Respiratory pathogen colonization of the dental plaque of institutionalized elders.
Respiratory pathogen colonization of the dental plaque of institutionalized elders.
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DOI：
10.1111/j.1754-4505.1999.tb01413.x
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发表时间：
1999-05-01
期刊：
影响因子：
--
通讯作者：
Katz, R V
中科院分区：
文献类型：
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作者：
Russell, S L;Boylan, R J;Katz, R V
虽然已经确定咽部细菌的吸入是医院获得性肺炎发展中的主要感染途径，但呼吸道病原体在咽部粘膜的定植已被证明是一种短暂现象。有人认为，牙菌斑可能构成一个额外的，可能更稳定的，呼吸道病原体的水库。本研究的目的是评估一组老年（平均年龄= 75.9岁）慢性病护理机构居民（n = 28）和一组年龄、性别和种族匹配的门诊对照受试者（n = 30）中潜在呼吸道病原体口腔定植的患病率，特别注意牙齿、义齿和口腔粘膜表面上存在的菌斑。慢性病护理机构（CCF）受试者的牙齿和义齿上的菌斑评分显著高于牙科门诊对照（DOC）受试者（PII 2.3 vs. 1.2和义齿菌斑1.4 vs. 0.3）。虽然DOC组中没有发现呼吸道病原体定植（> 1.0%的可培养需氧植物群），但发现14.3%（4/28）的CCF受试者定植。CCF受试者中呼吸道病原体的口腔定植与慢性阻塞性肺疾病（COPD）的存在和较高的斑块评分相关。这些结果表明，缺乏牙菌斑控制和慢性阻塞性肺病的存在可能与呼吸道病原体定植的牙菌斑慢性护理设施的居民。
Although it has been established that aspiration of pharyngeal bacteria is the major route of infection in the development of nosocomial pneumonia, colonization of the pharyngeal mucosa by respiratory pathogens has been shown to be a transient phenomenon. It has been suggested that the dental plaque may constitute an additional, possibly more stable, reservoir of respiratory pathogens. The purpose of this study was to assess the prevalence of oral colonization by potential respiratory pathogens in a group of elderly (mean age = 75.9 yrs) chronic-care-facility residents (n = 28) and a group of age-, gender-, and race-matched outpatient control subjects (n = 30), with specific attention to plaque present on tooth, denture, and oral mucosal surfaces. Plaque scores on teeth and dentures were significantly higher in the chronic-care-facility (CCF) subjects than in the dental outpatient control (DOC) subjects (PII 2.3 vs. 1.2 and denture plaque 1.4 vs. 0.3). While no subjects in the DOC group were found to be colonized with respiratory pathogens (> 1.0% of the cultivable aerobic flora), 14.3% (4/28) of the CCF subjects were found to be colonized. Oral colonization with respiratory pathogens in CCF subjects was associated with the presence of chronic obstructive pulmonary disease (COPD) and higher plaque scores. These results suggest that deficient dental plaque control and the presence of COPD may be related to respiratory pathogen colonization of dental plaque in chronic-care-facility residents.