Colonization of dental plaque by respiratory pathogens in medical intensive care patients

Scannapieco, Frank A.; Stewart, Ellen; Mylotte, Joseph M.

doi:10.1097/00003246-199206000-00007

Cited by 339 publications

(271 citation statements)

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“…The dental plaque is an important reservoir of potential respiratory bacterial pathogens, including Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter spp. and enteric bacteria (14,15).…”

Section: Discussionmentioning

confidence: 99%

Salivary Immunoglobulins in Individuals with Common Variable Immunodeficiency

et al. 2016

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Oral manifestations of common variable immunodeficiency (CVID) are rare, have rarely been studied and have given controversial results. There are few data about IgA, IgG, and IgM antibody salivary levels in the literature, and there are few papers about the clinical impact of antibody deficiencies and CVID on the oral health of such patients. The aim of this study was to measure serum and salivary IgA, IgG, and IgM levels in CVID participants and controls, and to associate immunoglobulin levels with caries and periodontal disease. This was a case-control study involving 51 CVID individuals and 50 healthy controls. All participants underwent examination for dental caries and periodontal disease. Blood and whole saliva samples were collected on the same day of the oral examination. Serum IgA, IgM, and IgG levels were measured by turbidimetry and salivary IgA, IgM, and IgG titers were assessed by enzyme-linked immunosorbent assay. Incidences of caries and gingivitis were significantly higher in the CVID group than in the control group (p<0.05). Salivary and blood IgA and IgM titers were significantly reduced in the CVID group, but there was no association of salivary immunoglobulin levels with periodontal disease or with caries incidence (p>0.05 for both). Although CVID was associated with increased susceptibility to caries and gingivitis, it was not associated with low salivary levels of IgA and IgM.

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Section: Discussionmentioning

confidence: 99%

Salivary Immunoglobulins in Individuals with Common Variable Immunodeficiency

et al. 2016

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“…42 Several published studies [42][43][44][45][46] strongly suggest that colonized dental plaque serves as a contributory factor in developing respiratory infections and VAP.…”

Section: Colonization Of Dental Plaquementioning

confidence: 99%

Reducing Ventilator-Associated Pneumonia Through Advanced Oral-Dental Care: A 48-Month Study

Garcia¹,

Jendresky²,

Colbert³

et al. 2009

American Journal of Critical Care

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Objective To determine the effect of implementing a comprehensive oral and dental care system and protocol on the rate of ventilator-associated pneumonia. Methods Patients more than 18 years old receiving mechanical ventilation for more than 48 hours in a medical intensive care unit at a university-affiliated medical center were studied in 2 consecutive 24-month periods. Patients in the group studied before the intervention (n = 779) had no oral assessments, no suctioning of the subglottic space, no toothbrushing, and suctioning of secretions in the oral cavity as needed. The group studied during the intervention (n = 759) included patients treated under a protocol whereby the oral cavity was assessed, deep suctioning was done every 6 hours, oral tissue cleansing was done every 4 hours or as needed, and toothbrushing was done twice daily. Results Compliance with protocol components exceeded 80%. The groups did not differ significantly in age, sex, or severity of illness. The rate of ventilator-associated pneumonia was 12.0 per 1000 ventilator days before the intervention and decreased to 8.0 per 1000 ventilator days during the intervention (P = .06). Duration of mechanical ventilation and length of stay in the intensive care unit differed significantly between groups, as did mortality. Conclusion Our findings suggest that use of advanced tools, a comprehensive oral care protocol, and staff compliance with the protocol can significantly reduce rates of ventilatorassociated pneumonia and associated costs. (American Journal of Critical Care.

