Changes in the Oral Streptococcal Flora Following Irradiation/Chemotherapy for Bone Marrow Transplantation

Abstract

Bone marrow transplantation has become increasingly effective in the treatment of a wide range of neoplastic, haematological, metabolic and immunological diseases.^{(1, 2, 6)} Before transplantation the patient undergoes a course of intensive treatment. This is the conditioning regimen and comprises chemotherapy which in this group of children was combined with fractionated total body irradiation. The regimen profoundly suppresses the bone marrow and the patient rapidly becomes neutropenic and immunosuppressed. It is during the neutropenic period that opportunistic infection is a serious problem. During the last decade increasing numbers of infections have been caused by Gram positive cocci. Oral streptococci, particularly the ‘oralis group’ of the viridans streptococci account for some 15–40% of septicaemias in bone marrow transplantation patients.^{(3, 4, 7, 8)}