) or to oral viridans streptococci (OVS), or both. Patients with gingivitis/periodontitis more often had bacteremia than those with a healthy periodontium (p = 0.047), and BOP was associated with bacteremia (p = 0.049). All patients developed ulcerative OM, but its severity and duration were not associated with bacteremia. OM duration and the length of stay in the hospital were strongly correlated (R = 0.835, p a parts per thousand currency signaEuro parts per thousand 0.001). This study indicates that periodontal infections may contribute to the risk of developing OVS and CONS bacteremia during neutropenia following HSCT. While our results point to the importance of periodontal evaluation and management before HSCT, further studies on periodontal contribution to systemic infectious complications are warranted.

引用

页码：1621 / 1627

页数：7

共 48 条

[1] A retrospective investigation of advanced periodontal disease as a risk factor for septicemia in hematopoietic stem cell and bone marrow transplant recipients [J].