The effect of tooth brushing, irrigation, and topical tetracycline administration on the reduction of oral bacteria in mechanically ventilated patients: a preliminary study
Identifieur interne : 000457 ( Main/Exploration ); précédent : 000456; suivant : 000458The effect of tooth brushing, irrigation, and topical tetracycline administration on the reduction of oral bacteria in mechanically ventilated patients: a preliminary study
Auteurs : Saki Hayashida [Japon] ; Madoka Funahara [Japon] ; Motohiro Sekino [Japon] ; Noriko Yamaguchi [Japon] ; Kosuke Kosai [Japon] ; Souichi Yanamoto [Japon] ; Katsunori Yanagihara [Japon] ; Masahiro Umeda [Japon]Source :
- BMC Oral Health [ 1472-6831 ] ; 2016.
Abstract
One of the main causes of ventilator-associated pneumonia (VAP) is thought to be aspiration of oropharyngeal fluid containing pathogenic microorganisms. The aim of this study was to examine the effects of various oral care methods on the reduction of oral bacteria during intubation.
First, the effect of mechanical oral cleaning was investigated. The bacterial count on the tongue and in the oropharyngeal fluid was measured after tooth brushing, irrigation, and three hours after irrigation in mechanically ventilated patients at the intensive care unit (ICU).
Next, the efficacy of topical administration of tetracycline and povidone iodine on the inhibition of bacterial growth on the tongue and in the oropharyngeal fluid was examined in oral cancer patients during neck dissection.
The number of bacteria in the oropharyngeal fluid was approximately 105–106 cfu/mL before surgery, but increased to 108 cfu/mL after intubation. Oral care with tooth brushing and mucosal cleaning did not reduce oral bacteria, while irrigation of the oral cavity and oropharynx significantly decreased it to a level of 105 cfu/mL (
Oral bacteria did not decrease by topical povidone iodine application. In contrast, 30 min after topical administration of tetracycline, the number of oral bacteria decreased to 105 cfu/mL, and remained under 106 cfu/mL throughout the entire experimental period of 150 min.
While the present studies are only preliminary, these results indicate that irrigation of the oral cavity and oropharynx followed by topical antibiotic administration may reduce oral bacteria in mechanically ventilated patients.
Url:
DOI: 10.1186/s12903-016-0224-x
PubMed: 27268137
PubMed Central: 4895927
Affiliations:
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xml:lang="en" level="a" type="main">The effect of tooth brushing, irrigation, and topical tetracycline administration on the reduction of oral bacteria in mechanically ventilated patients: a preliminary study</title><author><name sortKey="Hayashida, Saki" sort="Hayashida, Saki" uniqKey="Hayashida S" first="Saki" last="Hayashida">Saki Hayashida</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 41-7-1 Sakamoto, Nagasaki, 852-8588 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 41-7-1 Sakamoto, Nagasaki</wicri:regionArea><wicri:noRegion>Nagasaki</wicri:noRegion></affiliation></author><author><name sortKey="Funahara, Madoka" sort="Funahara, Madoka" uniqKey="Funahara M" first="Madoka" last="Funahara">Madoka Funahara</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 41-7-1 Sakamoto, Nagasaki, 852-8588 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 41-7-1 Sakamoto, Nagasaki</wicri:regionArea><wicri:noRegion>Nagasaki</wicri:noRegion></affiliation></author><author><name sortKey="Sekino, Motohiro" sort="Sekino, Motohiro" uniqKey="Sekino M" first="Motohiro" last="Sekino">Motohiro Sekino</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Division of intensive care, Nagasaki University Hospital, 41-7-1 Sakamoto, Nagasaki, 852-8588 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Division of intensive care, Nagasaki University Hospital, 41-7-1 Sakamoto, Nagasaki</wicri:regionArea><wicri:noRegion>Nagasaki</wicri:noRegion></affiliation></author><author><name sortKey="Yamaguchi, Noriko" sort="Yamaguchi, Noriko" uniqKey="Yamaguchi