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Filetici P, Gallottini SG, Corvaglia A, Amendolea M, Sangiovanni R, Nicoletti F, D'Addona A, Dassatti L. The role of oral microbiota in the development of oral mucositis in pediatric oncology patients treated with antineoplastic drugs: a systematic review. BMC Oral Health 2024; 24:183. [PMID: 38317151 PMCID: PMC10840280 DOI: 10.1186/s12903-024-03938-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND In the pediatric oncology population, oral mucositis as a consequence of chemotherapy is a highly prevalent complication which strongly affects both the quality of life and treatment possibilities of the patients. Still, the etiopathological mechanisms carrying to its development are not fully understood, although a possible role of oral dysbiosis has been previously investigated with unclear conclusions. The aim of this systematic review was to assess the available evidence on the role of microbiota in the development of oral mucositis. METHODS A systematic literature search was performed following PRISMA guidelines. Three electronic databases were searched up until April 2023 and a following manual search included the reference lists of the included studies and reviews. Studies reporting microbiological and clinical data of pediatric patients treated by antineoplastic drugs were included. RESULTS Thirteen studies met the inclusion criteria, reporting an average mucositis prevalence of 57,6%. Candida albicans infections were frequently observed in studies performing microbiological analysis on oral lesions, in contrast with the low rate detection of the Herpes simplex viruses. Bacterial species such as coagulase-negative Staphylococci and Streptococcus viridans were detected more frequently on lesion sites. Studies reporting a quantitative analysis of the general flora did not show comparable results. Risk of bias assessment among studies was generally considered high or very high. CONCLUSIONS While the specific role of certain microbiological agents, such as Candida albicans, was frequently reported among studies, data regarding the general dynamics of oral microbiota in the development of oral mucositis are lacking in the current literature. Thus, more studies are needed to provide the knowledge required in order to improve protocols for the prevention and treatment of this threatening complication.
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Affiliation(s)
- Pierfrancesco Filetici
- Department of Head and Neck and Sensory Organs, Università Cattolica del Sacro Cuore, Rome, Italy.
- Unit of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy.
| | - Sofia Germana Gallottini
- Department of Head and Neck and Sensory Organs, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Corvaglia
- Department of Head and Neck and Sensory Organs, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Martina Amendolea
- Department of Head and Neck and Sensory Organs, Università Cattolica del Sacro Cuore, Rome, Italy
- Unit of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - Roberta Sangiovanni
- Department of Head and Neck and Sensory Organs, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fabrizio Nicoletti
- Department of Head and Neck and Sensory Organs, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio D'Addona
- Department of Head and Neck and Sensory Organs, Università Cattolica del Sacro Cuore, Rome, Italy
- Unit of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - Leonardo Dassatti
- Department of Head and Neck and Sensory Organs, Università Cattolica del Sacro Cuore, Rome, Italy
- Unit of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
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Abstract
Oral squamous cell carcinoma (OSCC) is associated with oral Candida albicans infection, although it is unclear whether the fungus promotes the genesis and progression of OSCC or whether cancer facilitates fungal growth. In this study, we investigated whether C. albicans can potentiate OSCC tumor development and progression. In vitro, the presence of live C. albicans, but not Candida parapsilosis, enhanced the progression of OSCC by stimulating the production of matrix metalloproteinases, oncometabolites, protumor signaling pathways, and overexpression of prognostic marker genes associated with metastatic events. C. albicans also upregulated oncogenes in nonmalignant cells. Using a newly established xenograft in vivo mouse model to investigate OSCC-C. albicans interactions, oral candidiasis enhanced the progression of OSCC through inflammation and induced the overexpression of metastatic genes and significant changes in markers of the epithelial-mesenchymal transition. Finally, using the 4-nitroquinoline 1-oxide (4NQO) murine model, we directly correlate these in vitro and short-term in vivo findings with the progression of oncogenesis over the long term. Taken together, these data indicate that C. albicans upregulates oncogenes, potentiates a premalignant phenotype, and is involved in early and late stages of malignant promotion and progression of oral cancer. IMPORTANCE Oral squamous cell carcinoma (OSCC) is a serious health issue worldwide that accounts for 2% to 4% of all cancer cases. Previous studies have revealed a higher yeast carriage and diversity in oral cancer patients than in healthy individuals. Furthermore, fungal colonization in the oral cavity bearing OSCC is higher on the neoplastic epithelial surface than on adjacent healthy surfaces, indicating a positive association between oral yeast carriage and epithelial carcinoma. In addition to this, there is strong evidence supporting the idea that Candida contributes to carcinogenesis events in the oral cavity. Here, we show that an increase in Candida albicans burden promotes an oncogenic phenotype in the oral cavity.
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3
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Moshtaha W. Oral Complications of Dental Prosthetic for Patients after Chemotherapy and Radiotherapy Treatment. DENTAL HYPOTHESES 2021. [DOI: 10.4103/denthyp.denthyp_57_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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4
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Jolivet-Gougeon A, Bonnaure-Mallet M. Screening for prevalence and abundance of Capnocytophaga spp by analyzing NGS data: A scoping review. Oral Dis 2020; 27:1621-1630. [PMID: 32738007 DOI: 10.1111/odi.13573] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/07/2020] [Accepted: 07/19/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Capnocytophaga spp. are commensal bacteria of the oral cavity and constitute a genus of the core microbiome. OBJECTIVE This genus is responsible for many local and systemic conditions in both the immunocompetent and immunocompromised patients, but its beneficial or deleterious role in the microbiota has been little explored. DESIGN Online databases were used to identify papers published from 1999 to 2019 based on next-generation sequencing (NGS) data to study comparative trials. Work using other identification methods, case reports, reviews, and non-comparative clinical trials was excluded. RESULTS AND CONCLUSION We selected 42 papers from among 668 publications. They showed a link between the abundance of Capnocytophaga spp. in the oral microbiota and various local pathologies (higher for gingivitis and halitosis; lower in active smokers, etc.) or systemic diseases (higher for cancer and carcinomas, IgA nephropathy, etc.). After discussing the limits inherent to the NGS techniques, we present several technical and biological hypotheses to explain the diversity of results observed between studies, as well as the links between the higher or lower abundance of Capnocytophaga spp and the appearance of local or systemic conditions and diseases.
