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Title: The oral microflora of children undergoing bone marrow transplantation : a study of the changes in the oral microbial flora, gingival health and mucosal immunity before, during and after transplantation
Author: Lucas, Victoria Sorrell
Awarding Body: University of London
Current Institution: University College London (University of London)
Date of Award: 1997
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Changes in the oral flora and mucosal immunity of 2 groups of children undergoing bone marrow transplantation have been investigated. Patients and methods: Twenty three children received a conditioning regimen of fractionated total body irradiation and chemotherapy (TBI group). A further 11 children received a conditioning regimen of chemotherapy only (CTO group). Both groups were matched with healthy children. Dental indices; Dental caries, plaque and gingivitis scores were recorded. There were significant increases in the scores for dental plaque and gingivitis at 7 days post - transplantation in both the TBI and CTO groups (p < 0.03). Microbiological methods: Saliva was collected on 4 occasions during the peri - transplantation period. Standard microbiological techniques were used for enumeration and speciation of viridans streptococci, Candida, Enterobacteriaceae and enterococci. The most significant changes occurred at 7 days post - transplantation. There were decreases in the mean total aerobic and anaerobic bacterial counts in the TBI group (p < 0.0003 and p < 0.0002) and the CTO group (p < 0.03 and p< 0.009). The proportion of the 'oralis group' of the viridans streptococci as a percentage of the total anaerobic count was increased in the TBI group (p < 0.001) with simultaneous decreases in the isolation frequency of S. parasanguis (p < 0.008), S. sanguis (p < 0.03) and S. salivarius (p < 0.00001). Immunological methods: Total salivary IgA, secretory IgA, total IgG, IgA and antibodies to S. mitis and S. oralis were estimated with ELISA. The main findings were increased salivary IgG at 7 days post - transplantation in both the TBI (p < 0.01) and CTO groups (p < 0.02). Conclusions: The oral flora of children undergoing bone marrow transplantation changed so that they were at increased risk of opportunistic infection from the 'oralis group' during the period of intense immunosuppression.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available