Time course of oral aerobic microbiota in the patients after intensive chemotherapy and hematopoietic stem cell transplantation

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Authors

  • A.A. Spiridonova 1, head of the Clinical microbiology Department
    ORCID: 0000-0001-9866-5016
  • A.B. Chukhlovin 1, PhD in Medical Sciences, full professor of the Transplantology Lab
    ORCID: 0000-0001-9703-4378
  • I.B. Baranova 1, oral and maxillofacial surgeon of the Consulting and diagnostic Department at the Pediatric oncology, hematology, and transplantology research Institute
    ORCID: 0000-0001-5152-8639
  • A.P. Grigoriants 1, PhD in Medical Sciences, associate professor of the Dentistry diseases propaedeutics Department
    ORCID: 0000-0001-7518-4279
  • I.N. Antonova 1, PhD in Medical Sciences, full professor of the Dentistry diseases propaedeutics Department, director of the Dentistry and maxillofacial surgery research Institute
    ORCID: 0000-0003-2543-6137
  • M.D. Vladovskaya 1, PhD in Medical Sciences, hospital registry chief at Pediatric oncology, hematology, and transplantology research Institute
    ORCID: 0000-0002-0215-4623
  • L.S. Zubarovskaya 1, PhD in Medical Sciences, full professor of the Pediatric oncology, hematology, and transplantology
    ORCID: 0000-0003-2594-7703
  • B.V. Afanasyev 1, PhD in Medical Sciences, professor of the Hematology, transfusiology and transplantology Department, director of the Pediatric oncology, hematology, and transplantology research Institute
    ORCID: 0000-0002-1235-4530
  • 1 Pavlov University, 197022, Saint-Petersburg, Russia

Abstract

There are few data on time course of oral microbiota after intensive chemotherapy and hematopoietic stem transplantation (HSCT). The aim of present study was to evaluate detection frequency of aerobic microorganisms from oral cavity before therapy and within initial 120 days after HSCT.
Materials and methods.
We studied composition and time course of aerobic microbiota in oral cavity (oropharingeal area) in 419 patients aged from 1 to 76 years with, mostly, oncohematological diseases, who underwent intensive chemotherapy with subsequent allogeneic HSCT. Sampling of biological material for routine bacteriological studies was been carried out before chemotherapy and within 120 days after HSCT. Data analysis was performed for 4 age groups: from 1—5 to over 22 years old.
Results.
Positive findings were obtained in 66% of cases after analyzing 1472 cultures. Most common species were as follows: S. viridans, S. epidermidis, Neisseria spp., K. pneumoniae, Corynebacterium spp. Detection rate for K. pneumoniae, like as average number of microbial species per culture was increased in adult patients (over 22 years) as compared to pediatric and young patients. Following intensive therapy and HSCT, pronounced decrease in detection rates was revealed for S. viridans, Corynebacterium spp., Neisseria spp., as well as mean number of microbial associations in cultures within first month after treatment, most probably, due to early effective antibacterial prophylaxis. Meanhile, detection rates of K. pneumoniae from oropharyngeal mucosa did not decrease, followed by significant increase for 2—4 months after HSCT, thus being concordant with later development of infectious complications and evidence of polyresistant Klebsiella strains in other infected sites. Sampling from alveolar sockets was performed in 51 specimens within 0 to 2 months after HSCT showing predominant growth of S. viridans, S. epidermidis, Neisseria, Pseudomonas spp., Klebsiella spp., thus showing no differences from results yielded in other oral samples.
Conclusions.
Combined effect of cytostatic therapy upon immune response, along with antibiotic therapy, was accomplished by transient exhaustion of main classes of oral microbiota. Upon recovery of immune system, selective outgrowth of, most likely, resistant Klebsiella strains is observed. Full-spectrum microbiota analysis after HSCT, including anaerobic organisms, should be studied, e.g., by multiplex PCR or NGS of 16S rRNA gene.

Key words:

oncohematology, chemotherapy, hematopoietic stem cell transplantation, bacterial cultures, oral mucosa, risk factors

For Citation

[1]
Spiridonova A.A., Chukhlovin A.B., Baranova I.B., Grigoriants A.P., Antonova I.N., Vladovskaya M.D., Zubarovskaya L.S., Afanasyev B.V. Time course of oral aerobic microbiota in the patients after intensive chemotherapy and hematopoietic stem cell transplantation. Clinical Dentistry (Russia).  2021; 24 (3): 40—46

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Received

December 1, 2020

Accepted

July 16, 2021

Published on

September 1, 2021