Effect of oral hygiene interventions on opportunistic pathogens in patients after stroke

Lam, Olt; McMillan, AS; Samaranayake, LP; Li, Leonard S.W.; McGrath, Colman

doi:10.1016/j.ajic.2012.02.020

Cited by 33 publications

(81 citation statements)

References 51 publications

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“…Enterobacteriaceae was the predominant family of AGNB; isolated from a third of participants. This concurs with the results of other studies on patients with stroke during the acute and rehabilitation phases (Lam et al, ; Millns et al, ; Zhu et al, ). The most common species of Enterobacteriaceae isolated was K. pneumoniae (10.6%), and this concurs with the findings of Zhu et al () during the acute phase at baseline (~7%).…”

Section: Discussionsupporting

confidence: 93%

“…Anaerobic gram‐negative bacillus was isolated from approximately half of participants (47.9%) at baseline. This reflects a somewhat higher prevalence of AGNB than has been isolated from healthy subjects in Hong Kong (41.7%) (Sedgley & Samaranayake, ), but a lower prevalence than has been isolated among hospitalized stroke patients at the same centre in Hong Kong (72.8%) (Lam et al, ). A UK study which detected AGNB in oral swab samples from patients during acute stroke reported a lower prevalence (34.0%) (Millns, Gosney, Jack, Martin, & Wright, ).…”

Section: Discussionmentioning

confidence: 97%

“…The most common species of Enterobacteriaceae isolated was K. pneumoniae (10.6%), and this concurs with the findings of Zhu et al () during the acute phase at baseline (~7%). Lam et al () reported an even higher prevalence of K. pneumoniae during inpatient rehabilitation (~22%), but the most predominant species at baseline was Acinetobacter baumannii (~44%). The spectrum of AGNB species can be highly variable as is influenced by the type of underlying systemic diseases among the study subjects, the geographical location, and sampling and identification methods.…”

Section: Discussionmentioning

confidence: 99%

“…Prospective studies confirmed that oral colonization by these opportunistic pathogens is associated with an increased incidence of aspiration pneumonia (El‐Solh et al, ; Heo, Haase, Lesse, Gill, & Scannapieco, ). Patients with stroke are reported to have relatively high carriage rate and viable counts of oral opportunistic pathogens compared to health individuals (Lam, McMillan, Samaranayake, Li, & McGrath, ; Zhu, McMillan, McGrath, Li, & Samaranayake, ). Among all the poststroke infections, aspiration pneumonia is the most severe, accounting for a threefold increase of risk for death and the highest number of deaths (Aslanyan, Weir, Diener, Kaste, & Lees, ; Heuschmann et al, ).…”

Section: Introductionmentioning

confidence: 99%

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Effect of oral hygiene programmes on oral opportunistic pathogens during stroke rehabilitation

Dai

Lam²,

et al. 2018

Oral Diseases

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Objectives This study was to assess the effectiveness of a conventional oral hygiene care programme (COHCP) and an advanced oral hygiene care programme (AOHCP) on prevalence and viable counts of oral opportunistic pathogens among patients undergoing stroke rehabilitation. Methods A total of 94 patients were randomized to two groups. Subjects were block randomized to either (a) COHCP: manual toothbrushing with oral hygiene instruction (OHI); or (b) AOHCP: powered toothbrushing, mouthrinsing with chlorhexidine and OHI. Prevalence and viable counts of oral opportunistic pathogens including yeasts, aerobic and facultative anaerobic gram‐negative bacilli, Staphylococcus aureus, were assessed at baseline, the end of 3 and 6 months. Results No significant difference was observed in the prevalence of oral opportunistic pathogens within each group over the clinical trial period. A significant decrease in the viable counts of S. aureus was found over the clinical trial period within AOHCP group (p < 0.05), while the viable counts of yeasts and anaerobic gram‐negative bacillus (AGNB) remained stable within each group. Regression analysis failed to detect an association between intervention and the prevalence/viable counts of oral opportunistic pathogens. Conclusions Neither oral healthcare programme significantly affects AGNB, yeast or S. aureus over the study period in terms of prevalence and viable counts.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of oral hygiene programmes on oral opportunistic pathogens during stroke rehabilitation

Dai

Lam²,

et al. 2018

Oral Diseases

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“…For stroke patients in the acute hospital setting, it is recognized that oral hygiene care is of key importance to prevent complications that may compromise rehabilitation or potentially give rise to a recurrent stroke [4]. There is a growing interest in how to effectively increase the practice of providing oral hygiene care in the hospital setting through clinical interventions [5,6] and through education and training of caregivers [7,8]. Unfortunately, however, all this has met with limited success and a persistence of poor knowledge and attitudes toward providing oral hygiene care in the acute hospital setting typically prevails [9].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a Web-Based Health Education Program to Promote Oral Hygiene Care Among Stroke Survivors: Randomized Controlled Trial

Malik¹,

Yatim²,

Lam³

et al. 2017

J Med Internet Res

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BackgroundOral hygiene care is of key importance among stroke patients to prevent complications that may compromise rehabilitation or potentially give rise to life-threatening infections such as aspiration pneumonia.ObjectiveThe aim of this study was to evaluate the effectiveness of a Web-based continuing professional development (CPD) program on “general intention” of the health carers to perform daily mouth cleaning for stroke patients using the theory of planned behavior (TPB).MethodsA double-blind cluster randomized controlled trial was conducted among 547 stroke care providers across 10 hospitals in Malaysia. The centers were block randomized to receive either (1) test intervention (a Web-based CPD program on providing oral hygiene care to stroke patients using TPB) or (2) control intervention (a Web-based CPD program not specific to oral hygiene). Domains of TPB: “attitude,” “subjective norm” (SN), “perceived behavior control” (PBC), “general intention” (GI), and “knowledge” related to providing oral hygiene care were assessed preintervention and at 1 month and 6 months postintervention.ResultsThe overall response rate was 68.2% (373/547). At 1 month, between the test and control groups, there was a significant difference in changes in scores of attitude (P=.004) and subjective norm (P=.01), but not in other TPB domains (GI, P=.11; PBC, P=.51; or knowledge, P=.08). At 6 months, there were significant differences in changes in scores of GI (P=.003), attitude (P=.009), SN (P<.001) and knowledge (P=.001) between the test and control groups. Regression analyses identified that the key factors associated with a change in GI at 6 months were changes in SN (beta=.36, P<.001) and changes in PBC (beta=.23, P<.001).ConclusionsThe Web-based CPD program based on TPB increased general intention, attitudes, subjective norms, and knowledge to provide oral hygiene care among stroke carers for their patients. Changing subjective norms and perceived behavioral control are key factors associated with changes in general intention to provide oral hygiene care.Trial RegistrationNational Medical Research Register, Malaysia NMRR-13-1540-18833 (IIR); https://www.nmrr.gov.my/ fwbLoginPage.jsp

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Interventions for improving oral health in people after stroke

Campbell

Bain

Furlanetto

et al. 2020

Cochrane Database of Systematic Reviews

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Effect of oral hygiene interventions on opportunistic pathogens in patients after stroke

Cited by 33 publications

References 51 publications

Effect of oral hygiene programmes on oral opportunistic pathogens during stroke rehabilitation

Effect of oral hygiene programmes on oral opportunistic pathogens during stroke rehabilitation

Effectiveness of a Web-Based Health Education Program to Promote Oral Hygiene Care Among Stroke Survivors: Randomized Controlled Trial

Interventions for improving oral health in people after stroke

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