Colonization of dental plaques - A reservoir of respiratory pathogens for hospital acquired pneumonia in institutionalized elders
Colonization of dental plaques - A reservoir of respiratory pathogens for hospital acquired pneumonia in institutionalized elders
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DOI：
10.1378/chest.126.5.1575
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发表时间：
2004-11-01
期刊：
影响因子：
9.6
通讯作者：
Berbary, E
中科院分区：
文献类型：
--
作者：
El-Solh, AA;Pietrantoni, C;Berbary, E
研究目的：在长期护理机构的居民中，糟糕的口腔卫生与呼吸道病原体的定植有关。我们试图调查牙菌斑(DP)定植与下呼吸道感染和住院住院老年人上升的分子基因分型之间的关系。方法：我们评估了49名长期护理机构需要重症监护治疗的危重患者的牙齿状况。在ICU入院时获得DPS的斑块指数评分和定量培养。对14例发生医院获得性肺炎(HAT)的患者行保护性BAL(PBAL)。通过脉冲场凝胶电泳法对从Pbal液中回收的呼吸道病原体与从DPS中分离的呼吸道病原体进行了遗传学比较。测量和结果：28名受试者(57%)的DPS中有需氧病原体的定植。分离菌株以金黄色葡萄球菌(45%)为主，其次为肠道颗粒阴性杆菌(42%)和铜绿假单胞菌(13%)。有10例患者记录了HAP的病因。从Pbal液中回收的13株呼吸道病原菌中，有9株与从8例患者相应DPS中分离到的呼吸道病原菌基因匹配。结论：DPS中的需氧呼吸道病原体可能是住院老年人HAP的重要宿主。需要进一步的研究来描述住院老年人的日常口腔卫生是否会降低这一脆弱人群的医院内肺炎的风险。
Study objectives: Poor dental hygiene has been linked to respiratory pathogen colonization in residents of long-term care facilities. We sought to investigate the association between dental plaque (DP) colonization and lower respiratory tract infection An hospitalized institutionalized elders rising molecular genotyping.Methods: We assessed the dental status of 49 critically if residents of long-term care facilities requiring intensive care treatment. Plaque index scores and quantitative cultures of DPs were obtained on ICU admission. Protected BAL (PBAL) was performed on 14 patients who developed hospital-acquired pneumonia (HAT). Respiratory pathogens recovered from the PBAL fluid were compared genetically to those isolated from DPs by pulsed-field gel electrophoresis.Measurements and results: Twenty-eight subjects (57%) had colonization of their DPs with aerobic pathogens. Staphylococcus aureus (45%) accounted for the majority of the isolates, followed by enteric Grain-negative bacilli (42%) and Pseudomonas aeruginosa (13%). The etiology of HAP was documented in 10 patients. Of the 13 isolates recovered from PBAL fluid, nine respiratory pathogens matched genetically those recovered from the corresponding DPs of eight patients.Conclusions: These findings suggest that aerobic respiratory pathogens colonizing DPs may be an important reservoir for HAP in institutionalized elders. Future studies are needed to delineate whether daily oral hygiene in hospitalized elderly would reduce the risk of nosocomial pneumonia in this frail population.