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Affiliation(s)
- Anne Jolivet-Gougeon
- INSERM, INRAE, CHU Rennes, Institut NUMECAN (Nutrition Metabolisms and Cancer), Univ Rennes, Rennes, France
| | - Martine Bonnaure-Mallet
- INSERM, INRAE, CHU Rennes, Institut NUMECAN (Nutrition Metabolisms and Cancer), Univ Rennes, Rennes, France
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5
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Singh S, Singh S, Tiwari MB, Pal US, Kumar S. Microflora analysis in the postchemotherapy patients of oral cancer. Natl J Maxillofac Surg 2019; 10:141-145. [PMID: 31798247 PMCID: PMC6883871 DOI: 10.4103/njms.njms_7_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 05/27/2019] [Accepted: 06/03/2019] [Indexed: 12/18/2022] Open
Abstract
Background: To assess changes in oral microflora in dental plaque from cancer patients within 7 days of the first course of chemotherapy and the relationship of the changes with mucositis. Materials and Methods: Thirty cancer patients, divided into a test group undergoing chemotherapy and a control group not undergoing chemotherapy, were enrolled in this pilot study. Oral microflora was cultured from three samples of dental plaque at t0 (before chemotherapy), t1 (1 day after chemotherapy), and t2 (7 days after chemotherapy). Single and crossed descriptive analyses were used to establish prevalence, and the Chi-square test was used to establish the statistical significance of the differences observed in distributions (significance level: P < 0.05). Results: In most patients (55%), oral microflora consisted mainly of Gram-positive cocci, while the remaining 45% of the bacterial flora also had periodontal-pathogenic species. No Porphyromonas gingivalis appeared in the test group. Actinobacillus was the least frequently found bacterium among periodontal pathogens in the test group, while Fusobacterium nucleatum was the most frequently found. No significant differences were found in quantitative bacterial changes between t0, t1, and t2 in either the test or control groups, or between the two groups. According to World Health Organization scores, oral mucositis developed in 10 patients (66.6%) in the test group. Conclusions: The results of this pilot study indicate that there were no changes in microflora in dental plaque in cancer patients within 7 days of the first course of chemotherapy. No correlations between oral mucositis and specific microorganisms were assessed.
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Affiliation(s)
- Sunita Singh
- Department of Microbiology, King Georges Medical University, Lucknow, Uttar Pradesh, India
| | - Seema Singh
- Department of Respiratory Medicine, King Georges Medical University, Lucknow, Uttar Pradesh, India
| | - M B Tiwari
- Department of Microbiology, King Georges Medical University, Lucknow, Uttar Pradesh, India
| | - U S Pal
- Department of Oral and Maxillofacial Surgery, King Georges Medical University, Lucknow, Uttar Pradesh, India
| | - Santosh Kumar
- Department of Respiratory Medicine, King Georges Medical University, Lucknow, Uttar Pradesh, India
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6
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Bunetel L, Tamanai-Shacoori Z, Martin B, Autier B, Guiller A, Bonnaure-Mallet M. Interactions between oral commensal Candida and oral bacterial communities in immunocompromised and healthy children. J Mycol Med 2019; 29:223-232. [PMID: 31235209 DOI: 10.1016/j.mycmed.2019.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 06/07/2019] [Accepted: 06/07/2019] [Indexed: 01/09/2023]
Abstract
Candida species are usually found as commensal microorganisms in the oral cavity of healthy people. During chemotherapy, cytostatic drugs lead to depletion of the oral flora with the emergence of a dominant bacterial species. The transition from commensal to pathogenic state, further associated with yeast colonization and oral mucositis implies a replacement of the dominant microorganism by Candida albicans. This process goes plausibly through cooperation between C. albicans and bacteria. This study focused on the first step of cooperation between microorganisms isolated from the same oral flora either of leukemic or healthy children. C. albicans isolated from 8/20 children were cultured to display their noninvasive blastosporic yeast form and mixed with their dominant bacteria to study the capacity of planktonic aggregation and the early state of biofilm formation. None of the dominant bacteria opposed the presence of yeast, on the contrary, an interesting cooperation was observed. This behavior is apparently different from that observed when mixing the type strains. In fact, three mutated C. albicans strains display, by their spontaneous ability to form filament, enhanced risks of virulence for leukemic ill carriers. Despite such risks, neither oral nor systemic pathology were observed in ill patients probably because the study was conducted during the first course of chemotherapy and Candida colonization is related to the number of chemotherapeutic cycles. The presence of C. albicans during the initial cycle represents, by its ability to interact with oral bacteria, an actual threat for further cures.
