Association between the point-rating system used for oral health and the prevalence of Gram-negative bacilli in hematological inpatients: A retrospective cohort study

Gram-negative bacteremia is a major cause of death among hematology inpatients who require heavy-dose chemotherapy and hematopoietic stem cell transplantation. Gram-negative bacillus (GNB) is more likely to be detected when the oral health is poor. However, there is a dearth of studies on the relati...

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Published inMedicine (Baltimore) Vol. 100; no. 22; p. e26111
Main Authors Yoshizawa, Kunio, Moroi, Akinori, Iguchi, Ran, Yokomichi, Hiroshi, Ogihara, Shinji, Watanabe, Kazuaki, Nakajima, Kei, Kirito, Keita, Ueki, Koichiro
Format Journal Article
LanguageEnglish
Published United States Lippincott Williams & Wilkins 04.06.2021
Subjects
Age Factors
Aged
Aged, 80 and over
Blood Culture
Body Mass Index
Body Weights and Measures
Female
Gram-Negative Bacterial Infections - epidemiology
Hematologic Neoplasms - epidemiology
Humans
Inpatients
Male
Middle Aged
Observational Study
Oral Health - statistics & numerical data
Retrospective Studies
Sex Factors
Sputum - microbiology
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Summary:Gram-negative bacteremia is a major cause of death among hematology inpatients who require heavy-dose chemotherapy and hematopoietic stem cell transplantation. Gram-negative bacillus (GNB) is more likely to be detected when the oral health is poor. However, there is a dearth of studies on the relationship between oral assessment and prevalence of GNB in hematology inpatients.This retrospective study aimed to evaluate the relationship between the original point-rating system for oral health examinations (point-oral exam) and the prevalence of GNB in hematology inpatients at the hematology ward of the Yamanashi University Hospital. GNB was detected by cultivating samples from the sputum and blood of each patient.A total of 129 subjects underwent a medical checkup and point-oral exam. The sputum and blood culture results of 55 patients were included in this study. The total points of patients positive for GNB (n = 25, 45.5%) were significantly higher than those who were negative for GNB (total score: median, 25th, 75th, percentile; 6 [4, 7] vs 2 [1, 4]; P = .00016). Based on the receiver operating characteristic analysis, a cutoff score of 5 proved to be most useful to detect GNB.An oral evaluation with a cutoff value of 5 or higher in the point-oral exam might indicate the need for a more thorough oral management to prevent the development of systemic infections from GNB.
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This study was performed in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of Yamanashi University Hospital (approval number R02431). Informed consent was obtained from all study participants. Patients were free to withdraw from the study at any time.
The authors have no funding and conflicts of interest to disclose.
The datasets generated during and/or analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable request.
“Publication history”: “Posted history: This manuscript was previously posted as preprint, in 18 January 2021, DOI: 10.21203/rs.3.rs-143059/v1.” This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
The images presented in Figure 1 were reprinted with each patient's informed consent. The images were submitted without any identifying information to ensure patient anonymity. Some of the clinical images of “mucositis” in Figure 1 have been reprinted with permission from “Manual for the management of individual serious adverse drug reactions” (https://www.mhlw.go.jp/topics/2006/11/dl/tp1122-1l09.pdf) of the Japanese Ministry of Health, Labour and Welfare, and permission from the Department of Dentistry, National Cancer Center Hospital. Figure 1 is reprinted with permission from the International Journal of Functional Nutrition (https://doi.org/10.3892/ijfn.2020.8).
How to cite this article: Yoshizawa K, Moroi A, Iguchi R, Yokomichi H, Ogihara S, Watanabe K, Nakajima K, Kirito K, Ueki K. Association between the point-rating system used for oral health and the prevalence of Gram-negative bacilli in hematological inpatients: A retrospective cohort study. Medicine. 2021;100:22(e26111).
ISSN:0025-7974
1536-5964
1536-5964
DOI:10.1097/MD.0000000000026111