Bacterial substitution of coagulase-negative staphylococci for streptococci on the oral mucosa after hematopoietic cell transplantation
Bacterial substitution of coagulase-negative staphylococci for streptococci on the oral mucosa after hematopoietic cell transplantation
复制标题
造血细胞移植后口腔黏膜凝固酶阴性葡萄球菌替代链球菌
DOI：
10.1007/s00520-010-0923-9
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发表时间：
2011
影响因子：
3.1
通讯作者：
Takashiba S
中科院分区：
文献类型：
--
作者：
Soga Y;Maeda Y;Ishimaru F;Tanimoto M;Maeda H;Nishimura F;Takashiba S
目的凝固酶阴性葡萄球菌 (CoNS) 经常从造血细胞移植 (HCT) 患者的血培养物中分离出来。一般来说，中心静脉导管的使用被认为是 CoNS 感染的重要危险因素，而 HCT 中经常发生的口腔溃疡性粘膜炎引起的 CoNS 感染的影响可能被低估。在此，我们对HCT后的颊粘膜细菌进行了检查。方法从同种异体HCT前1周至术后3周，每周常规检查61名患者的颊粘膜细菌。将受试者分为短期和长期使用抗生素的组，并评估细菌替代的差异。还评估了 HCT 类型（传统 HCT 或 RIST）与细菌替代之间的关系。结果 HCT 前至 HCT 后 3 周，CoNS 和 α-链球菌的检出率变化显着（P< 0.05，χ2 检验）：分别为 14.5–53.3% 和 92.7–53.1%。在长期使用抗生素组中观察到CoNS对链球菌的显着细菌替代（P< 0.05，χ2检验），但也发生在短期或不使用抗生素的病例中。没有观察到HCT类型（传统HCT或RIST）之间的关系。结论HCT后颊粘膜频繁发生CoNS对链球菌的细菌替代。除了抗生素的使用之外，环境因素也可能与细菌替代有关。 HCT 后重要的是要考虑 CoNS 感染是否存在口腔粘膜炎。
PurposeCoagulase-negative staphylococci (CoNS) are frequently isolated from blood cultures of hematopoietic cell transplantation (HCT) patients. Generally, the use of central venous catheters is recognized as a significant risk factor for CoNS infection, while the impact of CoNS infection from oral ulcerative mucositis, which occurs frequently in HCT, may be underestimated. Here, we examined the bacteria on the buccal mucosa after HCT.MethodsSixty-one patients were examined for bacteria on the buccal mucosa routinely once a week from 1 week before to 3 weeks after allogeneic HCT. Subjects were divided into groups with short and long periods of antibiotic use, and differences in bacterial substitution were evaluated. The relationships between type of HCT (conventional HCT or RIST) and bacterial substitution were also evaluated.ResultsThe changes in detection frequencies of CoNS and α-streptococci from before to 3 weeks after HCT were significant (P< 0.05,χ2test): 14.5–53.3% and 92.7–53.1%, respectively. Significant bacterial substitution of CoNS for streptococci was observed in the long-term antibiotic use group (P< 0.05,χ2test), but also occurred in cases with short-term or no antibiotic use. No relationships between type of HCT (conventional HCT or RIST) were observed.ConclusionBacterial substitution of CoNS for streptococci occurred frequently on the buccal mucosa after HCT. In addition to antibiotic use, environmental factors may be involved in bacterial substitution. It is important to consider the presence of oral mucositis in CoNS infection after HCT.