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“…During the period of hospitalization in the ICU the oral microbiota is replaced by gram-negative and gram-positive pathogenic aerobic bacilli. (14) Research conducted in adults has shown that on admission to an ICU, patients were mainly colonized by species of microorganisms such as S. aureus, H. influenzae and S. pneumoniae, and that during the course of hospitalization there was rapid replacement of the normal oropharyngeal microbiota by gram-negative bacilli, such as P. aeruginosa. (15) The predominance of the species of normal microbiota such as, coagulase-negative Staphylococcus, viridans Streptococcus and Moraxella spp, in the oropharynx and trachea cultures of the children included in this study was similar to the results shown by an epidemiological study developed in populations of children at risk for the acquisition of gram-negative aerobic bacilli.…”

Section: Discussionmentioning

confidence: 99%

Colonização e translocação bacteriana orofaríngea, gástrica e traqueal em crianças submetidas à ventilação pulmonar mecânica

2012

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Objective: To describe the pattern of oropharyngeal colonization and bacterial translocation, gastric and tracheal, in children experiencing mechanical ventilation. Methods: This descriptive study was conducted in a pediatric intensive care unit (PICU). Thirty children were recruited for the study, and 216 serial cultures were analyzed from oropharyngeal, gastric and tracheal secretions. Microbiological characteristics, demographic, clinical and treatment data were evaluated. Results: Among those who participated in the gastric suctioning, there was a predominance of children with chronic diseases, for which antibiotics, sedatives and gastric protectors were used. There was an increase in the number of children colonized by pathogens during hospitalization, and there was a predominance of several species: Enterobacter spp, K.pneumoniae, P. aeruginosa, A. baumannii and S. aureus. The majority of children (80.0%) experienced oropharyngeal translocation during hospitalization in the PICU. Conclusion:Critically ill children may represent a group of patients at increased risk for colonization and bacterial translocation, predominantly from the oropharyngeal region to the trachea. Keywords: Bacterial translocation; Pneumonia, ventilator-associated; Pediatric nursing; Intensive care resumO Objetivo: Descrever o padrão de colonização e translocação bacteriana orofaríngea, gástrica e traqueal em crianças submetidas à ventilação pulmonar mecânica. Métodos: Estudo descritivo, realizado em uma Unidade de Cuidados Intensivos Pediátricos. Admitiram-se no estudo 30 crianças, sendo analisadas 216 culturas seriadas de secreção orofaríngea, gástrica e traqueal. Características microbiológicas, demográficas, clínicas, e terapêuticas foram avaliadas. Resultados: Houve predominância de crianças portadoras de doenças crônicas, que fizeram uso de antibióticos, sedativos e protetores gástricos, submetidas à sondagem gástrica. Houve aumento no número de crianças colonizadas por patógenos durante a internação e predomínio das espécies: Enterobacter spp, K.pneumoniae, P.aeruginosa, A. baumanii e S.aureus. A maioria das crianças (80,0%) sofreu translocação orofaríngea durante a internação na UCIP. Conclusão: Crianças criticamente enfermas podem representar grupo de pacientes com risco aumentado para colonização e translocação bacteriana predominantemente da região orofaríngea para a traquéia. Descritores: Translocação bacteriana; Pneumonia associada à ventilação mecânica; Enfermagem pediátrica; Terapia intensiva resumen Objetivo: Describir el patrón de colonización y translocación bacteriana orofaríngea, gástrica y traqueal en niños sometidos a ventilación pulmonar mecánica. Métodos: Estudio descriptivo, realizado en una Unidad de Cuidados Intensivos Pediátricos. Se admitieron en el estudio a 30 niños, siendo analizados 216 cultivos seriados de secreción orofaríngea, gástrica y traqueal. Fueron evaluadas características microbiológicas, demográficas, clínicas, y terapéuticas. Resultados: Hubo predominio de niños portadores de enfer...

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Colonization of dental plaque by respiratory pathogens in medical intensive care patients

Cited by 339 publications

References 0 publications

Salivary Immunoglobulins in Individuals with Common Variable Immunodeficiency

Salivary Immunoglobulins in Individuals with Common Variable Immunodeficiency

Reducing Ventilator-Associated Pneumonia Through Advanced Oral-Dental Care: A 48-Month Study

Colonização e translocação bacteriana orofaríngea, gástrica e traqueal em crianças submetidas à ventilação pulmonar mecânica

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