Detection and identification of pathogenic bacteria responsible for postoperative pneumonia after esophagectomy

Jimbo, Keiichi; Mori, Kazuhiko; Aikou, Susumu; Okazaki, Mitsuhiro; Sato, Tomoaki; Moriya, Kyoji; Kawase-Koga, Yoko; Mori, Yoshiyuki; Kanno, Yuki; Yamagata, Yukinori; Yagi, Koichi; Nishida, Masato; Yamashita, Hiroharu; Nomura, Sachiyo; Seto, Yasuyuki

doi:10.1007/s10388-016-0561-5

Cited by 10 publications

(15 citation statements)

References 12 publications

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“…In this study, most of the pathogenic bacteria responsible for postoperative pneumonia were detected in a routine perioperative bacteriological culture on the second postoperative day using an intratracheal sputum and gastric juice culture. This result is similar to a recent study by Jimbo et al who retrospectively reviewed the perioperative culture results in 105 patients with esophageal cancer who underwent esophagectomy, finding that eight of 14 patients who developed pneumonia had pathogenic bacteria in their gastric juice postoperatively and that the detected pathogenic bacteria were concordant with those detected in an endotracheal sputum culture at the occurrence of postoperative pneumonia in seven out of the eight cases. They also showed that 13 of 17 patients with pneumonia had pathogenic bacteria in the endotracheal sputum postoperatively and that the concordance of the detected pathogenic bacteria with those detected in an endotracheal sputum culture at the occurrence of postoperative pneumonia was nine out of 11.…”

Section: Discussionsupporting

confidence: 90%

“…This result is mostly consistent with previous studies. Two recent studies showed that there was no significant correlation between the detection of pathogenic bacteria in a perioperative routine bacteriological culture and the incidence of postoperative pneumonia . Thus, the existence of pathogenic bacteria in a perioperative organ, such as the trachea and gastric conduit, does not easily lead to the occurrence of postoperative pneumonia.…”

Section: Discussionmentioning

confidence: 99%

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Clinical usefulness of a perioperative bacteriological culture to treat patients with postoperative pneumonia after esophagectomy

Matsunaga

Miyata

Sugimura

et al. 2018

Annals of Gastroent Surgery

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AimThe aim of the present study was to examine the usefulness of a perioperative bacteriological culture in predicting the pathogenic bacteria responsible for postoperative pneumonia after esophagectomy.MethodsThis study included 293 consecutive esophageal cancer patients who underwent esophagectomy with gastric conduit reconstruction. We compared the pathological bacteria that were detected in bacteriological cultures of sputum, mouthwash and gastric fluid on the second postoperative day with the pathogenic bacteria responsible for postoperative pneumonia.ResultsPostoperative pneumonia occurred in 26 (8.8%) of the 293 patients. Enterobacter cloacae was detected most frequently in the perioperative bacteriological culture, followed by Enterococcus faecalis and Pseudomonas aeruginosa. Detection of each pathogenic bacterium in the perioperative bacteriological culture was not associated with the occurrence of pneumonia, excluding Pseudomonas aeruginosa. As the pathogens responsible for postoperative pneumonia, 32 bacteria were detected in 26 patients with postoperative pneumonia. Detection rate of the pathogenic bacteria responsible for postoperative pneumonia in a perioperative bacteriological culture was 43.8% in a sputum culture, 40.6% in a mouthwash culture and 65.6% in a gastric fluid culture. The detection rate of the pathogenic bacteria responsible for pneumonia was up to 78.1% in the combination of sputum and gastric fluid culture.ConclusionsAlthough the perioperative bacteriological culture does not seem to be useful for predicting the occurrence of postoperative pneumonia, it is useful for predicting the pathogenic bacteria responsible for pneumonia in cases of postoperative pneumonia. The perioperative bacteriological culture helps us to select appropriate antibiotics to treat pneumonia after esophagectomy.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Clinical usefulness of a perioperative bacteriological culture to treat patients with postoperative pneumonia after esophagectomy

