Association between the point-rating system used for oral health and the prevalence of Gram-negative bacilli in hematological inpatients

Abstract

Gram-negative bacteremia is a major cause of death among hematology inpatients who require heavy-dose chemotherapy and hematopoietic stem cell transplantation. Gram-negative bacillus (GNB) is more likely to be detected when the oral health is poor. However, there is a dearth of studies on the relationship between oral assessment and prevalence of GNB in hematology inpatients. This retrospective study aimed to evaluate the relationship between the original point-rating system for oral health examinations (point-oral exam) and the prevalence of GNB in hematology inpatients at the hematology ward of the Yamanashi University Hospital. GNB was detected by cultivating samples from the sputum and blood of each patient. A total of 129 subjects underwent a medical checkup and point-oral exam. The sputum and blood culture results of 55 patients were included in this study. The total points of patients positive for GNB (n = 25, 45.5%) were significantly higher than those who were negative for GNB (total score: median, 25th, 75th, percentile; 6 [4, 7] vs 2 [1, 4]; P = .00016). Based on the receiver operating characteristic analysis, a cutoff score of 5 proved to be most useful to detect GNB. An oral evaluation with a cutoff value of 5 or higher in the point-oral exam might indicate the need for a more thorough oral management to prevent the development of systemic infections from GNB.

Oral colonization by gram-negative bacilli in patients with hematologic malignancies and solid tumors compared with healthy controls

“…Previous studies have shown that maintaining good oral hygiene and moist oral mucosa is closely associated with a reduced risk of colonization and infection by pathogenic microorganisms in hematologic patients [ 4 ]. However, the oral hygiene of hospitalized patients is compromised by the disease and the unfamiliar environment, which hinders adherence to regular dental hygiene practices.…”

“…), can occasionally be found in healthy oral microbiota [ 3 ]. These organisms can cause systemic infection through three main mechanisms: dissemination into the bloodstream from the periodontal environment, bronchoaspiration, and migration to the gut microbiota [ 4 ]. In cancer patients, the GNB is associated with an increased risk of infectious complications, particularly neutropenic fever, and bacteremia [ 5 , 6 ].…”

Concomitant pyogenic spondylodiscitis and empyema following tongue cancer resection and wisdom tooth extraction: A case report and literature review

“…Although a few cases involve Fusobacterium spp., Mycobacterium tuberculosis, and Streptococcus milleri as causative agents of both spondylodiscitis and empyema, none have reported SA. [4] Oral bacteria can enter the bloodstream and cause systemic infections through 3 primary pathways [5] :…”

Oral care and protocols in cancer patients

“…For the patient population requiring nutritional support team intervention, such as those with head and neck cancer and those who are malnourished, elderly, and fragile, oral health screening, management, and care are especially important. 2 The three most frequent cancer treatment options are surgical resection, radiation, and chemotherapy, which can be used alone or in combination. Although these treatments are efficient in removing the tumour, they may cause inevitable harm to oral tissues and dental equipment, particularly in cases of head and neck cancer.…”