Ohbayashi Yumiko, Imataki Osamu, Uemura Makiko, Takeuchi Akihiro, Aoki Saki, Tanaka Mao, Nakai Yasuhiro, Nakai Fumi, Miyake Minoru
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan.
Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan.
Clin Oral Investig. 2021 Jul;25(7):4359-4367. doi: 10.1007/s00784-020-03749-9. Epub 2021 Jan 3.
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.
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.
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.
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.
Oral microorganism monitoring may be able to predict BSI during allo-HSCT.
我们旨在比较异基因造血干细胞移植（allo-HSCT）中血流感染（BSI）的口腔微生物和致病微生物。我们还研究了BSI与口腔黏膜炎之间的关系，以确定由口腔微生物引起的BSI的比例以及所涉及的致病微生物。
我们收集了2009年4月至2019年12月在我院接受allo-HSCT的96例患者的BSI数据，包括从血培养中分离出的BSI病原体（BBSI）以及用无菌蒸馏水冲洗口腔分离出的微生物。在BSI发病时（OBSI）和allo-HSCT期间（OSCT）获得的口腔微生物被定义为在血培养当周收集的分离株。研究纳入仅限于allo-HSCT后1个月内无BSI时收集的样本。当BBSI和OBSI相同时，我们认为口腔微生物导致了BSI。
BSI的发生率为27%，主要微生物是凝固酶阴性葡萄球菌。正常细菌菌群在OBSI中降至15.8%，在OSCT中降至25.5%。无正常细菌菌群的微生物分布在BBSI和OSCT之间存在显著差异（p<0.05）。在allo-HSCT患者中，72.9%出现口腔黏膜炎，46.2%的BSI由口腔微生物引起。
发现allo-HSCT期间BSI患者血液中获得的微生物分布与口腔培养中的微生物分布相似。
口腔微生物监测可能能够预测allo-HSCT期间的BSI。