N" first="Noriko" last="Yamaguchi">Noriko Yamaguchi</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Division of intensive care, Nagasaki University Hospital, 41-7-1 Sakamoto, Nagasaki, 852-8588 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Division of intensive care, Nagasaki University Hospital, 41-7-1 Sakamoto, Nagasaki</wicri:regionArea><wicri:noRegion>Nagasaki</wicri:noRegion></affiliation></author><author><name sortKey="Kosai, Kosuke" sort="Kosai, Kosuke" uniqKey="Kosai K" first="Kosuke" last="Kosai">Kosuke Kosai</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Laboratory Medicine, Nagasaki University Graduate School of Medicine, 41-7-1 Sakamoto, Nagasaki, 852-8588 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Laboratory Medicine, Nagasaki University Graduate School of Medicine, 41-7-1 Sakamoto, Nagasaki</wicri:regionArea><wicri:noRegion>Nagasaki</wicri:noRegion></affiliation></author><author><name sortKey="Yanamoto, Souichi" sort="Yanamoto, Souichi" uniqKey="Yanamoto S" first="Souichi" last="Yanamoto">Souichi Yanamoto</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 41-7-1 Sakamoto, Nagasaki, 852-8588 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 41-7-1 Sakamoto, Nagasaki</wicri:regionArea><wicri:noRegion>Nagasaki</wicri:noRegion></affiliation></author><author><name sortKey="Yanagihara, Katsunori" sort="Yanagihara, Katsunori" uniqKey="Yanagihara K" first="Katsunori" last="Yanagihara">Katsunori Yanagihara</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Laboratory Medicine, Nagasaki University Graduate School of Medicine, 41-7-1 Sakamoto, Nagasaki, 852-8588 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Laboratory Medicine, Nagasaki University Graduate School of Medicine, 41-7-1 Sakamoto, Nagasaki</wicri:regionArea><wicri:noRegion>Nagasaki</wicri:noRegion></affiliation></author><author><name sortKey="Umeda, Masahiro" sort="Umeda, Masahiro" uniqKey="Umeda M" first="Masahiro" last="Umeda">Masahiro Umeda</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 41-7-1 Sakamoto, Nagasaki, 852-8588 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 41-7-1 Sakamoto, Nagasaki</wicri:regionArea><wicri:noRegion>Nagasaki</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Oral Health</title><idno type="eISSN">1472-6831</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>One of the main causes of ventilator-associated pneumonia (VAP) is thought to be aspiration of oropharyngeal fluid containing pathogenic microorganisms. The aim of this study was to examine the effects of various oral care methods on the reduction of oral bacteria during intubation.</p></sec><sec><title>Methods</title><p>First, the effect of mechanical oral cleaning was investigated. The bacterial count on the tongue and in the oropharyngeal fluid was measured after tooth brushing, irrigation, and three hours after irrigation in mechanically ventilated patients at the intensive care unit (ICU).</p><p>Next, the efficacy of topical administration of tetracycline and povidone iodine on the inhibition of bacterial growth on the tongue and in the oropharyngeal fluid was examined in oral cancer patients during neck dissection.</p></sec><sec><title>Results</title><p>The number of bacteria in the oropharyngeal fluid was approximately 10<sup>5</sup>–10<sup>6</sup> cfu/mL before surgery, but increased to 10<sup>8</sup> cfu/mL after intubation. Oral care with tooth brushing and mucosal cleaning did not reduce oral bacteria, while irrigation of the oral cavity and oropharynx significantly decreased it to a level of 10<sup>5</sup> cfu/mL (<italic>p</italic> < 0.001). However, oral bacteria increased again to almost 10<sup>8</sup> cfu/mL within three hours of irrigation.</p><p>Oral bacteria did not decrease by topical povidone iodine application. In contrast, 30 min after topical administration of tetracycline, the number of oral bacteria decreased to 10<sup>5</sup> cfu/mL, and remained under 10<sup>6</sup> cfu/mL throughout the entire experimental period of 150 min.