Intensive oral care can reduce bloodstream infection with coagulase-negative staphylococci after neutrophil engraftment in allogeneic hematopoietic stem-cell transplantation

Suwabe, Tatsuya; Fuse, Kyoko; Katsura, Kouji; Soga, Marie; Katagiri, Takayuki; Shibasaki, Yasuhiko; Narita, Miwako; Sone, Hirohito; Masuko, Masayoshi

doi:10.1007/s00520-021-06447-8

Cited by 6 publications

(6 citation statements)

References 26 publications

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“…only recently reported that intensive oral care by a dental specialist reduced the number of blood stream infections by staphylococci after stem cell transplant. 25 Our results should be replicated in prospective, controlled trial, because our data are limited by the monocentric, retrospective design.…”

Section: Discussionmentioning

confidence: 81%

“…Patients with cirrhosis are very susceptible for bacterial infection, 1 which is caused by a syndrome of complex immunodeficiency specific for cirrhosis, coined cirrhosis‐associated immune dysfunction (CAID) 24 . In this context, it may be expected that dental foci increase the risk for bacterial infections in patients with cirrhosis similar to other risk groups with impaired immune defence 5,17,25 . Although the impact of dental foci on complications of cirrhosis has received little scientific interest so far, 15 it may be of great importance for patients, because our data suggest that treatment of dental foci may decrease the risk for infection.…”

Section: Discussionmentioning

confidence: 86%

“…Furthermore, Suwabe et al. only recently reported that intensive oral care by a dental specialist reduced the number of blood stream infections by staphylococci after stem cell transplant 25 …”

Section: Discussionmentioning

confidence: 99%

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Persisting dental foci increase the risk for bacterial infections before and after liver transplant

Göbel

Forsting

Klüners

et al. 2022

Clinical Transplantation

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Background Patients awaiting liver transplant are usually assessed for presence of dental foci to prevent bacterial infection post‐transplant, but evidence to support dental examination and treatment is limited. We investigated if treatment of dental foci decreased bacterial infections before and after transplant. Methods Patients transplanted at the university hospital of Bonn were retrospectively assessed for occurrence of bacterial infections before and after transplant according to presence and treatment of dental foci. Results 35/110 patients showed good oral health, 39/110 patients received dental care and 36/110 patients did not receive dental care despite poor oral health. Patients with alcohol‐associated liver disease presented with the highest rate of dental foci. Bleeding complications due to oral care occurred in five patients with poor coagulation. After transplant, the number of infections per patient was higher in patients with poor oral health (2.9) compared to patients after dental care (1.9) or with good oral health (1.8) (p = .02), with streptococcal infections being more frequent in patients with poor oral health. Before transplant, bacterial infections, in particular bacteraemia and spontaneous bacterial peritonitis, were also more common in patients with untreated dental foci. Streptococci and Staphylococci were more often detected in patients with dental foci. Dental treatment was associated with a reduction in bacterial infections. Conclusion Presence of dental foci is associated with an increased risk for bacterial infections not only after but also before liver transplant. Dental treatment might be a safe and effective procedure to mitigate this risk.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 86%

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Persisting dental foci increase the risk for bacterial infections before and after liver transplant

Göbel

Forsting

Klüners

et al. 2022

Clinical Transplantation

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“…Not only that, but the extension of engraftment time means patients need to experience a longer period of agranulocytosis. During this period, their immunity was extremely low, unable to resist the invasion of various pathogens, and some opportunistic infections also break out at this time ( Omrani and Almaghrabi, 2017 ; Suwabe et al., 2022 ). Moreover, infection may induce or aggravate GVHD, leading to transplant failure and even patient death ( Kolb et al., 2018 ; Mori et al., 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and mortality risk factors of mixed bacterial infections in hematopoietic stem cell transplantation recipients

Liu,

Chen

et al. 2023

Front. Cell. Infect. Microbiol.