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Affiliation(s)
- L Bunetel
- CNRS, ISCR UMR 6226, université Rennes, 35000 Rennes, France.
| | | | - B Martin
- Inserm U 1241, Inra, université Rennes, 35043 Rennes, France
| | - B Autier
- Centre hospitalier universitaire Rennes, 35033 Rennes, France
| | - A Guiller
- CNRS - UPJV Edysan FRE 3498, université Amiens, 80000 Amiens, France
| | - M Bonnaure-Mallet
- Inserm U 1241, Inra, université Rennes, 35043 Rennes, France; Centre hospitalier universitaire Rennes, 35033 Rennes, France
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7
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Zecha JAEM, Raber-Durlacher JE, Laheij AMGA, Westermann AM, Epstein JB, de Lange J, Smeele LE. The impact of the oral cavity in febrile neutropenia and infectious complications in patients treated with myelosuppressive chemotherapy. Support Care Cancer 2019; 27:3667-3679. [PMID: 31222393 PMCID: PMC6726710 DOI: 10.1007/s00520-019-04925-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 06/05/2019] [Indexed: 12/12/2022]
Abstract
Febrile neutropenia (FN) is an inflammatory response causing fever that may develop during cancer therapy-induced neutropenia. FN may herald life-threatening infectious complications and should therefore be considered a medical emergency. Patients presenting with FN are routinely subjected to careful history taking and physical examination including X-rays and microbiological evaluations. Nevertheless, an infection is documented clinically in only 20-30% of cases, whereas a causative microbial pathogen is not identified in over 70% of FN cases. The oral cavity is generally only visually inspected. Although it is recognized that ulcerative oral mucositis may be involved in the development of FN, the contribution of infections of the periodontium, the dentition, and salivary glands may be underestimated. These infections can be easily overlooked, as symptoms and signs of inflammation may be limited or absent during neutropenia. This narrative review is aimed to inform the clinician on the potential role of the oral cavity as a potential source in the development of FN. Areas for future research directed to advancing optimal management strategies are discussed.
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Affiliation(s)
- Judith A E M Zecha
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Judith E Raber-Durlacher
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.,Department of Oral Medicine, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Alexa M G A Laheij
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Anneke M Westermann
- Department of Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Joel B Epstein
- Cedars-Sinai Health System, Los Angeles and City of Hope Cancer Center, Duarte, CA, USA
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.,Academic Centre for Dentistry, (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - Ludi E Smeele
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.,Academic Centre for Dentistry, (ACTA), University of Amsterdam, Amsterdam, The Netherlands.,Department of Head & Neck Oncology & Surgery, Netherlands Cancer Institute- Antoni van Leeuwenhoek, Amsterdam, The Netherlands
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8
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Parra JJ, Alvarado MC, Monsalve P, Costa ALF, Montesinos GA, Parra PA. Oral health in children with acute lymphoblastic leukaemia: before and after chemotherapy treatment. Eur Arch Paediatr Dent 2019; 21:129-136. [PMID: 31214964 DOI: 10.1007/s40368-019-00454-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 05/17/2019] [Indexed: 10/26/2022]
Abstract
AIM To evaluate changes in the oral health status of children under the age of 14 years with acute lymphoblastic leukaemia (ALL) attending a cancer centre before and after chemotherapy treatment. MATERIALS AND METHODS A total of 32 children with ALL without distinction of gender were selected for study. The oral cavity of the patients was evaluated before the induction stage and 17 days later. Clinical evaluation of the submandibular, submental, and cervical lymph nodes was performed. Saliva samples were collected during the early morning hours. Bacterial plaque was assessed by using the Silness and Löe plaque index (SLPI) and gingiva status was evaluated with the gingival Löe and Silness index (GLSI). The WHO toxicity oral scale was used to record the degree of oral mucositis. The resulting data were analysed with McNemar's test, t test (for related samples), and Wilcoxon test. RESULTS There were statistically significant differences for palpable lymph nodes, paleness of oral mucosa, and ecchymoseis, respectively, P ≤ 0.000, P = 0.03, and P = 0.01, with these manifestations decreasing significantly after treatment. Incipient gingivitis had frequencies of 71.9% and 75% before and after treatment, respectively. The mean SLPI score declined significantly from 1.16 ± 0.52 (before treatment) to 0.56 ± 0.36 (after treatment) (P < 0.000); salivary flow increased significantly from 0.54 ± 0.34 to 1.22 ± 1.07 after chemotherapy treatment (P < 0.00). Oral mucositis was present in 24 children (75%) with a 1-2 severity level. CONCLUSIONS After chemotherapy treatment, there were changes in the oral conditions of children with ALL. Some manifestations decreased after treatment, whereas in others increased.
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Affiliation(s)
- J J Parra
- Department of Pediatric Dentistry, School of Pediatric Dentistry, University of Cuenca-Ecuador, Av. 12 de Abril y El Paraíso 3-52, Cuenca, Ecuador.
| | | | - P Monsalve
- Cancer Institute, SOLCA-Cuenca, Cuenca, Ecuador
| | - A L F Costa
- Postgraduate Program in Dentistry, Cruzeiro do Sul University (UNICSUL), São Paulo, SP, Brazil
| | - G A Montesinos
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - P A Parra
- Department of Pneumology, José Carrasco Arteaga Hospital, Cuenca, Ecuador
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9
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Basaranoglu ST, Ozsurekci Y, Aykac K, Aycan AE, Bıcakcigil A, Altun B, Sancak B, Cengiz AB, Kara A, Ceyhan M. Streptococcus mitis/oralis Causing Blood Stream Infections in Pediatric Patients. Jpn J Infect Dis 2018; 72:1-6. [PMID: 30175731 DOI: 10.7883/yoken.jjid.2018.074] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Viridans streptococci are still under investigation concerning epidemiology, pathogenesis and clinical presentations. We aimed to investigate the clinical presentations and outcomes of pediatric patients infected with Streptococcus mitis/oralis. Based on the accumulation of bloodstream infections (BSI) caused by S. mitis/oralis in 4 patients in our Hematology and Bone Marrow Transplantation Department at a particular time, a review of the medical and microbiological records of pediatric patients with positive blood cultures for S. mitis/oralis in the entire hospital was performed. In addition, a retrospective case-control study was conducted. Pulsed-field gel electrophoresis of S. mitis/oralis in 4 patients displayed unrelatedness of the strains. A total of 53 BSI (42 BSI and 11 catheter-related BSI) were analyzed. Thirty-four percent of patients with BSI caused by S. mitis/oralis had febrile neutropenia. Clinical and microbiological outcomes were favorable and infection-related mortality was not observed. Although not significant, previous antibiotic use and trimethoprim-sulfamethoxazole prophylaxis were more common in the case group. S. mitis/oralis seems likely an important agent in bacteremic children who are particularly neutropenic because of the underlying hematologic and oncologic diseases. Prompt management of infections with appropriate antimicrobials, regarding antibiotic susceptibilities of organisms, may facilitate favorable outcomes.
