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Alpha-hemolytic streptococci: clinical significance in the cancer patient
Abstract:
Alpha-hemolytic Streptococci were associated with 29 episodes of sepsis (12 polymicrobial) in 27 patients with cancer during a nine year period. Only two patients had dental manipulation prior to the onset of sepsis, but each had received chemotherapy and 75% were granulocytopenic (PMN less than 500/mm3) at the time of the infection. None of the patients developed bacterial endocarditis. Unlike the normal host in whom a transient bacteria with alpha-hemolytic Streptococci may occur following dental extraction or periodontal procedures, the cancer patient is at risk for more clinically significant sepsis. This risk is probably related to the presence of chemotherapy-induced oral mucusitis and granulocytopenia, and our results suggests that isolation of alpha-hemolytic Streptococci in febrile cancer patients should not be dismissed as a contaminent.
Insights
Cancer patients with neutropenia are at high risk for sepsis from alpha-hemolytic Streptococci, often linked to chemotherapy-induced oral issues. These infections warrant prompt medical attention and should not be disregarded as contaminants.
Area of Science:
- Infectious Diseases
- Oncology
- Microbiology
Background:
- Alpha-hemolytic Streptococci are common oral bacteria.
- Cancer patients, especially those undergoing chemotherapy, are immunocompromised.
- Oral complications like mucositis can increase infection risk.
Purpose of the Study:
- To investigate the clinical significance of alpha-hemolytic Streptococci in cancer patients.
- To identify risk factors associated with sepsis caused by these bacteria in this population.
- To determine if isolation of alpha-hemolytic Streptococci in febrile cancer patients should be considered a contaminant.
Main Methods:
- Retrospective analysis of cancer patients with sepsis over nine years.
- Review of patient records for demographics, cancer treatment, and infection episodes.
- Correlation of alpha-hemolytic Streptococci isolation with clinical outcomes and patient conditions (e.g., granulocytopenia).
Main Results:
- Twenty-seven cancer patients experienced 29 episodes of sepsis associated with alpha-hemolytic Streptococci.
- Most patients were granulocytopenic (less than 500 PMN/mm3) at the time of infection.
- Dental manipulation was infrequent; chemotherapy and oral issues were common risk factors.
Conclusions:
- Alpha-hemolytic Streptococci can cause significant sepsis in cancer patients, particularly those with chemotherapy-induced immunosuppression and oral mucositis.
- The presence of alpha-hemolytic Streptococci in febrile cancer patients should be considered a potential pathogen, not a contaminant.
- Cancer patients face a higher risk of clinically significant sepsis from these bacteria compared to the general population.