LOEVENICH H, KEULERTZ C, SCHUETT-GEROWITT H, BETHE U, SOEHNGEN D, WALDSCHMIDT D, CORNELY OA; Interscience Conference on Antimicrobial Agents and Chemotherapy (41st : 2001 : Chicago, Ill.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2001 Dec 16-19; 41: abstract no. K-1251.

University of Cologne, Dept. of Internal Med., Cologne, Germany

BACKGROUND: Mucositis is a severe side effect of high-dose chemotherapy. The role of infectious agents in the development of mucositis is still a matter of debate. We examined the changes in bacterial and fungal oral flora and the severity of mucositis during autologous stem cell transplantation (SCT). METHODS: From 5/00-01/01 the oral microflora of 12 patients (5 female; age 22-55; median: 36,5) undergoing PBSCT for relapse of high-grade lymphoma was examined. Days (d) of examinations: before myeloablative BEAM chemotherapy (d-6), on the day of peripheral blood SCT (d0) and on d6, d14 and d100. All patients received prophylactic ciprofloxacin 500mg bid and fluconazole 400mg qd and mouth rinses with polyene antifungals, povidone-iodine and hexetidine. Patients chewed on a paraffine block before saliva and buccal and palatinal swabs were taken. Following stepwise dilution, samples were cultured on different growth media to evaluate aerobes, gram-negative anaerobes and fungi. Severity of mucositis was determined by the Oral Assessment Guide and - using a 0-100 visual analogue scale - oral pain was self-assessed by the patient. RESULTS: In 11/12 cases a decrease of bacterial and fungal colony forming units occured until d6 (range -72-99%, median 99%). Simultaneously the severity of mucositis and oral pain increased. The remaining flora underwent considerable changes in composition, but these were inconsistent between the twelve patients. Microbial infection of the mucosa by any potential oral pathogen was not observed. The percentage of positive fungal cultures increased until d 100 (d -6: 58%, d 100: 86%) CONCLUSION: Oral mucositis in high-dose chemotherapy appeared to be associated with antineoplastic treatment rather than bacterial or fungal overgrowth. Chemotherapy plus local and systemic antiinfective prophylaxis resulted in changes of oral microflora.

Publication Types:

• Meeting Abstracts

Keywords:

• Anti-Infective Agents
• Female
• Fungi
• Humans
• Mouthwashes
• Pain Measurement
• Povidone-Iodine
• radiotherapy

Other ID:

• GWAIDS0030189

UI: 102269821

From Meeting Abstracts