Raised salivary endotoxin concentration as a predictor of infection in pediatric leukemia patients

Millns, B.; Martin, Michael V.; Williams, M.C.

doi:10.1016/s1079-2104(99)70193-9

Cited by 9 publications

(5 citation statements)

References 30 publications

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“…Despite so many positive reports of salivary applications, importantly there are reports clearly showing that saliva is not the fluid of choice for certain infectious conditions. For example, salivary endotoxin levels are not an accurate predictor of sepsis in pediatric leukemia patients and do not correlate with oropharyngeal carriage of aerobic gram‐negative bacilli in these patients (Millns, Martin and Williams, 1999).…”

Section: Infectious Diseasesmentioning

confidence: 99%

Saliva as a diagnostic fluid

2002

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In the last 10 years, the use of saliva as a diagnostic fluid has become somewhat of a translational research success story. Technologies are now available enabling saliva to be used to diagnose disease and predict disease progression. This review describes some important recent advances in salivary diagnostics and barriers to application and advancement. This review will also stimulate future research activity.

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Section: Infectious Diseasesmentioning

confidence: 99%

Saliva as a diagnostic fluid

2002

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“…11 However, endotoxin levels of up to 300 EU ml -1 have been found in the saliva of normal healthy subjects. 8 It is unlikely, therefore, that endotoxin concentrations of < 300 EU ml -1 will be of any clinical relevance. The ATP assay method used here was found to be very simple to use, was portable and gave virtually instant results (within one minute) making it very suitable for use at the chairside.…”

Section: Practitioner Studymentioning

confidence: 99%

Total viable counts, ATP, and endotoxin levels as potential markers of microbial contamination of dental unit water systems

Fulford¹,

Walker²,

Martin

et al. 2004

Br Dent J

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Objectives To determine if either ATP or endotoxin concentrations in water supplied by dental unit water systems (DUWS) correlated with total viable counts (TVC), and therefore could be used as a rapid, chairside measure of levels of microbial contamination. Design A prospective trial. Method Fifty-seven water samples were taken from the 'triple spray', air rotor and source water supplies from 25 dental units in eight practices. The samples were assayed for endotoxin concentration, total ATP and TVC. A pilot study was performed to assess the relationship between TVC and total cell counts, as determined by flow cytometry. Results ATP concentrations ranged from 22 to 958 relative light units (RLU) and free endotoxin ranged from 25 to 600 EU ml -1 . TVC varied from not detected to 2.16 x 10 4 CFU ml -1 . The ATP method proved to be a simple and rapid method that could be used at the chairside. However, there was no correlation between ATP or endotoxin concentrations and TVC in DUWS. TVC generally underestimated the total cell count by 50 to 500 fold. Conclusion Half of the water samples from DUWS exceeded recommended levels of TVC. However, ATP and endotoxin concentrations in DUWS water samples did not correlate with these TVC data and therefore could not be recommended as an alternative assay to TVC for measuring bacterial contamination or for monitoring water treatment efficacy.Dental unit water systems (DUWS) are generally contaminated with bacteria. 7,9,13,15 The normal method of measuring bacterial contamination is by total viable counts (TVC) following culture on microbiological media in a dedicated laboratory. This is a time- consuming and labour intensive process, and there is an inevitable delay before the data are available and can be acted upon. In order for the bacterial counts to be as accurate as possible, it is essential to ensure that the samples are processed without delay after collection. This may prove difficult if the site of collection is remote from the microbiology laboratory.In the brewing and food industry, bacterial and other cellular contamination is estimated by measuring total adenosine triphosphate (ATP). 4,5 Hygiene monitoring using ATP also offers a simple and valuable means of monitoring dental practice cleaning routines. 6 This test is relatively simple to perform and can be done at the site of sampling. The simplicity and rapidity of the ATP test system are features that could potentially make this a feasible approach to measure contamination of DUWS at the chairside. This would be particularly useful in confirming the efficacy of decontamination procedures.Another potential method of estimating TVC could be to measure endotoxin concentration. Much of the bacterial contamination of DUWS is by Gram-negative bacteria, which on lysis would release endotoxin. Thus, endotoxin estimation could potentially also be used as a measure of bacterial contamination of DUWS. This assay is used extensively in the pharmaceutical industry for testing the production of endotoxin-free water.The purp...

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“…Studies have demonstrated an increase in the number and proportion of Gram-negative bacilli such as Escherichia coli, Pseudomonas aeruginosa, Klebsiella and Enterobacter spp. in the oral cavity of oncological patients, which are detected in approximately twothirds of all bacterial isolates (7,8). Gram-positive bacteria including coagulase-negative staphylococci and Enterococcus have also been identified in samples collected from immunocompromised patients (9,10).…”

Section: Introductionmentioning

confidence: 99%

Frequency of oral mucositis and microbiological analysis in children with acute lymphoblastic leukemia treated with 0.12% chlorhexidine gluconate

Soares

Aquino²,

Carvalho³

et al. 2011

Braz. Dent. J.

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In view of the morbidity potential of oral complications in patients with leukemia, this study evaluated the clinical and microbiological alterations that occur in the oral mucosa of children with acute lymphoblastic leukemia (ALL) undergoing antineoplastic chemotherapy and prophylactic administration of 0.12% chlorhexidine gluconate. The sample consisted of 17 children aged 2 to 12 years that underwent clinical examination of the oral mucosa for the detection of oral lesions. In addition, biological material was collected from labial and buccal mucosa for microbiological analysis. Oral mucositis was observed in only 5 (29.4%) patients. Microbiological analysis revealed a reduced number of potentially pathogenic microorganisms, such as coagulase-negative staphylococci (47%), Candida albicans (35.3%), Klebsiella pneumoniae (5.9%), enteropathogenic Escherichia coli (5.9%), and Stenotrophomonas maltophilia (5.9%). Patients with oral mucositis showed a higher frequency of coagulase-negative staphylococci (80%) when compared with patients with normal oral mucosa (33.3%). In conclusion, the results of the present study suggest that the prophylactic use of 0.12% chlorhexidine gluconate reduces the frequency of oral mucositis and oral pathogens in children with ALL. In addition, the present findings suggest a possible relationship between coagulase-negative staphylococci and the development of oral mucositis.

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Raised salivary endotoxin concentration as a predictor of infection in pediatric leukemia patients

Cited by 9 publications

References 30 publications

Saliva as a diagnostic fluid

Saliva as a diagnostic fluid

Total viable counts, ATP, and endotoxin levels as potential markers of microbial contamination of dental unit water systems

Frequency of oral mucositis and microbiological analysis in children with acute lymphoblastic leukemia treated with 0.12% chlorhexidine gluconate

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