Prevalence of drug-resistant opportunistic microorganisms in oral cavity after treatment for oral cancer

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Drug-resistant opportunistic infections may cause health problems in immunocompromised hosts. Representative microorganisms in opportunistic infections of the oral cavity are Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. We investigated the prevalence of drug-resistant opportunistic microorganisms in elderly adults receiving follow-up examinations after primary treatment of oral cancer. Oral microorganisms were collected from patients satisfactorily treated for oral cancer (defined as good outcomes to date) and a group of healthy adults (controls). After identification of microorganisms, the prevalence of drug-resistant microorganisms was studied. Pulsed-field gel electrophoresis (PFGE) and staphylococcal cassette chromosome mec (SCCmec) typing were also performed for methicillin-resistant S aureus (MRSA). Statistical analysis revealed no significant differences in the prevalences of the three microorganisms between the groups. Surprisingly, 69.2% of S aureus isolates showed oxacillin resistance, suggesting that MRSA colonization is increasing among older Japanese. These MRSA isolates possessed SCCmec types II and IV but no representative toxin genes. Our results indicate that a basic infection control strategy, including standard precautions against MRSA, is important for elderly adults, particularly after treatment for oral cancer. (J Oral Sci 55, 145-155, 2013)