Factors associated with oral biofilm in ICU patients with infectious diseases

Abstract

ResumoIntrodução: A hospitalização pode provocar deterioração da saúde bucal, repercutindo em todo o corpo. A UTI pode ser um ambiente favorável ao acúmulo de biofilme oral em pacientes críticos. Objetivo: Identificar fatores associados à presença do biofilme em pacientes da UTI de um hospital de doenças infectocontagiosas. Método: Estudo retrospectivo, descritivo e inferencial, com abordagem quantitativa. Os dados foram obtidos em prontuários de pacientes da UTI, de janeiro de 2012 a julho de 2015. O biofilme foi avaliado de acordo com o índice de Greene e Vermillion. Os fatores influentes foram analisados por regressão logística. Resultado: Entre os pacientes da UTI, 69,1% eram homens, 60,7% pacientes com AIDS, 66,3% pacientes na enfermaria, 50,6% intubados e 50,0% sedados. Seus elementos orais eram na maioria normais. As seguintes características foram significativamente associadas a biofilmes orais: alterações orais nos lábios, gengivas, bochechas e palatos e sangramento. Pacientes da enfermaria apresentaram menor risco de apresentar biofilmes. Conclusão: o aumento do acúmulo de biofilme oral foi observado em pacientes com alterações na boca e a procedência do paciente foi associada à presença de biofilme.Descritores: Hospital; paciente; saúde bucal; manifestações orais; biofilme. AbstractIntroduction: Hospitalization may cause a decline in oral health and affect the entire body. The intensive care unit (ICU) may be a favorable environment for oral biofilm to accumulate in critically ill patients. Objective: To identify factors associated with oral biofilm in ICU patients in a hospital for infectious diseases. Method: This was a retrospective, descriptive and inferential study with a quantitative approach. Data were collected from 178 medical records of patients from January 2012 to July 2015. Biofilm presence was assessed according to the Greene and Vermillion index. Potential influential factors were analyzed by logistic regression. Result: Among ICU patients, 69.1% were men, 60.7% had acquired immune deficiency (AIDS), 66.3% were ward patients, 50.6% were intubated, and 50.0% were sedated. The oral elements of the patients were mostly normal. The following characteristics were significantly associated with oral biofilm: changes in the lips, gums, cheeks, and palates and bleeding. Patients from the ward had a lower risk of biofilm. Conclusion: Increased oral biofilm accumulation was observed in patients with oral changes, and patient origin was associated with the presence of biofilm.

A importância do cirurgião dentista na UTI: uma revisão de literatura

“…Os pacientes portadores de infecções sistêmicas, hospitalizados, muitas vezes se encontram totalmente dependentes de cuidados, portanto, impossibilitados de manter uma higienização bucal adequada, necessitando do suporte de profissionais da saúde para este e outros tipos de tarefas (Santos, et al 2018). A exemplo, Damascena et al (2017) relembra que a hospitalização pode causar um declínio na saúde bucal e afetar todo o corpo. A unidade de terapia intensiva (UTI) pode ser um ambiente favorável para o acúmulo de biofilme oral em pacientes críticos.…”

Analysis of diagnostic criteria for ventilator-associated pneumonia: a cohort study

“…Regarding this aspect, the present study showed a disagreement with the literature, because oral hygiene proved a risk factor to develop VAP. Knowing the general health and oral health conditions of patients admitted to ICUs is indispensable for health teams to deliver effective care with adequate techniques and, consequently, control biofilm formation, either in the oropharyngeal cavity or endotracheal tube, implementing an important strategy to prevent VAP (30)(31) .…”

“…Previous studies have reported the presence of microorganisms such as Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, and Streptococcus pneumoniae in patients under MV (31)(32) . As discussed above, preventing colonization of the oropharynx by microorganisms is essential for decreasing the chances of developing PAV.…”

Oral status and affecting factors in Iranian ICU patients: a cross-sectional study

“…In another study in ICUs of Birjand hospitals in Iran, 84.9% of nurses were trained in oral care, however, oral care was ranked as the 10th priority of nursing care [8]. In the study of Rafael et al, which was conducted under the title of the prevalence of oral disorders in patients hospitalized in ICUs in Brazil, the prevalence of normal structures of the lips, tongue, gums, cheeks, floor of the mouth, and palate was 8.56, 85.4, 85.2, 97.2, 100 and 98.3%, respectively [9].…”

“…The prevalence of oral disorders in ICU patients is different in various contexts, based on disparate factors [9]. Due to the lack of studies in Iran regarding oral cavity disorders in patients hospitalized in ICUs, the present study aimed for determining the rate of oral cavity disorders and affecting factors in ICU patients in the Kermanshah and Ilam provinces, west of Iran.…”