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Intensive oral care can reduce bloodstream infection with coagulase-negative staphylococci after neutrophil engraftment in allogeneic hematopoietic stem-cell transplantation

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Abstract

Purpose

Bloodstream infection (BSI) is a major complication of allogeneic hematopoietic stem-cell transplantation (allo-SCT). There are several causes of BSI; in particular, severe oral mucositis (OM) can induce BSI due to coagulase-negative staphylococci (CoNS). The OM severity may be reduced with intensive oral care. Thus, we evaluated whether the type of oral care affects the BSI incidence eventually.

Method

We performed retrospective analysis on 206 recipients who underwent allo-SCT from 2006 to 2017 at our institute. Intensive oral care by a dental specialist was performed for 111 recipients (intensive-care group) and self-oral care was performed by 95 recipients (self-care group). Incidence of BSI was assessed by type of the oral care, before neutrophil engraftment (pre-E-BSI) and after neutrophil engraftment (post-E-BSI) period until 180 days after allo-SCT.

Result

A total of 112 BSI occurred in 90 of the 206 recipients and 120 bacteria were identified, with CoNS being the most prevalent. There was no significant difference in the incidence of pre-E-BSI between the self-care and intensive-care groups (30.8% and 30.6%, respectively; P = 0.508). Meanwhile, the incidence of post-E-BSI was significantly lower in the intensive-care group than in the self-care group (14.3% and 28.6%; P = 0.008). In addition, the intensive-care group had significantly lower incidence of post-E-BSI with CoNS than the self-care group (8.5% and 21.5%, respectively; P = 0.009).

Conclusion

Intensive oral care through the period of allo-HCT can significantly reduce the post-E-BSI occurrence, especially due to CoNS.

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Data availability

The authors have full control of all primary data and allow the journal to review the code if requested.

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Funding

This study was supported by JSPS KAKENHI Grant Number JP915697 to KF from the Ministry of Education, Culture, Sports, Science, and Technology of Japan.

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Authors and Affiliations

  1. Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, 1-757 Asahimachi-dori Chuoh-ku, Niigata, 951-8510, Japan

    Tatsuya Suwabe, Takayuki Katagiri, Yasuhiko Shibasaki & Hirohito Sone

  2. Department of Hematopoietic Cell Transplantation, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori Chuoh-ku, Niigata, 951-8510, Japan

    Kyoko Fuse & Masayoshi Masuko

  3. Department of Oral Radiology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori Chuoh-ku, Niigata, 951-8510, Japan

    Kouji Katsura & Marie Soga

  4. Laboratory of Hematology and Oncology, Graduate School of Health Sciences, Niigata University, 2-746 Asahimachi-dori, Chuo-ku, Niigata, 951-8518, Japan

    Miwako Narita

Authors
  1. Tatsuya Suwabe
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  2. Kyoko Fuse
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  4. Marie Soga
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  9. Masayoshi Masuko
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Contributions

TS and KF designed this study, analyzed the data, and wrote the manuscript. KK, KT, TK, YS, MN, and HS participated in the conception of the study and providing patient data. MM revised the manuscript and provided administrative support for the study. All authors reviewed and approved the final version of the manuscript.

Corresponding author

Correspondence to Kyoko Fuse.

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Ethics approval

This study was performed as per the Japanese Ethical Guidelines for Medical and Health Research Involving Humans and approved by the ethical committees of Niigata University (Application number: 2018–0087).

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(https://www.med.niigata-u.ac.jp/contents/activity/clinical_research/naika01_1/index.html).

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The authors declare no competing interests.

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Suwabe, T., Fuse, K., Katsura, K. et al. Intensive oral care can reduce bloodstream infection with coagulase-negative staphylococci after neutrophil engraftment in allogeneic hematopoietic stem-cell transplantation. Support Care Cancer 30, 475–485 (2022). https://doi.org/10.1007/s00520-021-06447-8

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