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Oral microorganisms and bloodstream infection in allogeneic hematopoietic stem cell transplantation

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Abstract

Objectives

We aimed to compare oral and pathogenic microorganisms in bloodstream infections (BSIs) in allogeneic hematopoietic stem cell transplantation (allo-HSCT). We also investigated the relationship between BSIs and oral mucositis to identify the ratio of BSIs caused by oral microorganisms and the pathogenic microorganisms involved.

Materials and methods

We collected data on BSIs in 96 patients who underwent allo-HSCT in our institute between April 2009 and December 2019, including BSI pathogens isolated from blood cultures (BBSIs) and microorganisms isolated from washing the oral cavity with sterile distilled water. Oral microorganisms obtained at the onset of BSI (OBSIs) and during allo-HSCT (OSCTs) were defined as isolates collected during the week of blood culturing. Study entry was limited to samples collected up to 1 month after allo-HSCT without BSI. When the BBSI and OBSI were the same, we considered the oral microorganism to have caused the BSI.

Results

The incidence rate of BSIs was 27%, and the predominant microorganism was coagulase-negative Staphylococci. Normal bacterial flora were decreased to 15.8% in OBSIs and 25.5% in OSCTs. The distribution of microorganisms without normal bacterial flora showed significant difference between BBSIs and OSCTs (p < 0.05). Oral mucositis was found in 72.9%, and BSI caused by oral microorganisms occurred in 46.2% of BSIs in allo-HSCT patients.

Conclusion

The distribution of microorganisms obtained from blood in patients with BSI during allo-HSCT was found to be similar to that of microorganisms from oral cultures.

Clinical relevance

Oral microorganism monitoring may be able to predict BSI during allo-HSCT.

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Funding

The work was supported by the Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan

    Yumiko Ohbayashi, Saki Aoki, Mao Tanaka, Yasuhiro Nakai, Fumi Nakai & Minoru Miyake

  2. Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan

    Osamu Imataki & Makiko Uemura

  3. Akihiro Takeuchi, Department of Laboratory Medicine, Kagawa University Hospital, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan

    Akihiro Takeuchi

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  1. Yumiko Ohbayashi
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  2. Osamu Imataki
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  3. Makiko Uemura
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  4. Akihiro Takeuchi
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  7. Yasuhiro Nakai
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  8. Fumi Nakai
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  9. Minoru Miyake
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Osamu Imataki, Makiko Uemura, Akihiro Takeuchi, Saki Aoki, Mao Tanaka, Yasuhiro Nakai, Fumi Nakai, and Minoru Miyake. The first draft of the manuscript was written by Yumiko Ohbayashi and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yumiko Ohbayashi.

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Conflict of interest

Yumiko Ohbayashi, Osamu Imataki, Makiko Uemura, Akihiro Takeuchi, Saki Aoki, Mao Tanaka, Yasuhiro Nakai, Fumi Nakai, and Minoru Miyake declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Kagawa University Ethical Committee (H24-#107). and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

This study was a retrospective observational study, carried out by the opt-out method of our hospital website.

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Ohbayashi, Y., Imataki, O., Uemura, M. et al. Oral microorganisms and bloodstream infection in allogeneic hematopoietic stem cell transplantation. Clin Oral Invest 25, 4359–4367 (2021). https://doi.org/10.1007/s00784-020-03749-9

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