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Affiliation(s)
| | - Yasemin Ozsurekci
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine
| | - Kubra Aykac
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine
| | - Ahmet Emre Aycan
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine
| | - Asiye Bıcakcigil
- Department of Microbiology, Hacettepe University Faculty of Medicine
| | - Belgin Altun
- Department of Microbiology, Hacettepe University Faculty of Medicine
| | - Banu Sancak
- Department of Microbiology, Hacettepe University Faculty of Medicine
| | - Ali Bülent Cengiz
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine
| | - Ates Kara
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine
| | - Mehmet Ceyhan
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine
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10
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Mathews J, Patel M. Bacterial endotoxins and microorganisms in the oral cavities of patients on cancer therapy. Microb Pathog 2018; 123:190-195. [PMID: 30016679 DOI: 10.1016/j.micpath.2018.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 05/28/2018] [Accepted: 07/13/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES This study investigated the presence of Streptococci, Staphylococci, aerobic gram negative bacteria (AGNB), Candida and bacterial endotoxins in the oral cavities of patients receiving chemo- and/or radiotherapy for cancer. METHODS Samples of oral cavity rinse were collected from 100 patients on cancer treatment and 70 healthy individuals. Demographic and clinical data were recorded. Samples were cultured onto various agar plates for qualitative and quantitative analysis and tested for the presence of endotoxin. Results were analysed using the Mann-Whitney and chi-square tests. RESULTS In cancer patients, S. aureus counts were high and 66.7% of patients on chemo- and radiotherapy carried these bacteria (p=<0.05). The Candida carrier rate was significantly (p < 0.01) high in cancer patients (54%). No significant difference was found in the carrier rate of Streptococci and AGNB between the healthy and cancer group as well as between the cancer patients with chemo and radio- and chemotherapy alone. No significant difference was found in the level of endotoxin between the cancer patients and healthy individuals, and cancer patients with and without AGNB. CONCLUSIONS No differences in the prevalence of bacteria and bacterial endotoxins were found between the cancer patients and healthy individuals. Oral cavity endotoxins did not correlate with the carriage of AGNB. However, due to the high prevalence in cancer patients, the role of Candida species and S. aureus in the pathology may not be excluded.
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Affiliation(s)
- J Mathews
- Department of Oral Biological Sciences, School of Oral Health Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - M Patel
- Department of Oral Biological Sciences, School of Oral Health Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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11
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Villafuerte KRV, Martinez CDJH, Dantas FT, Carrara HHA, dos Reis FJC, Palioto DB. The impact of chemotherapeutic treatment on the oral microbiota of patients with cancer: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:552-566. [DOI: 10.1016/j.oooo.2018.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/31/2018] [Accepted: 02/10/2018] [Indexed: 01/01/2023]
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12
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Aghazadeh Z, Pouralibaba F, Yari Khosroushahi A. The prophylactic effect of Acetobacter syzygii probiotic species against squamous cell carcinoma. J Dent Res Dent Clin Dent Prospects 2017; 11:208-214. [PMID: 29354246 PMCID: PMC5768952 DOI: 10.15171/joddd.2017.037] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 05/31/2017] [Indexed: 11/09/2022] Open
Abstract
Background. Squamous cell carcinoma is a prevalent carcinoma of the oral cavity. Recently anti-proliferative effect of probiotics has been considered and assessed against different cancers. The aim of this study was to evaluate the cytotoxicity of Acetobacter syzygii strain supernatant on KB human oral cancer cell line and KDR human epithelial normal cell line. Methods. The cytotoxicity assessments were performed through 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) as well as through qualitative (4',6-diamidino-2-phenylindole staining) and quantitative (flow cytometry assessments using the BD Biosciences Annexin V-FITC Kit) evaluations of apoptosis. Results.A. syzygii secretions exhibited significant cytotoxicity against KB cancer cell lines similar to cisplatin (75.7% apoptosis) while the rate of apoptosis in KDR normal cells was only 9.36%. The prophylactic effects of Lactobacillus acidophilus (PTCC 1643), as a reference bacterium, was similar to A. syzygii, indicating beneficial effects of useful bacteria on prevention of oral diseases. Conclusion. The anticancer bioactivity of A. syzygii strain secretions depends on the induction of apoptosis in KB cancer cells. However, several investigations should be conducted to precisely determine effective compounds to be used as anticancer therapeutics in the future.
