The bacterial association with oral cavity and intra-abdominal abscess after gastrectomy

Mao Nishikawa, Michitaka Honda, Ryosuke Kimura, Ayaka Kobayashi, Yuji Yamaguchi, Soshi Hori, Hiroshi Kobayashi, Mitsuru Waragai, Hidetaka Kawamura, Yujiro Nakayama, Yukitoshi Todate, Yoshinao Takano, Hisashi Yamaguchi, Koichi Hamada, Susumu Iketani, Ichiro Seto, Yuichi Izumi, Kanichi Seto, Mao Nishikawa, Michitaka Honda, Ryosuke Kimura, Ayaka Kobayashi, Yuji Yamaguchi, Soshi Hori, Hiroshi Kobayashi, Mitsuru Waragai, Hidetaka Kawamura, Yujiro Nakayama, Yukitoshi Todate, Yoshinao Takano, Hisashi Yamaguchi, Koichi Hamada, Susumu Iketani, Ichiro Seto, Yuichi Izumi, Kanichi Seto

Abstract

Background: Perioperative oral management has been reported to be effective for preventing postoperative infectious complications. In addition, severe periodontal disease was identified as the significant risk factor for complications after gastrointestinal surgery. We investigated the bacteriological association between the periodontal pocket, stomach mucosa and drainage fluid to determine whether oral bacteria directly cause intra-abdominal infection after gastrectomy.

Methods: Patients who were scheduled to undergo surgery for gastric cancer were prospectively enrolled. We evaluated the similarity of bacterial strains in periodontal pocket, stomach mucosa and fluid from drainage tube. Gingival crevicular fluid and dental plaque were collected from the periodontal pocket and cultured to detect bacteria. Specimens from the resected stomach were collected and used for bacterial culturing. Drainage fluid from the abdominal cavity was also cultured.

Results: All of 52 patients were enrolled. In the periodontal pocket, α-Streptococcus spp., Neisseria sp., and Prevotella sp. were mainly detected. Bacterial cultures in the stomach mucosa were positive in 26 cases. In 20 cases (76.9%), the detected strains were the same as those in the periodontal pocket. Six patients had the postoperative intra-abdominal infection after gastrectomy, and the same bacterial strains was detected in both of drainage fluid and periodontal pocket in two patients with severe periodontal disease.

Conclusions: We found the bacteriological association that same strain detected in periodontal pocket, stomach and in intra-abdominal drainage fluid after gastrectomy in patients with periodontal disease.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Sample collection.
Fig 1. Sample collection.
Samples were collected from the periodontal pocket and stomach mucosa. a: Gingival crevicular fluid and dental plaque were collected from the periodontal pocket and cultured. b: The stomach specimen was cut open and a section of the stomach mucosa (20x20mm) was collected under sterile conditions.
Fig 2. The bacterial strains in the…
Fig 2. The bacterial strains in the periodontal pocket and stomach mucosa.
The black and gray bars show the positive number of each strain in periodontal pocket and stomach mucosa, respectively.

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