A randomized trial of chlorhexidine gluconate on oral bacterial pathogens in mechanically ventilated patients.
A randomized trial of chlorhexidine gluconate on oral bacterial pathogens in mechanically ventilated patients.
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DOI：
10.1186/cc7967
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Mylotte JM
中科院分区：
文献类型：
--
作者：
Scannapieco FA;Yu J;Raghavendran K;Vacanti A;Owens SI;Wood K;Mylotte JM
机械通气重症监护病房患者牙菌斑生物膜被呼吸道病原体定植。因此，改善这些患者的口腔卫生可以预防呼吸机相关性肺炎。本研究的目的是在创伤重症监护室的175名插管患者中确定减少病原体口腔定植所需的0.12%葡萄糖酸氯己定应用的最低频率（每天一次或两次）。一项随机、双盲、安慰剂对照的临床试验测试了口服局部0.12%葡萄糖酸氯己定或安慰剂（单独的溶剂），由护士每天应用一次或两次。测量呼吸道病原体（牙齿/义齿/颊粘膜）在口腔中定植的定量。从2004年3月1日至2007年11月30日招募受试者。175例受试者接受了随机化，146例受试者的微生物学基线数据可用，其中115例受试者在至少48小时后进行了完整的结局评估。洗必泰减少了金黄色葡萄球菌的数量，但不能减少受试者牙菌斑中肠杆菌、假单胞菌或不动杆菌的总数。与安慰剂组相比，氯己定治疗组的肺炎发生率无显著降低（OR = 0.54，95%CI：0.23 - 1.25，P = 0.15）。没有证据表明氯己定耐药，也没有观察到不良事件。治疗组之间的微生物学或临床结局无差异。虽然用洗必泰对口腔进行消毒并没有减少潜在呼吸道病原体的总数，但确实减少了沙门氏菌的数量。创伤重症监护患者牙菌斑中金黄色葡萄球菌的含量。clinicaltrials.gov NCT00123123。
Dental plaque biofilms are colonized by respiratory pathogens in mechanically-ventilated intensive care unit patients. Thus, improvements in oral hygiene in these patients may prevent ventilator-associated pneumonia. The goal of this study was to determine the minimum frequency (once or twice a day) for 0.12% chlorhexidine gluconate application necessary to reduce oral colonization by pathogens in 175 intubated patients in a trauma intensive care unit. A randomized, double-blind, placebo-controlled clinical trial tested oral topical 0.12% chlorhexidine gluconate or placebo (vehicle alone), applied once or twice a day by staff nurses. Quantitation of colonization of the oral cavity by respiratory pathogens (teeth/denture/buccal mucosa) was measured. Subjects were recruited from 1 March, 2004 until 30 November, 2007. While 175 subjects were randomized, microbiologic baseline data was available for 146 subjects, with 115 subjects having full outcome assessment after at least 48 hours. Chlorhexidine reduced the number of Staphylococcus aureus, but not the total number of enterics, Pseudomonas or Acinetobacter in the dental plaque of test subjects. A non-significant reduction in pneumonia rate was noted in groups treated with chlorhexidine compared with the placebo group (OR = 0.54, 95% CI: 0.23 to 1.25, P = 0.15). No evidence for resistance to chlorhexidine was noted, and no adverse events were observed. No differences were noted in microbiologic or clinical outcomes between treatment arms. While decontamination of the oral cavity with chlorhexidine did not reduce the total number of potential respiratory pathogens, it did reduce the number of S. aureus in dental plaque of trauma intensive care patients. clinicaltrials.gov NCT00123123.
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用洗涤酰胺对口腔去污染对医院肺炎发病率的影响：一项荟萃分析。
影响因子：
15.1
作者：
Pineda, Lilibeth A.;Saliba, Ranime G.;El Solh, Ali A.
通讯作者：
El Solh, Ali A.
DOI：
10.1086/593193
发表时间：
2008-12-15
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
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通讯作者：
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影响因子：
3.5
作者：
LANG, NP;BRECX, MC
通讯作者：
BRECX, MC
影响因子：
38.9
作者：
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通讯作者：
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影响因子：
6.7
作者：
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通讯作者：
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