Potentially Pathogenic Microorganisms in the Oral Cavity during Febrile Episodes in Immunocompromised Patients with Haematologic Malignancies

Abstract

The purpose of the study was to describe the occurrence of potentially pathogenic microorganisms during febrile episodes in haematologic patients, who had been treated with anti-neoplastic drugs within the previous 4 weeks. During a 9-month period 78 consecutive febrile episodes occurred in 46 patients who were examined daily. On day 1, before antibiotic treatment was started, members of the normal flora were found in 83%, Candida spp. in 72%, Enterobacteriaceae in 29%, Pseudomonas aeruginosa in 8%, Staphylococcus aureus in 14%, coagulase-negative staphylococci in 26% and enterococci in 17% of the febrile episodes. During the subsequent antibiotic treatment, the prevalence of members of the normal oral flora was markedly reduced from day 1 (83%) to day 7 (6%), and the normal flora was replaced by potentially pathogenic microorganisms. A rise was found in the prevalences of Candida spp. (from 72 to 92%) and coagulase-negative staphylococci (from 26 to 49%) from day 1 to day 4. The prevalences of Enterobacteriaceae and P. aeruginosa showed no day-to-day changes, and were not different in patients hospitalized for more or less than 24 h prior to inclusion into the study, suggesting that their detection was not due to acquisition during hospitalization or antibiotic treatment. The oral occurrence of species of microorganisms regularly found in septicaemia, suggests that the oral cavity may play a role as a port of entry of septicaemia in patients with haematologic malignancies.

Systemic Diseases in Association with Microbial Species in Oral Biofilm from Elderly Requiring Care

“…Previous studies have suggested that the oral carriage of bacteria causing pneumonia such as K. pneumoniae, Pseudomonas spp., and Staphylococcus spp. is low in healthy subjects, and higher in immunodeficient and myelo-suppressed subjects [20][21][22] and also in patients with severe periodontal disease [23,24]. The significantly higher prevalence of these bacteria in the elderly requiring care is of interest, as they may be at greater risk of developing systemic disease such as pneumonia and heart disease.…”

Ecological control of the gastrointestinal tract. The role of probiotic flora

“…Furthermore, patients with severe diseases such as acute pancreatitis, inflammatory bowel disease, and infection with HIV or AIDS suffer an unacceptably high rate of opportunistic infections. In haematological malignancies, infections constitute the leading cause of morbidity, and 85% of these infections are caused by only a few families of microorganisms, for example, Enterobacteriaceae, Pseudomonaceae, and Micrococcae 13. These potentially pathogenic microorganisms (PPMs) occur normally in healthy individuals as a subflora in the GI tract, but can become dominant by overgrowth in sick patients, especially after antibiotic treatment.…”

Herpes simplex virus and intraoral ulcers in immunocompromised patients with haematologic malignancies

“…According to a sampling method described previously (13), a cotton swab sample was obtained from all patients on each day of the investigation period in order to compare the qualitative composition of the aerobic and facultatively anaerobic oral microflora in febrile episodes with and without the presence of intraoral ulcers. All microbiological samples were taken by the same person.…”