To investigate the changes in aerobic and facultative anaerobic oral microflora during remission-induction chemotherapy in patients with acute myeloid leukemia, 10 consecutive patients were studied during a period of 28 days. One day before,
during
and
after the induction therapy, patients were given 10% Betadine solution for mouthrinses after breakfast and kept from eating and drinking. After 3 hours, paraffin-stimulated were dispersed and homogenized by use of vortex mixer for 20 seconds.
From
these
samples 10-fold serial dilutions(from 10-1 through 10-3) were prepared.
Each dilution of 0.1 ml was plated on duplicate set of one nonselective medium (Blood agar) and four selective media (Sabourauds dextrose agar, Mannitol salt, agar, Mac-Conkey agar, SF medium) using applicator woods. All agar plates were
incubated
at
37°C for 48 hours.
The total number of microorganisms was calculated and the percentage distribution o f the various microorganisms from each specimen was drawn.
1. The salivary flow rate decreased by 66%, going from 5.38 ml/2min to 1.81 ml/2min over two days during the chemotherapy.
2. The total number of microorganisms in saliva increased by 2.2% going from 4.88×1105/ml to 6.00×015/ml over two days during the chemotherapy.
3. The salivary flow rate and the total number of microorganisms in saliva were recovered within 28 days after the chemotherapy.
4. The quantitative alteration in oral Enterobacteria, Enterococci, Staphylococci, Candida during the chemotherapy had no statistical significance.
5. In saliva of the patients with acute myeloid leukemia who had intraoral ulcer, Enterobacteria was quantitatively predominent.
Our study suggests that chemotherapy-induced transient xerostomia may induce acute oral infection. Consequently, the use of saliva substitute, the removal of intraoral infection source and the consistent oral hygiene care seem to be required to
avoid
the transmission of potential pathogens in this group of patients.
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