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Affiliation(s)
- Zahra Aghazadeh
- Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Firoz Pouralibaba
- Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Yari Khosroushahi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Pharmacognosy, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
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13
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Vozza I, Caldarazzo V, Ottolenghi L. Changes in microflora in dental plaque from cancer patients undergoing chemotherapy and the relationship of these changes with mucositis: A pilot study. Med Oral Patol Oral Cir Bucal 2015; 20:e259-66. [PMID: 25662538 PMCID: PMC4464911 DOI: 10.4317/medoral.19934] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 10/02/2014] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND To assess changes in oral microflora in dental plaque from cancer patients within 7 days of the first course of chemotherapy, and the relationship of the changes with mucositis. MATERIAL AND METHODS Thirty cancer patients, divided into a test group undergoing chemotherapy and a control group no undergoing chemotherapy, were enrolled in this pilot study. Oral microflora were cultured from three samples of dental plaque at t0 (before chemotherapy), t1 (1 day after chemotherapy) and t2 (7 days after chemotherapy). Single and crossed descriptive analyses were used to establish prevalence, and the χ² test was used to establish the statistical significance of the differences observed in distributions (significance level: P<0.05). RESULTS In most patients (57%), oral microflora consisted mainly of Gram-positive cocci, while the remaining 43% of the bacterial flora also had periodontal-pathogenic species. No Porphyromonas gingivalis appeared in the test group. Actinobacillus was the least frequently found bacterium among periodontal pathogens in the test group, while Fusobacterium nucleatum was the most frequently found. No significant differences were found in quantitative bacterial changes between t0, t1 and t2 in either the test or control groups, or between the two groups. According to World Health Organization scores, oral mucositis developed in 10 patients (66.6%) in the test group. CONCLUSIONS The results of this pilot study indicate that there were no changes in microflora in dental plaque in cancer patients within 7 days of the first course of chemotherapy. No correlations between oral mucositis and specific microorganisms were assessed.
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Affiliation(s)
- Iole Vozza
- Oral and Maxillo-facial Sciences Department, Sapienza University of Rome, Via Caserta 6 - 00161 Rome, Italy,
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14
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Wang Y, Xue J, Zhou X, You M, Du Q, Yang X, He J, Zou J, Cheng L, Li M, Li Y, Zhu Y, Li J, Shi W, Xu X. Oral microbiota distinguishes acute lymphoblastic leukemia pediatric hosts from healthy populations. PLoS One 2014; 9:e102116. [PMID: 25025462 PMCID: PMC4099009 DOI: 10.1371/journal.pone.0102116] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 06/15/2014] [Indexed: 02/05/2023] Open
Abstract
In leukemia, oral manifestations indicate aberrations in oral microbiota. Microbiota structure is determined by both host and environmental factors. In human hosts, how health status shapes the composition of oral microbiota is largely unknown. Taking advantage of advances in high-throughput sequencing, we compared the composition of supragingival plaque microbiota of acute lymphoblastic leukemia (ALL) pediatric patients with healthy controls. The oral microbiota of leukemia patients had lower richness and less diversity compared to healthy controls. Microbial samples clustered into two major groups, one of ALL patients and another of healthy children, with different structure and composition. Abundance changes of certain taxa including the Phylum Firmicutes, the Class Bacilli, the Order Lactobacillales, the Family Aerococcaceae and Carnobacteriaceae, as well as the Genus Abiotrophia and Granulicatella were associated with leukemia status. ALL patients demonstrated a structural imbalance of the oral microbiota, characterized by reduced diversity and abundance alterations, possibly involved in systemic infections, indicating the importance of immune status in shaping the structure of oral microbiota.
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Affiliation(s)
- Yan Wang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jing Xue
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Meng You
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qin Du
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xue Yang
- Department of Pediatric Hematology and Oncology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Jingzhi He
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jing Zou
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Mingyun Li
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuqing Li
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yiping Zhu
- Department of Pediatric Hematology and Oncology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Jiyao Li
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wenyuan Shi
- UCLA School of Dentistry, Los Angeles, California, United States of America
| | - Xin Xu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- * E-mail:
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15
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Yamashita K, Ohara M, Kojima T, Nishimura R, Ogawa T, Hino T, Okada M, Toratani S, Kamata N, Sugai M, Sugiyama M. Prevalence of drug-resistant opportunistic microorganisms in oral cavity after treatment for oral cancer. J Oral Sci 2014; 55:145-55. [PMID: 23748454 DOI: 10.2334/josnusd.55.145] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Drug-resistant opportunistic infections may cause health problems in immunocompromised hosts. Representative microorganisms in opportunistic infections of the oral cavity are Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. We investigated the prevalence of drug-resistant opportunistic microorganisms in elderly adults receiving follow-up examinations after primary treatment of oral cancer. Oral microorganisms were collected from patients satisfactorily treated for oral cancer (defined as good outcomes to date) and a group of healthy adults (controls). After identification of microorganisms, the prevalence of drug-resistant microorganisms was studied. Pulsed-field gel electrophoresis (PFGE) and staphylococcal cassette chromosome mec (SCCmec) typing were also performed for methicillin-resistant S aureus (MRSA). Statistical analysis revealed no significant differences in the prevalences of the three microorganisms between the groups. Surprisingly, 69.2% of S aureus isolates showed oxacillin resistance, suggesting that MRSA colonization is increasing among older Japanese. These MRSA isolates possessed SCCmec types II and IV but no representative toxin genes. Our results indicate that a basic infection control strategy, including standard precautions against MRSA, is important for elderly adults, particularly after treatment for oral cancer.