Matsunaga

Miyata

Sugimura

et al. 2018

Annals of Gastroent Surgery

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“…Perioperative culture studies Culture specimens were collected at the sites and timings reported below and sent immediately to the laboratory. Bacteriological studies were performed in exactly the same way as those in our previous study (13). The culture specimens were (A) dental plaque and (B) tongue coating immediately before surgery; (C) gastric juice from the gastric conduit immediately before anastomosis; (D) sputum obtained by endotracheal suction during the operation; (E) gastric juice from the nasogastric tube on the rst or the second postoperative day; (F) sputum obtained by endotracheal suction within three days after surgery.…”

Section: Oral Hygiene Carementioning

confidence: 99%

“…Evidence of the effectiveness of oral hygiene care to prevent postoperative pneumonia has not been convincing, however, due to the small number of studies conducted so far. Our own previous study of 105 esophageal cancer patients suggested that pathological bacteria responsible for postoperative pneumonia were rarely detected in preoperative oro-nasal culture specimens (13). This calls into question the theory that postoperative pneumonia is caused by oral pathogenic bacteria.…”

Section: Introductionmentioning

confidence: 98%

“…to March 2016 in The University of Tokyo Hospital were enrolled. We previously reported the incidence of postoperative pneumonia as 20% (21 out of 105 patients) from 2009 to 2012 in a patient cohort without preoperative oral hygiene care; this cohort was used as a historical control (13). All of the current study participants received preoperative oral hygiene care from dentists and perioperative bacteriological studies were performed routinely as standard perioperative care.…”

Section: Introductionmentioning

confidence: 99%

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The Effectiveness and Impact of Preoperative Dental Hygiene Care on the Incidence of Postoperative Pneumonia after Esophagectomy: An Interventional Prospective Study

Mori

Jimbo

Aikou

et al. 2020

Preprint

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Background: Postoperative pneumonia is a major cause of postoperative mortality after esophagectomy. Preoperative oral hygiene care is reportedly effective to prevent pulmonary complications after esophagectomy. Methods: Since April 2012, we have included preoperative oral hygiene in the standard perioperative care regimen for esophagectomy and have accumulated data on 188 consecutive patients undergoing esophagectomy to evaluate oral hygiene care’s effectiveness. To determine basic (i.e. non-clinical) and clinical effects of preoperative oral care, we prospectively observed the incidence rate of postoperative pneumonia and accumulated perioperative culture study and oral bacteria count data on these 188 patients. One hundred five patients studied in our previous retrospective study from 2009 to 2012 were enrolled as a historical control.Results: In the current study’s patients, no significant reduction of postoperative pneumonia was observed compared to the historical control (30 out of 188 vs. 21 out of 105, P=0.423). Perioperative culture studies showed significantly decreased positivity in preoperative oral samples (11% in dental plaque and 13% in tongue coating) but no such decrease was observed in studies of postoperative gastric juice and endotracheal sputum. With the exception of postoperative endotracheal sputum, perioperative cultures had few of the pathogenic microbes identified in pneumonia patients. In the analyses of oral bacterial count, oral microbial flora were significantly decreased after oral care in both dental plaque (median ratio to before care: 1:0.13, P<0.0001) and tongue coating (median ratio: 1:0.015, P<0.0001); however, only in the dental plaque did the decrease last until the day of the operation (median ratio: 1:0.10, P=0.0008). Logistic regression analysis showed only the bacterial amount in dental plaque on the operation day (P=0.026) to be marginally correlated to the incidence of pneumonia. Conclusions: Although perioperative oral hygiene care had a significant impact on oral bacterial load, its contribution to the prevention of postoperative pneumonia was limited.Trial registration: This study was registered and approved by the institutional review board of The University of Tokyo Hospital: Approval number: 3383, Date: 26th November, 2011

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Postoperative Complications in Patients with Esophageal Cancer

Inoue¹,

Ono²

2022

Physical Therapy and Research in Patients With Cancer

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Detection and identification of pathogenic bacteria responsible for postoperative pneumonia after esophagectomy

Cited by 10 publications

References 12 publications

Clinical usefulness of a perioperative bacteriological culture to treat patients with postoperative pneumonia after esophagectomy

Clinical usefulness of a perioperative bacteriological culture to treat patients with postoperative pneumonia after esophagectomy

The Effectiveness and Impact of Preoperative Dental Hygiene Care on the Incidence of Postoperative Pneumonia after Esophagectomy: An Interventional Prospective Study

Postoperative Complications in Patients with Esophageal Cancer

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