To: The use of 2% chlorhexidine gel and toothbrushing for oral hygiene of patients receiving mechanical ventilation: effects on ventilator-associated pneumonia

Ataee, Ramezan Ali

doi:10.5935/0103-507x.20140068

Cited by 9 publications

(18 citation statements)

References 10 publications

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“…Five [ 13 , 17 , 18 , 22 , 24 ] studies defined the clinical onset of VAP by using the clinical pulmonary infection score (CPIS) more than 6; 6 studies [ 9 , 14 – 16 , 20 , 23 ] applied the modified version of CPIS which has been recommended for the detection and management of VAP by the American Thoracic Society. In 1 study, the diagnosis of suspected VAP was based on the colonization of supragingival dental plague.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 3 studies [ 16 , 22 , 23 ] compared toothbrushing plus chlorhexidine rinse and toothbrushing plus placebo rinse (184 in the intervention arm and 192 in the control arm). Owing to no significant heterogeneity, ( P = .93, I 2 = 0%), the fixed effects model was used for meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen studies [9,13–24] published between 2008 and 2018 and performed in 8 countries were included. Ten of them, [9,13–16,18–20,22,23] with 657 patients, were eventually subjected to the meta-analysis. The maximum sample size for a single study was 145 cases.…”

Section: Resultsmentioning

confidence: 99%

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Impact of oral care modalities on the incidence of ventilator-associated pneumonia in the intensive care unit: A meta-analysis

Zhu

Yang

et al. 2023

Medicine

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Background: At present, evidence of the role of oral hygiene in ICU-related pneumonia is rare. The study aimed to evaluate the effectiveness of toothbrush-based oral care in preventing ventilator-associated pneumonia (VAP) in patients with mechanical ventilation in the ICU. Methods: Ten databases were searched for randomized controlled trials (RCTs) evaluating toothbrush-based oral care for preventing VAP in patients with mechanical ventilation in ICU. Quality assessment and data extraction were independently performed by 2 researchers. The meta-analysis was performed using RevMan 5.3 software. Results: Thirteen RCTs with 657 patients were included. Tooth brushing + 0.2%/0.12% chlorhexidine was associated with reduced incidence of VAP compared to chlorhexidine (OR = 0.63, 95% confidence interval [CI]: 0.43–0.91, P = .01) or tooth brushing + placebo (OR = 0.47, 95% CI: 0.25–0.86, P = .02) in patients with mechanical ventilation in ICU, but was similar to cotton wipe with 0.2% or 0.12% chlorhexidine (OR = 1.33, 95% CI: 0.77–2.29, P = .31). Conclusions: Tooth brushing combined with chlorhexidine mouthwash can prevent VAP in patients with mechanical ventilation in ICU. There is no advantage of tooth brushing combined with chlorhexidine mouthwash over cotton wipe with chlorhexidine mouthwash for preventing VAP in these patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Impact of oral care modalities on the incidence of ventilator-associated pneumonia in the intensive care unit: A meta-analysis

Zhu

Yang

et al. 2023

Medicine

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“…Também é empregada, em menor escala, como desinfetante e conservante. 6,7 Os mecanismos gerais de resistência bacteriana aos antibióticos, como por exemplo, efluxo, impermeabilidade, modificação de sítios alvos, inativação ou modificação da droga, são também aplicáveis aos biocidas, existindo, portanto a possibilidade de haver resistência cruzada entre antibióticos e biocidas. 8 O presente estudo teve como objetivo investigar a susceptibilidade de amostras clínicas de Pseudomonas aeruginosa a antibióticos e a clorexidina.…”

Section: -11unclassified

Susceptibilidade De Amostras Clínicas De Pseudomonas Aeruginosa a Antibióticos E a Clorexidina