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Affiliation(s)
- Kaoru Yamashita
- Department of Public Oral Health, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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16
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Laheij AMGA, de Soet JJ, von dem Borne PA, Kuijper EJ, Kraneveld EA, van Loveren C, Raber-Durlacher JE. Oral bacteria and yeasts in relationship to oral ulcerations in hematopoietic stem cell transplant recipients. Support Care Cancer 2012; 20:3231-40. [PMID: 22531876 PMCID: PMC3480583 DOI: 10.1007/s00520-012-1463-2] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 04/02/2012] [Indexed: 11/09/2022]
Abstract
BACKGROUND Oral mucositis is a serious and debilitating side effect of conditioning regimens for hematopoietic stem cell transplant (HSCT). Through HSCT, the homeostasis in the oral cavity is disrupted. The contribution of the oral microflora to mucositis remains to be clarified. The aim of our study was to investigate the relationship between yeasts, bacteria associated with periodontitis, and oral ulcerations in HSCT recipients. METHODS This prospective observational study included 49 adult HSCT recipients. Twice weekly, oral ulcerations were scored, and oral rinsing samples were obtained. Samples were evaluated for the total bacterial load; the Gram-negative bacteria: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Parvimonas micra, Fusobacterium nucleatum, Tannerella forsythia, and Treponema denticola; and the yeasts: Candida albicans, Candida glabrata, Candida kefyr, Candida krusei, Candida parapsilosis, and Candida tropicalis using real-time polymerase chain reaction with specific primers and probes. Explanatory variables for oral ulcerations were calculated using the multilevel generalized estimated equations (GEE) technique. RESULTS None of the samples was positive for A. actinomycetemcomitans, while F. nucleatum was found most often (66 % of samples). C. albicans was the most isolated yeast (88 % of samples), whereas C. parapsilosis was found in only 8 % of the samples. Multivariate GEE analyses identified P. gingivalis, P. micra, T. denticola, F. nucleatum, C. glabrata, and C. kefyr as significant explanatory variables of oral ulcerations. CONCLUSIONS Our data indicate that P. gingivalis in particular, but also P. micra, T. denticola, F. nucleatum, C. glabrata, and C. kefyr may play a role in ulcerative oral mucositis in patients undergoing HSCT.
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Affiliation(s)
- Alexa M G A Laheij
- Department of Preventive Dentistry, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands.
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17
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Ullman A, Long D, Lewis P. The oral health of critically ill children: an observational cohort study. J Clin Nurs 2011; 20:3070-80. [PMID: 21801254 DOI: 10.1111/j.1365-2702.2011.03797.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES This study will describe the oral health status of critically ill children over time spent in the paediatric intensive care unit, examine influences on the development of poor oral health and explore the relationship between dysfunctional oral health and healthcare-associated infections. BACKGROUND The treatment modalities used to support children experiencing critical illness and the progression of critical illness may result in dysfunction in the oral cavity. In adults, oral health has been shown to worsen during critical illness as well as influence systemic health. DESIGN A prospective observational cohort design was used. METHOD The study was undertaken at a single tertiary-referral Paediatric Intensive Care Unit. Oral health status was measured using the Oral Assessment Scale and culturing oropharyngeal flora. Information was also collected surrounding the use of supportive therapies, clinical characteristics of the children and the occurrence of healthcare-associated infections. RESULTS Of the 46 participants, 63% (n = 32) had oral dysfunction and 41% (n = 19) demonstrated pathogenic oropharyngeal colonisation during their critical illness. The potential systemic pathogens isolated from the oropharynx and included Candida sp., Staphylococcus aureus, Haemophilus influenzae, Enterococcus sp. and Pseudomonas aeruginosa. The severity of critical illness had a significant positive relationship (p < 0·05) with pathogenic and absent colonisation of the oropharynx. Sixty-three percent of healthcare-associated infections involved the preceding or simultaneous colonisation of the oropharynx by the causative pathogen. CONCLUSIONS This study suggests paediatric oral health to be frequently dysfunctional and the oropharynx to repeatedly harbour potential systemic pathogens during childhood critical illness. RELEVANCE TO CLINICAL PRACTICE Given the frequency of poor oral health during childhood critical illness in this study and the subsequent potential systemic consequences, evidence based oral hygiene practices should be developed and validated to guide clinicians when nursing critically ill children.
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Affiliation(s)
- Amanda Ullman
- School of Nursing, Queensland University of Technology, Paediatric Intensive Care Unit, Royal Children's Hospital, Herston, Qld, Australia.
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18
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Meurman JH. Oral microbiota and cancer. J Oral Microbiol 2010; 2. [PMID: 21523227 PMCID: PMC3084564 DOI: 10.3402/jom.v2i0.5195] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2010] [Revised: 06/29/2010] [Accepted: 06/29/2010] [Indexed: 12/15/2022] Open
Abstract
Inflammation caused by infections may be the most important preventable cause of cancer in general. However, in the oral cavity the role of microbiota in carcinogenesis is not known. Microbial populations on mouth mucosa differ between healthy and malignant sites and certain oral bacterial species have been linked with malignancies but the evidence is still weak in this respect. Nevertheless, oral microorganisms inevitably up-regulate cytokines and other inflammatory mediators that affect the complex metabolic pathways and may thus be involved in carcinogenesis. Poor oral health associates statistically with prevalence of many types of cancer, such as pancreatic and gastrointestinal cancer. Furthermore, several oral micro-organisms are capable of converting alcohol to carcinogenic acetaldehyde which also may partly explain the known association between heavy drinking, smoking, poor oral health and the prevalence of oral and upper gastrointestinal cancer. A different problem is the cancer treatment-caused alterations in oral microbiota which may lead to the emergence of potential pathogens and subsequent other systemic health problems to the patients. Hence clinical guidelines and recommendations have been presented to control oral microbiota in patients with malignant disease, but also in this area the scientific evidence is weak. More controlled studies are needed for further conclusion.
