Streptococcal bacteremia in patients submitted to hematopoietic stem celltransplantation: The role of tooth brushing and use of chlorhexidine

ABSTRACT

A retrospective evaluation of 73 consecutive recipients of hematopoietic stem cell transplantation (HSCT) wasconducted to investigated the role of oral care and incidence of streptococcal bacteremia in patients submittedto hematopoietic stem cell transplantation. Patients were retrospectively evaluated and divided into group A(GA=38) and group B (GB=35). During hospitalization patients from GA performed oral hygiene daily with extrasoft toothbrush and toothpaste besides performing mouth cleaning with an ethanol-free 0.12% chlorhexidine solutiontree times a day. In contrast GB patients performed mouth cleaning with extra soft toothbrush and toothpaste,but no chlorhexidine was used. Using the Chi square test it was observed that all patients from GA presentednegative blood culture for alpha-hemolytic Streptococcus viridans and Candida albicans and only 1 patient withoutoral mucositis from GB presented positive blood cultures for Streptococcus intermedius (p=0.48). The resultsindicate that methodology used for oral care before the HSCT and the practice of tooth brushing during the periodwere effective in preventing streptococcal bacteremia. Moreover, our data suggest that the mouth cleaning withchlorhexidine during HSCT may be not mandatory (AU)