title: Streptococcal bacteraemia in patients submitted to hematopoietic stem cell transplantation: the role of tooth brushing and use of chlorhexidine.
abstract: 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.
authors.affiliation: Clinical Research Service, Instituto Nacional de Câncer, Rio de Janeiro, Brazil. hspindola@inca.gov.br
authors.forename: Héliton-Spíndola
authors.initials: HS
authors.lastname: Antunes
authors.forename: Elza-Maria de Sá
authors.initials: EM
authors.lastname: Ferreira
authors.forename: Lúcia-Maria-Dias
authors.initials: LM
authors.lastname: de Faria
authors.forename: Marcelo
authors.initials: M
authors.lastname: Schirmer
authors.forename: Pedro-Carvalho
authors.initials: PC
authors.lastname: Rodrigues
authors.forename: Isabele-Avila
authors.initials: IA
authors.lastname: Small
authors.forename: Marta
authors.initials: M
authors.lastname: Colares
authors.forename: Luis-Fernando-da Silva
authors.initials: LF
authors.lastname: Bouzas
authors.forename: Carlos-Gil
authors.initials: CG
authors.lastname: Ferreira
mesh_terms: 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
chemical_list: D009067:Mouthwashes; D002710:Chlorhexidine