Biofilms on the surface of oral squamous cell carcinomas (OSCC) play a key role in the development of postoperative infections in patients with OSCC, according to a new study in Clinical Oral Investigations (June 22, 2013).
But antibiotics such as azithromycin, telithromycin, levofloxacin, and moxifloxacin used in a prophylactic regime can dramatically reduce the risk of infection in these patients.
Researchers from Martin Luther University Halle-Wittenberg swabbed the mouths of 90 patients, then cultured the swabs on media for aerobes and anaerobes. They found that the predominant pathogens of the normal healthy oral mucosa were aerobes, while the ratio between aerobes and anaerobes was 2:1 in risk patients and inverted in the OSCC group.
Altogether, they cultured 1,006 isolates. The most frequent strains were viridans streptococci (47), 30 Staphylococcus species (30), Enterococcus faecalis (14), Neisseria species (36), Escherichia coli (14), other aerobes (23), Peptostreptococcus species (66), Fusobacterium species (39), and Prevotella species (34). The resistance rates in the OSCC group were penicillin (40%), ampicillin (57%), doxycycline (23%), clindamycin (47%), and amoxicillin/clavulanic acid (20%).
"Gram-negative anaerobes play a decisive role in the development of postoperative infections in patients with OSCC," the study authors concluded. "This tumor special type of colonization does not agree with the normal flora of the oral cavity."