Ferreira

Garcia

Carrara-Marrone

et al. 2015

Rev Epidemiol Control Infect

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DESCRITORES Pseudomonas aeruginosa.Clorexidina Resistência KEYWORDS Pseudomonas aeruginosa Chlorhexidine ResistanceJustificativa e Objetivos: Pseudomonas aeruginosa é um importante patógeno hospitalar oportunista que apresenta diferentes mecanismos de resistência aos antibióticos constituindo um problema de grande importância em saúde pública.O objetivo deste estudo foi investigar a existência de uma possível associação entre a resistência a antibióticos e a susceptibilidade a clorexidina de 65 amostras clínicas de Pseudomonas aeruginosa, isoladas de pacientes internados em um hospital brasileiro. Métodos: As amostras foram identificadas pelo sistema automatizado de identificação de microrganismos MicroScan e o perfil de sensibilidade aos antibióticos foi realizado pela técnica de disco-difusão. A concentração inibitória mínima (CIM) da clorexidina foi avaliada pelo método de diluição em caldo e a atividade bactericida, nas concentrações de 0,2% e de 2%, foi avaliada pelo teste de suspensão, de acordo com a Norma Européia 1040. Resultados: Todas as amostras testadas apresentaram sensibilidade a polimixina, seguida da piperacilina/tazobactam (75,4%). A CIM da clorexidina variou de 2,5 a 40 µg/ml, com CIM50 e CIM90 de 10 e 20 µg/ml. No teste de suspensão, a clorexidina na concentração de 0,2% eliminou 24,2%(15/65) das amostras. Uma amostra apresentou susceptibilidade reduzida a clorexidina, isto é, no teste de suspensão, a redução de bactérias viáveis do inóculo foi inferior a 5 Log10. Outras três amostras sofreram uma redução logarítmica muito próxima de 5. Conclusão: Os resultados dos testes in vitro com a clorexidina foram homogêneos, parecendo não indicar uma associação deste biocida com a múltipla resistência aos antibióticos das amostras de P. aeruginosa testadas. Destaca-se o achado de uma amostra de P. aeruginosa com reduzida susceptibilidade a clorexidina na diluição de uso de 0,2%. Backgound and Objectives:Aimed to investigate whether there is a possible association between antibiotic resistance and susceptibility to chlorhexidine of 65 clinical strains of Pseudomonas aeruginosa isolated from patients in a Brazilian hospital. Methods: The samples were identified by the MicroScan system and the sensitivity to antibiotics was performed by the disk diffusion technique. The minimum inhibitory concentration (MIC) of chlorhexidine was evaluated by broth dilution method and bactericidal activity at concentrations of 0.2% and 2%, was evaluated by the test suspension, according to the European Standard 1040. Results: All strains tested showed sensitivity to polymyxin, followed by piperacillin / tazobactam (75.4%), ceftazidime and cefepime (41.5%), tobramycin (36.9%), aztreonam and amikacin (33.8%), levofloxacin (30.8%), ciprofloxacin (29.2%), ofloxacin (27.3%), gentamicin (26.2%) and ceftriaxone (7.7%). The MIC of chlorhexidine ranged from 2.5 to 40 micrograms / ml, with MIC50 and MIC90 of 10 and 20 mg / ml. In a suspension test, the concentration of chlorhexidine in 2% destroy any bacterial cell inoculum of 65 s...

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“…( 4 ) New guidelines and a bundle of simple interventions are being developed to identify VAP and to reduce its incidence. ( 5 - 7 )…”

Section: Introductionmentioning

confidence: 99%

Antibacterial activity of standard and N-doped titanium dioxide-coated endotracheal tubes: an in vitro study

Caratto

Ball

Sanguineti

et al. 2017

Revista Brasileira De Terapia Intensiva

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ObjectiveThe aim of this study was to assess the antibacterial activity against Staphylococcus aureus and Pseudomonas aeruginosa of two nanoparticle endotracheal tube coatings with visible light-induced photocatalysis.MethodsTwo types of titanium dioxide nanoparticles were tested: standard anatase (TiO2) and N-doped TiO2 (N-TiO2). Nanoparticles were placed on the internal surface of a segment of commercial endotracheal tubes, which were loaded on a cellulose acetate filter; control endotracheal tubes were left without a nanoparticle coating. A bacterial inoculum of 150 colony forming units was placed in the endotracheal tubes and then exposed to a fluorescent light source (3700 lux, 300-700 nm wavelength) for 5, 10, 20, 40, 60 and 80 minutes. Colony forming units were counted after 24 hours of incubation at 37°C. Bacterial inactivation was calculated as the percentage reduction of bacterial growth compared to endotracheal tubes not exposed to light.ResultsIn the absence of light, no relevant antibacterial activity was shown against neither strain. For P. aeruginosa, both coatings had a higher bacterial inactivation than controls at any time point (p < 0.001), and no difference was observed between TiO2 and N-TiO2. For S. aureus, inactivation was higher than for controls starting at 5 minutes for N-TiO2 (p = 0.018) and 10 minutes for TiO2 (p = 0.014); inactivation with N-TiO2 was higher than that with TiO2 at 20 minutes (p < 0.001), 40 minutes (p < 0.001) and 60 minutes (p < 0.001).ConclusionsNanosized commercial and N-doped TiO2 inhibit bacterial growth under visible fluorescent light. N-TiO2 has higher antibacterial activity against S. aureus compared to TiO2.

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To: The use of 2% chlorhexidine gel and toothbrushing for oral hygiene of patients receiving mechanical ventilation: effects on ventilator-associated pneumonia

Cited by 9 publications

References 10 publications

Impact of oral care modalities on the incidence of ventilator-associated pneumonia in the intensive care unit: A meta-analysis

Impact of oral care modalities on the incidence of ventilator-associated pneumonia in the intensive care unit: A meta-analysis

Susceptibilidade De Amostras Clínicas De Pseudomonas Aeruginosa a Antibióticos E a Clorexidina

Antibacterial activity of standard and N-doped titanium dioxide-coated endotracheal tubes: an in vitro study

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