Streptococcal bacteraemia in patients submitted to hematopoietic stem cell transplantation: the role of tooth brushing and use of chlorhexidine.
A retrospective evaluation of 73 consecutive recipients of hematopoietic stem cell transplantation (HSCT) was conducted to investigated the role of oral care and incidence of streptococcal bacteremia in patients submitted to hematopoietic stem cell transplantation. Patients were retrospectively evaluated and divided into group A (GA=38) and group B (GB=35). During hospitalization patients from GA performed oral hygiene daily with extra soft toothbrush and toothpaste besides performing mouth cleaning with an ethanol-free 0.12% chlorhexidine solution tree times a day. In contrast GB patients performed mouth cleaning with extra soft toothbrush and toothpaste, but no chlorhexidine was used. Using the Chi square test it was observed that all patients from GA presented negative blood culture for alpha-hemolytic Streptococcus viridans and Candida albicans and only 1 patient without oral mucositis from GB presented positive blood cultures for Streptococcus intermedius (p=0.48). The results indicate that methodology used for oral care before the HSCT and the practice of tooth brushing during the period were effective in preventing streptococcal bacteremia. Moreover, our data suggest that the mouth cleaning with chlorhexidine during HSCT may be not mandatory.
Antunes
Héliton-Spíndola
HS
Clinical Research Service, Instituto Nacional de Câncer, Rio de Janeiro, Brazil. hspindola@inca.gov.br
Ferreira
Elza-Maria de Sá
EM
de Faria
Lúcia-Maria-Dias
LM
Schirmer
Marcelo
M
Rodrigues
Pedro-Carvalho
PC
Small
Isabele-Avila
IA
Colares
Marta
M
Bouzas
Luis-Fernando-da Silva
LF
Ferreira
Carlos-Gil
CG
D000293:Adolescent; D000328:Adult; D016470:Bacteremia / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D002710:Chlorhexidine / Q000627:therapeutic use*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use*; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D014099:Toothbrushing; D055815:Young Adult
D009067:Mouthwashes; D002710:Chlorhexidine