Radiotherapeutic effect on oropharyngeal flora in patients with head and neck cancer

Shara, K. A. Abu; Ghareeb, M. A.; Zaher, Salah; Mobacher, A.; Khalifa, Muhammad; Saleh, SM

doi:10.1017/s0022215100122686

Cited by 17 publications

(11 citation statements)

References 12 publications

(14 reference statements)

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“…To our knowledge this is the first study to characterize aerobic and facultatively anaerobic gram‐negative rods and cocci oral isolates from irradiated individuals suffering from solid tumors similar in nature and subjected to the same therapeutic irradiation protocol. A few reports are available on the increased oral colonization of aerobic and facultatively anaerobic gram‐negative rods and cocci in mucositis either during or immediately after irradiation therapy for what were usually a mixed collection of patients with various head and neck cancers ( 1, 16, 36). However only a few have investigated the delayed colonization patterns of these organisms in head and neck–irradiated individuals, particularly after resolution of irradiation‐induced mucositis.…”

Section: Discussionmentioning

confidence: 99%

Oral colonization of aerobic and facultatively anaerobic gram‐negative rods and cocci in irradiated, dentate, xerostomic individuals

Leung

Yam

et al. 2001

Oral Microbiology and Immunology

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This study aimed at investigating the oral colonization of aerobic and facultatively anaerobic gram-negative rods and cocci in head- and neck-irradiated, dentate, xerostomic individuals. Subjects were recruited from a nasopharyngeal carcinoma clinic and were segregated into group A: <60 years (n=25, 48+/-6 years, 5+/-5 years post-irradiation) and group B: >or=60 years (n=8, 67+/-4 years, 2+/-2 years post-irradiation) and were compared with age- and sex-matched normal individuals, group C: <60 years (n=20, 44+/-12 years) and group D: >or=60 years (n=10, 70+/-3 years). Selective culture of the oral rinse samples was carried out to isolate, quantify and speciate (using API 20E kit) aerobic and facultatively anaerobic gram-negative rods and cocci recovery. All test subjects were put under comprehensive oral and preventive care for 3 months, and 12 group A and 5 group B subjects were recalled for reassessment of aerobic and facultatively anaerobic gram-negative rods and cocci colonization. All identical isolates, pre- and post-hygienic care, were phenotypically (Vitek, Hazelwood, MA and antibiogram profile) and genotypically (pulsed-field gel electrophoresis) evaluated. The aerobic and facultatively anaerobic gram-negative rods and cocci isolated from the first round oral rinse samples included: Acinetobacter, Neisseria, Chryseomonas, Flavimonas, Pseudomonas, Citrobacter, Enterobacter, Escherichia, Klebsiella, Flavobacterium and Weeksella species. The aerobic and facultatively anaerobic gram-negative rods and cocci isolation rate was high for irradiated individuals, and they were 64/25% and 100/80% for groups A/C and B/D, respectively. Recovery of aerobic and facultatively anaerobic gram-negative rods and cocci and Klebsiella pneumoniae subsp. pneumoniae in oral rinse samples were found to be significantly more prevalent in the irradiated subjects (groups A and B). Enterobacteriaceae were more frequently isolated from oral rinse samples of aged irradiated subjects (group B vs D, P<0.05), where the quantity of Citrobacter freundii (colony-forming units/ml oral rinse) was also significantly elevated. The isolation rate of aerobic and facultatively anaerobic gram-negative rods and cocci after hygienic care remained unchanged; 3 of 12 and 3 of 5 of the recalled subjects from groups A and B, respectively, harbored same aerobic and facultatively anaerobic gram-negative rods and cocci species. However, only two pairs of K. pneumoniae subsp. pneumoniae, sequentially isolated from same patients in group B, were found to be identical by pulsed-field gel electrophoresis. This may be due to reinfection of the microbes from the same source or permanent colonization. In conclusion, irradiation-induced xerostomia seems to favor frequent, repeated, transient intraoral colonization of aerobic and facultatively anaerobic gram-negative rods and cocci.

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Section: Discussionmentioning

confidence: 99%

Oral colonization of aerobic and facultatively anaerobic gram‐negative rods and cocci in irradiated, dentate, xerostomic individuals

Leung

Yam

et al. 2001

Oral Microbiology and Immunology

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“…Pulmonary abscesses due to MRSA have been described. 11 Irradiation itself has a significant effect on oropharyngeal flora, and Abu Shara et al 12 reported that Staphylococcus aureus may significantly increase after irradiation. Every effort should be made to ensure patients are rendered microbiologically 'sterile' prior to entering a transplant programme.…”

Section: Discussionmentioning

confidence: 99%

Successful unrelated BMT in a patient with Kostmann syndrome complicated by pre-transplant pulmonary ‘bacterial’ abscesses

Toyoda

Azuma

Hori

et al. 2001

Bone Marrow Transplant

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Kostmann syndrome is a hematologic disorder characterized by a maturation arrest of myelopoiesis. This arrest results in severe neutropenia leading to absolute neutrophil counts (ANC) below 0.2 × 10 9 /l associated with severe bacterial infections.1 The availability of granulocyte colonystimulating factor (G-CSF) has changed the prognosis of Kostmann syndrome.2,3 However, BMT remains the only currently available treatment for those patients refractory to G-CSF. There have been no reports of successful unrelated donor BMT in Kostmann syndrome without myelodysplastic syndrome or leukemic transformation. Zeidler et al 4 reported that most patients received cells from an HLAidentical sibling and concluded that data on alternative donor transplants was insufficient to allow recommendations for their use. Although there are several reports describing successful BMT in the setting of fungal infections, the option of BMT is not well-established in patients with pre-existing bacterial infections, particularly with myeloablative conditioning. This is probably because bacterial infections are usually more aggressive than fungal infections. We describe a patient with pre-transplant pulmonary abscesses which resolved after unrelated HLA-matched BMT.

