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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Oral Microbial and Respiratory Status of Persons with Mental Retardation/Intellectual & Developmental Disability – An Observational Cohort Study</title>
<author><name sortKey="Binkley, Catherine J" sort="Binkley, Catherine J" uniqKey="Binkley C" first="Catherine J." last="Binkley">Catherine J. Binkley</name>
<affiliation><nlm:aff id="A1"> Department of Surgical and Hospital Dentistry, University of Louisville, Louisville, Kentucky, USA, 40292</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Haugh, Gilbert S" sort="Haugh, Gilbert S" uniqKey="Haugh G" first="Gilbert S." last="Haugh">Gilbert S. Haugh</name>
<affiliation><nlm:aff id="A2"> Office of Clinical Trials Services and Support, University of Louisville, Louisville, KY, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kitchens, Dinah H" sort="Kitchens, Dinah H" uniqKey="Kitchens D" first="Dinah H." last="Kitchens">Dinah H. Kitchens</name>
<affiliation><nlm:aff id="A3"> Clover Bottom Developmental Center, Nashville, TN</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Wallace, Debra L" sort="Wallace, Debra L" uniqKey="Wallace D" first="Debra L." last="Wallace">Debra L. Wallace</name>
<affiliation><nlm:aff id="A1"> Department of Surgical and Hospital Dentistry, University of Louisville, Louisville, Kentucky, USA, 40292</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sessler, Daniel I" sort="Sessler, Daniel I" uniqKey="Sessler D" first="Daniel I." last="Sessler">Daniel I. Sessler</name>
<affiliation><nlm:aff id="A4"> Department of Outcomes Research, The Cleveland Clinic, Cleveland, OH</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">19748295</idno>
<idno type="pmc">2763931</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763931</idno>
<idno type="RBID">PMC:2763931</idno>
<idno type="doi">10.1016/j.tripleo.2009.06.027</idno>
<date when="2009">2009</date>
<idno type="wicri:Area/Pmc/Corpus">002139</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002139</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Oral Microbial and Respiratory Status of Persons with Mental Retardation/Intellectual & Developmental Disability – An Observational Cohort Study</title>
<author><name sortKey="Binkley, Catherine J" sort="Binkley, Catherine J" uniqKey="Binkley C" first="Catherine J." last="Binkley">Catherine J. Binkley</name>
<affiliation><nlm:aff id="A1"> Department of Surgical and Hospital Dentistry, University of Louisville, Louisville, Kentucky, USA, 40292</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Haugh, Gilbert S" sort="Haugh, Gilbert S" uniqKey="Haugh G" first="Gilbert S." last="Haugh">Gilbert S. Haugh</name>
<affiliation><nlm:aff id="A2"> Office of Clinical Trials Services and Support, University of Louisville, Louisville, KY, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kitchens, Dinah H" sort="Kitchens, Dinah H" uniqKey="Kitchens D" first="Dinah H." last="Kitchens">Dinah H. Kitchens</name>
<affiliation><nlm:aff id="A3"> Clover Bottom Developmental Center, Nashville, TN</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Wallace, Debra L" sort="Wallace, Debra L" uniqKey="Wallace D" first="Debra L." last="Wallace">Debra L. Wallace</name>
<affiliation><nlm:aff id="A1"> Department of Surgical and Hospital Dentistry, University of Louisville, Louisville, Kentucky, USA, 40292</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sessler, Daniel I" sort="Sessler, Daniel I" uniqKey="Sessler D" first="Daniel I." last="Sessler">Daniel I. Sessler</name>
<affiliation><nlm:aff id="A4"> Department of Outcomes Research, The Cleveland Clinic, Cleveland, OH</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics</title>
<idno type="ISSN">1079-2104</idno>
<idno type="eISSN">1528-395X</idno>
<imprint><date when="2009">2009</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title>
<p id="P2">The objective of this study was to determine the prevalence of select microorganisms in oral biofilms and to investigate relationships between oral and respiratory status in persons with mental retardation/intellectual and developmental disabilities (IDD).</p>
</sec>
<sec id="S2"><title>Study Design</title>
<p id="P3">We conducted a 6-month-long observational cohort study with 63 persons with IDD. Oral examinations, oral sampling, and medical record reviews were performed at baseline and then monthly. Polymerase chain reaction (PCR) was used to analyze all baseline oral samples for the presence of <italic>Streptococcus pneumoniae (S. pneumoniae), Methicillin-Resistant Staphylococcus aureus (MRSA), Prevotella melaninogenica (P. melaninogenica)</italic>
and <italic>Candida albicans (C. albicans).</italic>
PCR analyses were also performed on participants’ samples collected in the month prior to being diagnosed with a respiratory infection.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P4">All subjects had <italic>P. melaninogenica</italic>
detected by PCR in their oral samples. Fifty-five percent (35 of 63) of participants had <italic>S. pneumoniae, MRSA</italic>
and <italic>C. albicans</italic>
in their oral samples at baseline. No dental decay was detected clinically, oral hygiene was fair, and dysphagia was common. During the 6 months of the study, there were 22 respiratory infections (35% of participants) – 12 pneumonias, 7 sinusitis, 1 bronchitis, and 1 upper respiratory tract infection. Participants with microorganisms in their baseline samples were significantly more likely to develop any respiratory infection and those who had poor oral status were significantly more likely to develop pneumonia. Almost 60% of participants who developed respiratory infections had the same microorganism detected in the sample collected in the month prior to infection as had been detected in their baseline sample.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P5">Potentially pathogenic microorganisms in the oral cavity and poor oral status significantly increased the risk of developing respiratory infections, including pneumonia, in persons with IDD. The results suggest that colonization with these microorganisms may persist despite routine tooth brushing. Meticulous comprehensive oral hygiene of the oral cavity may be needed to reduce oropharyngeal microbial load.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9508562</journal-id>
