Respiratory pathogen colonization of dental plaque, the lower airways, and endotracheal tube biofilms during mechanical ventilation

Sands, Kirsty; Wilson, Matthew; Lewis, Michael Alexander Oxenham; Wise, Matthew Peter; Palmer, Nicki; Hayes, Anthony Joseph; Barnes, Rosemary Ann; Williams, David Wynne

doi:10.1016/j.jcrc.2016.07.019

Cited by 85 publications

(73 citation statements)

References 61 publications

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“…Oral bacteria may be transferred to the lower airways in patients fitted with orotracheal tubes and cause pneumonia associated with MV. This finding was reported in a study that identified the presence of S. aureus and P. aeruginosa, which are potential respiratory pathogens, in oral biofilm 25 .…”

supporting

confidence: 72%

Factors associated with oral biofilm in ICU patients with infectious diseases

Damascena

Rodrigues

Costa

et al. 2017

Rev. odontol. UNESP

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ResumoIntrodução: A hospitalização pode provocar deterioração da saúde bucal, repercutindo em todo o corpo. A UTI pode ser um ambiente favorável ao acúmulo de biofilme oral em pacientes críticos. Objetivo: Identificar fatores associados à presença do biofilme em pacientes da UTI de um hospital de doenças infectocontagiosas. Método: Estudo retrospectivo, descritivo e inferencial, com abordagem quantitativa. Os dados foram obtidos em prontuários de pacientes da UTI, de janeiro de 2012 a julho de 2015. O biofilme foi avaliado de acordo com o índice de Greene e Vermillion. Os fatores influentes foram analisados por regressão logística. Resultado: Entre os pacientes da UTI, 69,1% eram homens, 60,7% pacientes com AIDS, 66,3% pacientes na enfermaria, 50,6% intubados e 50,0% sedados. Seus elementos orais eram na maioria normais. As seguintes características foram significativamente associadas a biofilmes orais: alterações orais nos lábios, gengivas, bochechas e palatos e sangramento. Pacientes da enfermaria apresentaram menor risco de apresentar biofilmes. Conclusão: o aumento do acúmulo de biofilme oral foi observado em pacientes com alterações na boca e a procedência do paciente foi associada à presença de biofilme.Descritores: Hospital; paciente; saúde bucal; manifestações orais; biofilme. AbstractIntroduction: Hospitalization may cause a decline in oral health and affect the entire body. The intensive care unit (ICU) may be a favorable environment for oral biofilm to accumulate in critically ill patients. Objective: To identify factors associated with oral biofilm in ICU patients in a hospital for infectious diseases. Method: This was a retrospective, descriptive and inferential study with a quantitative approach. Data were collected from 178 medical records of patients from January 2012 to July 2015. Biofilm presence was assessed according to the Greene and Vermillion index. Potential influential factors were analyzed by logistic regression. Result: Among ICU patients, 69.1% were men, 60.7% had acquired immune deficiency (AIDS), 66.3% were ward patients, 50.6% were intubated, and 50.0% were sedated. The oral elements of the patients were mostly normal. The following characteristics were significantly associated with oral biofilm: changes in the lips, gums, cheeks, and palates and bleeding. Patients from the ward had a lower risk of biofilm. Conclusion: Increased oral biofilm accumulation was observed in patients with oral changes, and patient origin was associated with the presence of biofilm.

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supporting

confidence: 72%

Factors associated with oral biofilm in ICU patients with infectious diseases

Damascena

Rodrigues

Costa

et al. 2017

Rev. odontol. UNESP

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“…18 In this study, respiratory pathogens, such as Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa, Table 2. Distribution of pathogens identified in the first (at admission) oral collection of patients on mechanical ventilation in the adult intensive care unit according to the pulmonology evolution of the patient.…”

Section: Discussionmentioning

confidence: 97%

Association between pathogens from tracheal aspirate and oral biofilm of patients on mechanical ventilation

et al. 2017

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The aim of this study was to detect possible associations between respiratory pathogens from tracheal aspirate and oral biofilm samples in intubated patients in an intensive care unit (ICU), and to identify the most common respiratory pathogens in oral biofilm, particularly in patients that developed ventilator-associated pneumonia (VAP). Two oral biofilm samples were collected from the tongue of intubated patients (at admission and after 48 hours) and analyzed by culture with the Antibiotic Sensitivity Test. The results from the tongue biofilm samples were compared with the tracheal secretions samples. A total of 59.37% of patients exhibited the same species of pathogens in their tracheal aspirate and oral biofilm, of which 8 (42.1%) developed VAP, 10 (52.63%) did not develop pneumonia and one (5.26%) had aspiration pneumonia. There was a statistically significant association between presence of microorganisms in the tracheal and mouth samples for the following pathogens: Klebsiella pneumoniae, Candida albicans, Pseudomonas aeruginosa, Enterobacter gergoviae, Streptococcus spp and Serratia marcescens (p < 0.05). Pathogens that are present in tracheal aspirates of intubated patients can be detected in their oral cavity, especially in those who developed VAP or aspiration pneumonia. Thus, the results indicate that an improved oral care in these patients could decrease ICU pneumonia rates.

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“…Commensal oral bacteria like S. aureus colonise the tracheostomy tube lumen and may lead to Ventilator associated pneumonia (VAP). (14) In the current ongoing study, a comparison has been done between antibiotic sensitivity of biofilm producing and nonbiofilm producing microorganisms. In biofilm producing K. pneumoniae, cephalosporins, aminoglycosides, few of the carbapenems and fluoroquinolones were resistant and the most effective drug came out to be Tigecycline and Colistin ( Figure: 1).…”

Section: Discussionmentioning

confidence: 99%