</p></sec><sec><title>Conclusions</title><p>While the present studies are only preliminary, these results indicate that irrigation of the oral cavity and oropharynx followed by topical antibiotic administration may reduce oral bacteria in mechanically ventilated patients.</p></sec><sec><title>Trial registration</title><p><ext-link ext-link-type="uri" xlink:href="http://www.umin.ac.jp/ctr/index-j.htm">UMIN000018318</ext-link>, 1 August 2015.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Chastre, J" uniqKey="Chastre J">J Chastre</name></author><author><name sortKey="Fagon, Jy" uniqKey="Fagon J">JY Fagon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Haley, Rw" 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Coopersmith</name></author><author><name sortKey="Boyle, Wa" uniqKey="Boyle W">WA Boyle</name></author><author><name sortKey="Buchman, Tg" uniqKey="Buchman T">TG Buchman</name></author><author><name sortKey="Mazuski, Je" uniqKey="Mazuski J">JE Mazuski</name></author><author><name sortKey="Schuerer, Dje" uniqKey="Schuerer D">DJE Schuerer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Funahara, M" uniqKey="Funahara M">M Funahara</name></author><author><name sortKey="Hayashida, S" uniqKey="Hayashida S">S Hayashida</name></author><author><name sortKey="Sakamoto, Y" uniqKey="Sakamoto Y">Y Sakamoto</name></author><author><name sortKey="Yanamoto, S" uniqKey="Yanamoto S">S Yanamoto</name></author><author><name sortKey="Kosai, K" uniqKey="Kosai K">K Kosai</name></author><author><name sortKey="Yanagihara, K" uniqKey="Yanagihara K">K Yanagihara</name></author><author><name sortKey="Umeda, M" uniqKey="Umeda M">M Umeda</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Scannapieco, Fa" uniqKey="Scannapieco F">FA Scannapieco</name></author><author><name sortKey="Stewart, Em" uniqKey="Stewart E">EM Stewart</name></author><author><name sortKey="Mylotte, Jm" uniqKey="Mylotte J">JM Mylotte</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fourrier, F" uniqKey="Fourrier F">F Fourrier</name></author><author><name sortKey="Duvivier, B" uniqKey="Duvivier B">B Duvivier</name></author><author><name sortKey="Boutigny, H" uniqKey="Boutigny H">H Boutigny</name></author><author><name sortKey="Roussel Delvallez, M" uniqKey="Roussel Delvallez M">M Roussel-Delvallez</name></author><author><name sortKey="Chopin, C" uniqKey="Chopin C">C Chopin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Penel, N" uniqKey="Penel N">N Penel</name></author><author><name sortKey="Fournier, C" uniqKey="Fournier C">C Fournier</name></author><author><name sortKey="Lefebvre, D" uniqKey="Lefebvre D">D Lefebvre</name></author><author><name sortKey="Lefebvre, Jl" uniqKey="Lefebvre J">JL Lefebvre</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Japon</li></country></list><tree><country name="Japon"><noRegion><name sortKey="Hayashida, Saki" sort="Hayashida, Saki" uniqKey="Hayashida S" first="Saki" last="Hayashida">Saki Hayashida</name></noRegion><name sortKey="Funahara, Madoka" sort="Funahara, Madoka" uniqKey="Funahara M" first="Madoka" last="Funahara">Madoka Funahara</name><name sortKey="Kosai, Kosuke" sort="Kosai, Kosuke" uniqKey="Kosai K" first="Kosuke" last="Kosai">Kosuke Kosai</name><name sortKey="Sekino, Motohiro" sort="Sekino, Motohiro" uniqKey="Sekino M" first="Motohiro" last="Sekino">Motohiro Sekino</name><name sortKey="Umeda, Masahiro" sort="Umeda, Masahiro" uniqKey="Umeda M" first="Masahiro" last="Umeda">Masahiro Umeda</name><name sortKey="Yamaguchi, Noriko" sort="Yamaguchi, Noriko" uniqKey="Yamaguchi N" first="Noriko" last="Yamaguchi">Noriko Yamaguchi</name><name sortKey="Yanagihara, Katsunori" sort="Yanagihara, Katsunori" uniqKey="Yanagihara K" first="Katsunori" last="Yanagihara">Katsunori Yanagihara</name><name sortKey="Yanamoto, Souichi" sort="Yanamoto, Souichi" uniqKey="Yanamoto S" first="Souichi" last="Yanamoto">Souichi Yanamoto</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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