Bacterial substitution of coagulase-negative staphylococci for streptococci on the oral mucosa after hematopoietic cell transplantation.
OBJECTIVE
Coagulase-negative staphylococci (CoNS) are frequently isolated from blood cultures of hematopoietic cell transplantation (HCT) patients. Generally, the use of central venous catheters is recognized as a significant risk factor for CoNS infection, while the impact of CoNS infection from oral ulcerative mucositis, which occurs frequently in HCT, may be underestimated. Here, we examined the bacteria on the buccal mucosa after HCT.


METHODS
Sixty-one patients were examined for bacteria on the buccal mucosa routinely once a week from 1 week before to 3 weeks after allogeneic HCT. Subjects were divided into groups with short and long periods of antibiotic use, and differences in bacterial substitution were evaluated. The relationships between type of HCT (conventional HCT or RIST) and bacterial substitution were also evaluated.


RESULTS
The changes in detection frequencies of CoNS and α-streptococci from before to 3 weeks after HCT were significant (P < 0.05, χ (2) test): 14.5-53.3% and 92.7-53.1%, respectively. Significant bacterial substitution of CoNS for streptococci was observed in the long-term antibiotic use group (P < 0.05, χ (2) test), but also occurred in cases with short-term or no antibiotic use. No relationships between type of HCT (conventional HCT or RIST) were observed.


CONCLUSIONS
Bacterial substitution of CoNS for streptococci occurred frequently on the buccal mucosa after HCT. In addition to antibiotic use, environmental factors may be involved in bacterial substitution. It is important to consider the presence of oral mucositis in CoNS infection after HCT.
Department of Pathophysiology-Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan.
Yoshihiko
Y
Soga
Yoshinobu
Y
Maeda
Fumihiko
F
Ishimaru
Mitsune
M
Tanimoto
Hiroshi
H
Maeda
Fusanori
F
Nishimura
Shogo
S
Takashiba
D000328:Adult; D001419:Bacteria / Q000378:metabolism; D016009:Chi-Square Distribution; D003030:Coagulase / Q000378:metabolism; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009061:Mouth Mucosa / Q000382:microbiology; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013210:Staphylococcus / Q000302:isolation & purification*; D013223:Statistics as Topic; D013290:Streptococcal Infections / Q000453:epidemiology*; D013291:Streptococcus / Q000302:isolation & purification*
D003030:Coagulase