<journal-id journal-id-type="pubmed-jr-id">8728</journal-id>
<journal-id journal-id-type="nlm-ta">Oral Surg Oral Med Oral Pathol Oral Radiol Endod</journal-id>
<journal-title>Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics</journal-title>
<issn pub-type="ppub">1079-2104</issn>
<issn pub-type="epub">1528-395X</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">19748295</article-id>
<article-id pub-id-type="pmc">2763931</article-id>
<article-id pub-id-type="doi">10.1016/j.tripleo.2009.06.027</article-id>
<article-id pub-id-type="manuscript">NIHMS129569</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Oral Microbial and Respiratory Status of Persons with Mental Retardation/Intellectual & Developmental Disability – An Observational Cohort Study</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Binkley</surname>
<given-names>Catherine J.</given-names>
</name>
<degrees>DDS, MSPH, PhD</degrees>
<xref rid="A1" ref-type="aff">1</xref>
<xref rid="FN1" ref-type="author-notes">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Haugh</surname>
<given-names>Gilbert S.</given-names>
</name>
<degrees>MS</degrees>
<xref rid="A2" ref-type="aff">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kitchens</surname>
<given-names>Dinah H.</given-names>
</name>
<degrees>DMD, MSPH</degrees>
<xref rid="A3" ref-type="aff">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wallace</surname>
<given-names>Debra L.</given-names>
</name>
<degrees>BS</degrees>
<xref rid="A1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sessler</surname>
<given-names>Daniel I.</given-names>
</name>
<degrees>MD</degrees>
<xref rid="A4" ref-type="aff">4</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Department of Surgical and Hospital Dentistry, University of Louisville, Louisville, Kentucky, USA, 40292</aff>
<aff id="A2"><label>2</label>
Office of Clinical Trials Services and Support, University of Louisville, Louisville, KY, USA</aff>
<aff id="A3"><label>3</label>
Clover Bottom Developmental Center, Nashville, TN</aff>
<aff id="A4"><label>4</label>
Department of Outcomes Research, The Cleveland Clinic, Cleveland, OH</aff>
<author-notes><corresp id="FN1">Corresponding author, <email>cjbink01@louisville.edu</email>
, phone 502-852-5083, fax 502-852-5988</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>7</day>
<month>7</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="epub"><day>12</day>
<month>9</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="ppub"><month>11</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>1</day>
<month>11</month>
<year>2010</year>
</pub-date>
<volume>108</volume>
<issue>5</issue>
<fpage>722</fpage>
<lpage>731</lpage>
<abstract><sec id="S1"><title>Objective</title>
<p id="P2">The objective of this study was to determine the prevalence of select microorganisms in oral biofilms and to investigate relationships between oral and respiratory status in persons with mental retardation/intellectual and developmental disabilities (IDD).</p>
</sec>
<sec id="S2"><title>Study Design</title>
<p id="P3">We conducted a 6-month-long observational cohort study with 63 persons with IDD. Oral examinations, oral sampling, and medical record reviews were performed at baseline and then monthly. Polymerase chain reaction (PCR) was used to analyze all baseline oral samples for the presence of <italic>Streptococcus pneumoniae (S. pneumoniae), Methicillin-Resistant Staphylococcus aureus (MRSA), Prevotella melaninogenica (P. melaninogenica)</italic>
and <italic>Candida albicans (C. albicans).</italic>
PCR analyses were also performed on participants’ samples collected in the month prior to being diagnosed with a respiratory infection.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P4">All subjects had <italic>P. melaninogenica</italic>
detected by PCR in their oral samples. Fifty-five percent (35 of 63) of participants had <italic>S. pneumoniae, MRSA</italic>
and <italic>C. albicans</italic>
in their oral samples at baseline. No dental decay was detected clinically, oral hygiene was fair, and dysphagia was common. During the 6 months of the study, there were 22 respiratory infections (35% of participants) – 12 pneumonias, 7 sinusitis, 1 bronchitis, and 1 upper respiratory tract infection. Participants with microorganisms in their baseline samples were significantly more likely to develop any respiratory infection and those who had poor oral status were significantly more likely to develop pneumonia. Almost 60% of participants who developed respiratory infections had the same microorganism detected in the sample collected in the month prior to infection as had been detected in their baseline sample.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P5">Potentially pathogenic microorganisms in the oral cavity and poor oral status significantly increased the risk of developing respiratory infections, including pneumonia, in persons with IDD. The results suggest that colonization with these microorganisms may persist despite routine tooth brushing. Meticulous comprehensive oral hygiene of the oral cavity may be needed to reduce oropharyngeal microbial load.</p>
</sec>
</abstract>
<contract-num rid="DE1">R21 DE016477-02</contract-num>
<contract-num rid="DE1">R21 DE016477-01</contract-num>
<contract-sponsor id="DE1">National Institute of Dental and Craniofacial Research : NIDCR</contract-sponsor>
</article-meta>
</front>
</pmc>
</record>
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