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Background and objectiveMixed bacterial infections (MBI) is one of the complications after hematopoietic stem cell transplantation (HSCT) and increases the risk of patient death. However, there are few reports specifically on this topic. The purpose of this study was to investigate the clinical characteristics and mortality risk factors of MBI in HSCT recipients.MethodsThe electronic medical records of patients undergoing HSCT were collected. The epidemiological features and antibiotic resistance of patients with and without MBI were compared. Logistic regression and Cox regression were used to identify the risk factors for MBI acquisition and death. R language was used to construct a prediction model for the overall survival of HSCT recipients with MBI.ResultsThe cumulative incidence of MBI was 6.3% and the mortality was 48.8%. Time interval from diagnosis to transplantation > 180 days (HR=2.059, 95% CI 1.042-4.069, P=0.038) and ICU admission after transplantation (HR=2.271, 95% CI 1.053-4.898, P=0.036) were independent risk factors for MBI acquisition. Engraftment period > 20 days (HR=2.273, 95% CI 1.028-5.027, P=0.043), continuous renal replacement therapy (HR=5.755, 95% CI 1.691-19.589, P=0.005) and septic shock (HR=4.308, 95% CI 2.085-8.901, P=0.000) were independent risk factors associated with mortality.ConclusionsMBI has become a serious problem that cannot be ignored after HSCT. It is urgent for clinicians to pay high attention to it and formulate reasonable monitoring and treatment plans to improve the prognosis of patients.

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“…Shieh revealed that with proper oral health care support, there was a later onset of OM and a lesser degree of oral mucosal injury [27]. Suwabe et al also pointed out the decreased incidence of streptococcal bloodstream infections in patients undergoing intensive oral care during HSCT [28]. A study by Kawajiri et al suggested that oral care could decrease the number of bacteria translocating into the peripheral blood [29].…”

Section: Discussionmentioning

confidence: 99%

Oral Mucositis Association with Periodontal Status: A Retrospective Analysis of 496 Patients Undergoing Hematopoietic Stem Cell Transplantation

Radochová

Sembera

Slezák

et al. 2021

JCM

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Background: Hematopoietic stem cell transplantation (HSCT) can induce serious oral complications, including oral mucositis (OM). The presence of periodontal inflammation before HSCT is believed to be associated with OM. The aim of our study was to determine the prevalence and severity of OM in patients undergoing HSCT and its relation to periodontal status. Patients and methods: This is a retrospective study of patients who underwent HSCT and a detailed dental examination between 2007 and 2015. The dental and periodontal status of all patients was evaluated by clinical and radiographic examination prior to HSCT. Oral health was assessed with the gingival index, the the community periodontal index, presence of plaque-related gingivitis, and marginal periodontitis. During the HSCT period, patients were examined daily for the presence of OM, which was graded according to World Health Organization (WHO) classification if present. The patients were assigned to the groups according to type of transplantation: autologous HSCT, myeloablative allogeneic HSCT, and non-myeloablative allogeneic HSCT. Results: A total of 496 patients were included in the study. OM was present in 314 of 496 patients (63.3%): 184/251 (73.3%) in the autologous group, 100/151 (66.2%) in the myeloablative allogeneic group, and 30/94 (31.9%) in the nonmyeloablative allogeneic group. Significantly more patients suffered from OM in the autologous and myeloablative groups versus the nonmyeloablative conditioning group (p < 0.001). The presence of periodontal inflammation did not significantly differ among the groups. There was only a borderline trend for the higher prevalence of OM in the non-myeloablative allogeneic nonmyeloablative group when periodontal inflammation was present (0.073939). Conclusions: Oral mucositis prevalence and severity after stem cell transplantation is not widely affected by the oral hygiene and periodontal disease presence before HSCT. We confirmed the wide-known connection of the conditioning regimen intensity to the prevalence of OM.

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Intensive oral care can reduce bloodstream infection with coagulase-negative staphylococci after neutrophil engraftment in allogeneic hematopoietic stem-cell transplantation

Cited by 6 publications

References 26 publications

Persisting dental foci increase the risk for bacterial infections before and after liver transplant

Persisting dental foci increase the risk for bacterial infections before and after liver transplant

Clinical characteristics and mortality risk factors of mixed bacterial infections in hematopoietic stem cell transplantation recipients

Oral Mucositis Association with Periodontal Status: A Retrospective Analysis of 496 Patients Undergoing Hematopoietic Stem Cell Transplantation

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