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Affiliation(s)
- Jukka H Meurman
- Institute of Dentistry, University of Helsinki, Helsinki, Finland
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19
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Jolivet-Gougeon A, Guérin J, Tamanai-Shacoori Z, Gandemer V, Sixou JL, Bonnaure-Mallet M. Influence of previous antimicrobial therapy on oral carriage of beta-lactamase producing Capnocytophaga isolates. Acta Paediatr 2008; 97:964-7. [PMID: 18532936 DOI: 10.1111/j.1651-2227.2008.00824.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM In order to assess the prevalence of beta-lactamase producing oral bacteria in childhood, the influence of different parameters on the oral carriage of Capnocytophaga was studied in a specific population of children with cancer. The examined parameters included clinical observation of oropharyngeal mucosa, type of malignant disease and intake of chemotherapy and antimicrobial treatment. METHODS The gingival and mucosal status of the patients was recorded before each sampling procedure. Samples were collected by oropharyngeal swabbing in children with leukaemia or other oncological diseases for isolation of Capnocytophaga strains. RESULTS Capnocytophaga strains were more often isolated in samples from children with oncological diseases (71%) other than leukaemia (57%). Concomitant chemotherapy had no influence on oral Capnocytophaga carriage. A significant decrease of the prevalence of Capnocytophaga strains isolated was observed in children who received antimicrobial treatment within 8 days before the sampling procedure (15.5% vs. 28%). But, the incidence of beta-lactamase-producing strains was not linked to previous antimicrobial treatments. CONCLUSION Oral carriage of Capnocytophaga strains can be linked to haematological disease and previous antibiotherapy, but results did not confirm that beta-lactamase treatments exert a selective pressure. Other factors might be involved in emerging for oral beta-lactamase-producing Capnocytophaga strains.
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20
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Avşar A, Elli M, Darka O, Pinarli G. Long-term effects of chemotherapy on caries formation, dental development, and salivary factors in childhood cancer survivors. ACTA ACUST UNITED AC 2007; 104:781-9. [PMID: 17618135 DOI: 10.1016/j.tripleo.2007.02.029] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2006] [Revised: 12/07/2006] [Accepted: 02/22/2007] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the long-term effects of chemotherapy on oral health and dental development in childhood cancer survivors (CCS). STUDY DESIGN Ninety-six CCS patients with a mean age of 10.8 years and 96 healthy children of the same age and sex and social background composed the study group. The caries experience of the children was recorded according to the criteria of the World Health Organization, and plaque-gingival status was evaluated according to the Silness-Loe Index. The children were also investigated for stimulated salivary flow rate, buffer capacity, salivary mutans streptococci, and lactobacilli. Disturbances of enamel mineralization were recorded according to the index of developmental defects in dental enamel. Dental development disturbances were diagnosed on panoramic radiographs. RESULTS The caries experience, mutans streptococci, and lactobacilli colonization in CCS children were found significantly higher than in the healthy subjects (P < .05). White/cream colored opacities were the most frequent enamel mineralization disturbances (69.8 %). The occurrence of arrested root development with short V-shaped root malformation was significantly higher in CCS children than in the healthy subjects (P < .05). No statistically significant difference was found between group <or=5 years and >5 years. CONCLUSION This current investigation has shown that CCS children are at an increased risk of caries and developmental dental disturbances.
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Affiliation(s)
- Aysun Avşar
- Department of Pediatric Dentistry, Faculty of Dentistry, University of Ondokuz Mayis, Samsun, Turkey.
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21
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Abstract
Infection with viridans group streptococci (VGS) causes morbidity and mortality in children with cancer. Incidence of these infections has increased over time. Neutropenic patients with acute myeloid leukemia and those receiving high-dose cytarabine or undergoing stem cell transplantation are at highest risk. One-third of infected patients develop a shock syndrome despite prompt antibiotic therapy. Host defense mechanisms contribute substantially to colonization and tissue damage, but the origin of the shock syndrome is not well understood. VGS infection may be accompanied by neurological complications, myocarditis, and acute respiratory distress syndrome. Routine systemic antimicrobial prophylaxis against VGS infection has not been proven effective. Current recommendations include appropriate antibiotic therapy and intensive supportive care.
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MESH Headings
- Antibiotic Prophylaxis
- Child
- Child, Preschool
- Cytarabine/administration & dosage
- Cytarabine/adverse effects
- Humans
- Incidence
- Leukemia, Myeloid, Acute/complications
- Leukemia, Myeloid, Acute/mortality
- Leukemia, Myeloid, Acute/therapy
- Myocarditis/etiology
- Myocarditis/mortality
- Myocarditis/prevention & control
- Nervous System Diseases/etiology
- Nervous System Diseases/mortality
- Nervous System Diseases/prevention & control
- Neutropenia/complications
- Practice Guidelines as Topic
- Respiratory Distress Syndrome/etiology
- Respiratory Distress Syndrome/mortality
- Respiratory Distress Syndrome/prevention & control
- Shock, Septic/etiology
- Shock, Septic/mortality
- Shock, Septic/prevention & control
- Stem Cell Transplantation
- Streptococcal Infections/etiology
- Streptococcal Infections/mortality
- Streptococcal Infections/prevention & control
- Viridans Streptococci
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Affiliation(s)
- Anne F Reilly
- Division of Oncology, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
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22
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Gandemer V, Le Deley MC, Dollfus C, Auvrignon A, Bonnaure-Mallet M, Duval M, De Lumley L, Hartmann O, Mechinaud F, Sirvent N, Orbach D, Doireau V, Boutard P, Dalle JH, Reguerre Y, Pautard B, Aubier F, Schneider P, Suc A, Couillaut G, Schmitt C. Multicenter randomized trial of chewing gum for preventing oral mucositis in children receiving chemotherapy. J Pediatr Hematol Oncol 2007; 29:86-94. [PMID: 17279004 DOI: 10.1097/mph.0b013e318030a3e4] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The properties of saliva led us to hypothesize that the salivary flow increase induced by gum chewing might protect the oral mucosa from lesions due to cancer chemotherapy. We conducted a multicenter randomized trial to evaluate the efficacy of chewing gum in preventing oral mucositis in 145 children receiving chemotherapy regimens expected to induce WHO grade 3-4 oral mucositis in at least 30% of patients. Patients were allocated at random to standard oral care with or without 5 gum pieces per day. No overall reduction in severe oral mucositis occurred in the gum arm (51%) compared with the standard arm (44%). VIDE, COPADM, and multidrug intensive chemotherapy caused severe oral mucositis in 75% of patients in both arms. In patients receiving less toxic regimens, a decrease in WHO grade 1-4 oral mucositis was noted in the gum arm compared with the standard arm (49% vs. 72%, P=0.03). In the multivariate analysis, the risk of oral mucositis was related only to the type of chemotherapy regimen, suggesting that further strategies for preventing oral mucositis could be mainly based on these criteria.
