Microbiology of acute periodontal infection in myelosuppressed cancer patients.

Abstract

This study characterized the subgingival microbial flora associated with 27 acute exacerbations of preexistent periodontal disease in 24 patients with chemotherapy-induced myelosuppression. All but two acute periodontal infections developed at low granulocyte levels (less than 1,000/microL). Suspected pathogens were detected in high concentrations in subgingival plaque specimens in 17 episodes of acute periodontal infection; a single pathogen was recovered in ten acute infections, and more than one pathogen was recovered in seven acute infections. Staphylococcus epidermidis, Candida albicans, S aureus, and Pseudomonas aeruginosa predominated, with combinations of these detected in some patients. Concomitant bacteremias developed in two of these patients. The subgingival microflora associated with ten acute periodontal infections was characterized by predominantly indigenous microorganisms, which in nine episodes were in abnormal proportions compared with microbial profiles in noncancer patients with similar degrees of periodontal disease. These data demonstrate that pathogens normally associated with infections in myelosuppressed cancer patients, as well as indigenous oral flora, are associated with acute periodontal infections during granulocytopenia. This finding is important, since this body site has not commonly been recognized as a source for acute infection in these patients.

The ecology of Staphylococcus species in the oral cavity

“…Only low proportions (,1%) of staphylococci were present in the cultivable subgingival¯ora in 95% of the patients studied. No signi®cant differences were detected in the occurrence of S. aureus between patients with gingi- [47] and acute periodontal abscesses in immunocompromised patients [49]. In early studies [50,51], cellular components of S. aureus were found in the subepithelial connective tissues of 47% of specimens of in¯amed gingival tissue, but not in healthy gingival tissue.…”

Candida and Oral Candidosis: A Review

“…Paper Points C. albicans has been detected previously in high numbers in the subgingival flora (Slots et al, 1988) or in the gingival tissues of acute periodontal abscesses (Peterson et al, 1987). An absorbent sterile paper point is inserted to the depth of the pocket and then transferred to a transport medium .…”

Prevalence of clinically relevant oral mucositis in outpatients receiving myelosuppressive chemotherapy for solid tumors

“…An association between underdiagnosed oral pathologies, such as periodontal disease, and infectious complications during chemotherapy-induced myelosuppression has been demonstrated previously [22,24]. In order to optimize a patient's compliance regarding oral hygiene and dental therapy measures, it will be necessary to thoroughly inform patients about the importance of oral health as related to the prevention of debilitating chemotherapy side effects, such as pain, infections, and nutritional dysfunction.…”