Transient bacteremia induced by dental cleaning is not associated with infection of central venous catheters in patients with cancer

Publication date: Available online 11 January 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Saad Usmani, Linda Choquette, Robert Bona, Richard Feinn, Zainab Shahid, Rajesh V. Lalla
ObjectiveTo determine incidence of bacteremia from a dental cleaning, and subsequent established blood stream infection (BSI) caused by oral microorganisms, in cancer patients with central venous catheters (CVC).Study DesignTwenty-six cancer patients with CVCs, and absolute neutrophil count (ANC) over 1000 cells/µl, received dental cleaning without antibiotic prophylaxis. Periodontal status was assessed at baseline using Periodontal Screening and Recording (PSR) score. Blood cultures were drawn via CVC at baseline, 20 minutes into cleaning, and 30 minutes and 24 hours after cleaning. Medical records were monitored for 6 months.ResultsBaseline blood cultures were negative in 25 subjects. Nine of 25 subjects (36%) had positive blood culture 20 minutes into cleaning, all associated with at least 1 microorganism typically found in the mouth. These 9 subjects had significantly higher mean PSR score (3.22) compared to the other 16 (2.56; p=0.035). These expected bacteremias did not persist with no positive blood cultures (0/25) at 30 minutes and 24 hours after cleaning (p = 0.001). There were no cases of CVC infection or BSI attributable to dental cleaning.ConclusionsBacteremias following a dental cleaning are transient and unlikely to cause CVC infection or BSI in patients with ANC over 1000 cells/µl.



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