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Affiliation(s)
- Virginie Gandemer
- Department of Paediatrics, Teaching Hospitals 35203 Rennes Cedex, France.
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23
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Napeñas JJ, Brennan MT, Bahrani-Mougeot FK, Fox PC, Lockhart PB. Relationship between mucositis and changes in oral microflora during cancer chemotherapy. ACTA ACUST UNITED AC 2007; 103:48-59. [PMID: 17178494 DOI: 10.1016/j.tripleo.2005.12.016] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2005] [Revised: 11/11/2005] [Accepted: 12/12/2005] [Indexed: 10/24/2022]
Abstract
It is thought that the incidence and severity of cancer chemotherapy-associated mucositis is caused in part by changes in the oral bacterial microflora. This systematic review examined the role of oral bacterial microflora changes in the development of oral mucositis during chemotherapy. Thirteen prospective clinical trials were identified, involving 300 patients with 13 different cancer diagnoses. There was great variability in patient populations, bacterial sample collection methodology, and oral sample sites. No clear pattern regarding qualitative and quantitative oral flora changes emerged among these studies. The most frequent Gram-negative species isolated during chemotherapy were from the Enterobacteriaceae family, Pseudomonas sp. and E. coli. The most common Gram-positive species isolated were Staphylococcus sp. and Streptococcus sp. Five studies assessed the role of oral flora changes in the genesis of oral mucosal changes, with no consensus among them. More detailed studies are required to understand the relationship between chemotherapy, alterations in the nature and magnitude of the oral microflora, and the presence of mucositis.
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Affiliation(s)
- Joel J Napeñas
- Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA.
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24
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Sixou JL, Aubry-Leuliette A, De Medeiros-Battista O, Lejeune S, Jolivet-Gougeon A, Solhi-Pinsard H, Gandemer V, Barbosa-Rogier M, Bonnaure-Mallet M. Capnocytophaga in the dental plaque of immunocompromised children with cancer. Int J Paediatr Dent 2006; 16:75-80. [PMID: 16430520 DOI: 10.1111/j.1365-263x.2006.00697.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES (i) To compare the prevalence and levels of Capnocytophaga, a known systemic pathogen in immunocompromised patients, in the dental plaque of healthy children and children with cancer, and (ii) to determine the susceptibility of strains isolated from cancer patients to a range of antibiotics. PATIENTS AND METHODS Thirty-one children with cancer undergoing a first course of immunosuppressive chemotherapy and 30 healthy control children were included in the study. Samples were collected on days 0, 7, 14, and 21 of the cure (and equivalent dates in controls). Susceptibility to antibiotics was tested using an agar dilution method and galleries with predefined concentrations of selected antibiotics. RESULTS There was a significant drop in the total anaerobic cultivable flora on day 14 and in the prevalence of Capnocytophaga on days 14 and 21 in the children with cancer. The proportion of Capnocytophaga in the anaerobic flora, however, was high in certain cancer patients. Beta-lactam/beta-lactamase inhibitor combinations, imipenem, clindamycin, and tetracycline were the most effective against Capnocytophaga. CONCLUSION This study showed that Capnocytophaga decreased in prevalence and proportion in the dental plaque of cancer patients during chemotherapy but became predominant in some cases. It is recommended that imipenem or beta-lactam/beta-lactamase inhibitor combinations be used to treat Capnocytophaga bacteraemia.
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Affiliation(s)
- J L Sixou
- Department of Paediatric Dentistry, Rennes Cedex, France.
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25
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Jolivet-Gougeon A, Buffet A, Dupuy C, Sixou JL, Bonnaure-Mallet M, David S, Cormier M. In vitro susceptibilities of Capnocytophaga isolates to beta-lactam antibiotics and beta-lactamase inhibitors. Antimicrob Agents Chemother 2000; 44:3186-8. [PMID: 11036049 PMCID: PMC101629 DOI: 10.1128/aac.44.11.3186-3188.2000] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The susceptibilities of 43 pharyngeal isolates of Capnocytophaga to beta-lactam antibiotics, alone or in combination with beta-lactamase inhibitors, were tested by an agar dilution method. The 34 beta-lactamase-positive strains were highly resistant to beta-lactams, but the intrinsic activities of clavulanate, tazobactam, and sulbactam against Capnocytophaga, even beta-lactamase producers, indicates that these beta-lactamase inhibitors could be used for empirical treatment of neutropenic patients with oral sources of infection.
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Affiliation(s)
- A Jolivet-Gougeon
- Laboratoire de Microbiologie Pharmaceutique, UPRES-EA 1254, Université de Rennes I, 35000 Rennes, France
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