Dissociations of oral foci of infections with infectious complications and survival after haematopoietic stem cell transplantation

PLoS One. 2019 Dec 18;14(12):e0225099. doi: 10.1371/journal.pone.0225099. eCollection 2019.

Abstract

Introduction: Haematopoietic stem cell transplantation (HSCT) recipients are at increased risk for severe infections. This study examined the associations of common oral infections with survival and infectious complications in HSCT recipients.

Materials and methods: All autologous and allogeneic HSCT recipients transplanted in the University Hospital of Basel, Switzerland, between 2008 and 2016 and referred to oral infection control pre-HSCT were included in this retrospective case-control study. All patients had a clinical and a panoramic radiological dental examination taken immediately prior to HSCT. Presence of acute or chronic oral foci of infections, decayed, missing or filled tooth index (DMFT) and radiological attachment loss (RAL) were examined. Survival and infections of the subjects were followed up for 6 months post-HSCT.

Results: Altogether 341 allogeneic and 125 autologous HSCT recipients were included in the study. Within 6 months post-HSCT, 47 (14%) of the allogeneic and 4 (3%) of the autologous recipients died. Oral foci of infections (acute or chronic), DMFT or periodontitis pre-HSCT were not associated with survival 6 months post-HSCT. Oral foci of infections were also not associated with hospital treated infectious diseases or blood culture positive bacteremia during the 6 month follow-up period. Untreated oral foci of infections were not associated with survival or severe infectious complications within 6 months post-HSCT.

Conclusion: The results of this study suggest that radical dental interventions to chronic oral infections could be postponed until post-HSCT.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bacteremia / etiology*
  • Bacteremia / mortality
  • Case-Control Studies
  • Communicable Diseases / etiology*
  • Communicable Diseases / mortality
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Mouth Diseases / etiology*
  • Mouth Diseases / mortality
  • Retrospective Studies
  • Survival Rate

Grants and funding

This study (TW) was supported by Swiss National Science Foundation, 32003B-121582 (www.snf.ch) and Schweizerische Zahnärzte-Gesellschaft, SSO Fonds 246-09 (www.sso.ch). MM received personal grant from Finnish Hematology Association (www.hematology.fi/fi). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.