Professional oral health care by dental hygienists reduced respiratory infections in elderly persons requiring nursing care.
Professional oral health care by dental hygienists reduced respiratory infections in elderly persons requiring nursing care.
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DOI：
10.1111/j.1601-5037.2007.00233.x
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发表时间：
2007-05-01
影响因子：
2.4
通讯作者：
Okuda, K
中科院分区：
文献类型：
--
作者：
Adachi, M;Ishihara, K;Okuda, K
呼吸道感染是老年人死亡的主要原因。我们已经评估了牙科医生在减少老年人呼吸道感染方面的作用，需要护理。方法：对两个老年人群体进行了检查，一个接受POHC，一个不接受，以确定微生物数量，呼吸道感染的强病原体，唾液中的酶活性，发烧，致命性吸入性肺炎的患病率和流感的患病率。结果：在第一个人群中，我们发现了高患病率的潜在呼吸道病原体，如葡萄球菌属，铜绿假单胞菌和白色念珠菌。接受POHC的患者显示这些病原体的患病率低于未接受POHC的患者。POHC组24个月内致死性吸入性肺炎的发生率显著低于非POHC组（P < 0.05）。POHC组发热≥ 37.8 ℃的发生率明显低于非POHC组（P < 0.05）。在第二个研究人群中，我们调查了POHC在6个月内对流感感染的影响。在POHC组中，神经氨酸酶和胰蛋白酶样蛋白酶活性降低，98例患者中有1例被诊断为流感;而在非POHC组中，92例患者中有9例被诊断为流感。结论：口腔科医师对老年人进行口腔保健治疗是预防老年人呼吸道感染的有效方法。
OBJECTIVES: Respiratory infection is a major cause of death in the elderly. We have evaluated the role of professional oral health care (POHC) by dental hygienists in reducing respiratory infections in elderly persons requiring nursing care.METHODS: Two populations of elderly persons, one receiving POHC and one not, were examined to determine numbers of microorganisms, potent pathogens of respiratory infection, enzymatic activity in saliva, fevers, prevalence of fatal aspiration pneumonia and prevalence of influenza.RESULTS: In the first population, we found a high prevalence of potent respiratory pathogens such as Staphylococcus species, Pseudomonas aeruginosa and Candida albicans. Patients who received POHC showed a lower prevalence for these pathogens than those who did not. The ratio of fatal aspiration pneumonia in POHC patients was significantly lower than that in patients without POHC (non-POHC) over a 24-month period (P < 0.05). The prevalence of a fever of 37.8 degrees C or more in POHC patients was significantly lower than that in the non-POHC group (P < 0.05). In the second study population, we investigated the effects of POHC on infection with influenza over a 6-month period. In the POHC group, neuraminidase and trypsin-like protease activities decreased, and one of 98 patients was diagnosed with influenza; whereas, in the non-POHC group, nine of 92 patients were diagnosed with influenza. The relative risk of developing influenza while under POHC was 0.1 (95% CI 0.01-0.81, P = 0.008).CONCLUSION: These results suggest that POHC by dental hygienists is effective in preventing respiratory infections in elderly persons requiring nursing care.