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“…RT has been associated with the reduction of the blood supply to the irradiated areas, leading to a significant reduction of local immunity, redox potential of the tissues and delay of the wound repair, creating favorable conditions for the proliferation obligate anaerobes, such as genera Fusobacterium, Prevotella, Porphyromonas, and Treponema 23 , most of them considered putative periodontopathogens. In addition, radiation-induced xerostomia appears to affect the populations of anaerobic bacteria in oral cavity and exacerbate the prevalence and proportions of non-oral opportunistic pathogens, particularly staphylococci, enteric rods and cocci, as well pseudomonads in the oral biofilm from irradiated patients with adequate oral hygiene conditions 19,32,51,52 . However, only Gramnegative anaerobes producing black pigment (Porphyromonas spp.…”

Section: Mucositis Oral Bacterial Microbiota Enterobacteriaceae Andmentioning

confidence: 99%

Oral microbiota and mucositis in patients with head and neck cancer undergoing radiotherapy: literature review

Jardim¹,

Cunha-Correia²,

Okamoto³

et al. 2017

Arch Health Invest

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Oral microbiota and mucositis in patients with head and neck cancer undergoing radiotherapy: literature review AbstractThe occurrence and severity of mucositis are the main complaints of patients with head and neck cancer submitted to radiotherapy (RT). This condition appears to be associated with changes in the oral microbiota and other side effects of RT, such as xerostomia and candidiasis. The aim of this study was to evaluate the effect of RT on the oral microbiota and its impact on radioinduced mucositis through literature review. Descriptors were selected for the collection of information in different databases, especially SciELO, BIREME, LILACS and PubMed. It was decided to consider only articles published since 1985. The descriptors radiotherapy, mucositis, dental caries, xerostomia, head and neck neoplasms and health promotion were used. It was selected 91 articles specifically discussing the microbiological aspects of mucositis, dental caries, oral candidiasis and microbial effects on the oral health of cancer patients, and 59 were included in the review. It was observed that microbial contamination is a secondary phenomenon capable of exacerbate the inflammation induced by the interaction of the radiation with the oral tissues, aggravating mucositis mainly in patients who present precarious conditions of oral hygiene, which reinforces the role of preventive dentistry in the follow up of the irradiated patient. Descriptors: Radiotherapy; Mucositis; Dental Caries; Xerostomia; Head And Neck Neoplasms; Health Promotion. ResumoA ocorrência e a severidade da mucosite constituem as principais queixas dos pacientes com câncer de cabeça e pescoço submetidos à radioterapia (RT). Essa condição parece estar associada às modificações da microbiota bucal e aos demais efeitos colaterais da RT, como xerostomia e a candidíase. O presente trabalho de revisão da literatura teve como objetivo avaliar o efeito que a RT exerce sobre a microbiota bucal e seu impacto na mucosite radioinduzida através de revisão de literatura. Foram selecionados os descritores para a coleta de informações em diferentes bancos de dados, destacando-se SciELO, BIREME, LILACS e PubMed. Decidiu-se considerar apenas artigos publicados desde 1985. Utilizou-se como descritores os termos radioterapia, mucosite, cárie dentária, xerostomia, neoplasias de cabeça e pescoço e promoção da saúde. Foram selecionados 91 artigos que discutiam especificamente os aspectos microbiológicos da mucosite, cárie dentária, candidíase oral e efeitos microbianos na saúde bucal de pacientes oncológicos e 59 foram incluídos na revisão. Observou-se que a contaminação microbiana é fenômeno secundário capaz de agravar a inflamação induzida pela interação da radiação com os tecidos bucais, agravando-se, principalmente, em pacientes que apresentam condições precárias de higiene bucal, o que reforça o papel da odontologia preventiva no acompanhamento do paciente irradiado. Descritores: Radioterapia; Mucosite; Cárie Dentária; Xerostomia; Neoplasias de Cabeça e Pescoço; Promoção da...

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Radiotherapeutic effect on oropharyngeal flora in patients with head and neck cancer

Cited by 17 publications

References 12 publications

Oral colonization of aerobic and facultatively anaerobic gram‐negative rods and cocci in irradiated, dentate, xerostomic individuals

Oral colonization of aerobic and facultatively anaerobic gram‐negative rods and cocci in irradiated, dentate, xerostomic individuals

Successful unrelated BMT in a patient with Kostmann syndrome complicated by pre-transplant pulmonary ‘bacterial’ abscesses

Oral microbiota and mucositis in patients with head and neck cancer undergoing radiotherapy: literature review

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