Soares Andréa Ferreira, Aquino Ana Rafaela Luz de, Carvalho Cyntia Helena Pereira de, Nonaka Cassiano Francisco Weege, Almeida Dulce, Pinto Leão Pereira
Department of Morphology, Dental School, UFS - Federal University of Sergipe, Aracaju, SE, Brazil.
Braz Dent J. 2011;22(4):312-6. doi: 10.1590/s0103-64402011000400009.
In view of the morbidity potential of oral complications in patients with leukemia, this study evaluated the clinical and microbiological alterations that occur in the oral mucosa of children with acute lymphoblastic leukemia (ALL) undergoing antineoplastic chemotherapy and prophylactic administration of 0.12% chlorhexidine gluconate. The sample consisted of 17 children aged 2 to 12 years that underwent clinical examination of the oral mucosa for the detection of oral lesions. In addition, biological material was collected from labial and buccal mucosa for microbiological analysis. Oral mucositis was observed in only 5 (29.4%) patients. Microbiological analysis revealed a reduced number of potentially pathogenic microorganisms, such as coagulase-negative staphylococci (47%), Candida albicans (35.3%), Klebsiella pneumoniae (5.9%), enteropathogenic Escherichia coli (5.9%), and Stenotrophomonas maltophilia (5.9%). Patients with oral mucositis showed a higher frequency of coagulase-negative staphylococci (80%) when compared with patients with normal oral mucosa (33.3%). In conclusion, the results of the present study suggest that the prophylactic use of 0.12% chlorhexidine gluconate reduces the frequency of oral mucositis and oral pathogens in children with ALL. In addition, the present findings suggest a possible relationship between coagulase-negative staphylococci and the development of oral mucositis.
鉴于白血病患者口腔并发症的发病可能性，本研究评估了接受抗肿瘤化疗并预防性使用0.12%葡萄糖酸氯己定的急性淋巴细胞白血病（ALL）儿童口腔黏膜发生的临床和微生物学改变。样本包括17名年龄在2至12岁的儿童，他们接受了口腔黏膜临床检查以检测口腔病变。此外，从唇黏膜和颊黏膜采集生物材料进行微生物学分析。仅5名（29.4%）患者观察到口腔黏膜炎。微生物学分析显示潜在致病微生物数量减少，如凝固酶阴性葡萄球菌（47%）、白色念珠菌（35.3%）、肺炎克雷伯菌（5.9%）、肠道致病性大肠杆菌（5.9%）和嗜麦芽窄食单胞菌（5.9%）。与口腔黏膜正常的患者（33.3%）相比，口腔黏膜炎患者凝固酶阴性葡萄球菌的频率更高（80%）。总之，本研究结果表明，预防性使用0.12%葡萄糖酸氯己定可降低ALL儿童口腔黏膜炎和口腔病原体的频率。此外，本研究结果表明凝固酶阴性葡萄球菌与口腔黏膜炎的发生可能存在关联。
