Oral and endotracheal tubes colonization by periodontal bacteria: a case–control ICU study

Abstract

Periodontal infection is a possible risk factor for respiratory disorders; however, no studies have assessed the colonization of periodontal pathogens in endotracheal tubes (ET). This case-control study analyzed whether periodontal pathogens are able to colonize ET of dentate and edentulous patients in intensive care units (ICU) and whether oral and ET periodontal pathogen profiles have any correlation between these patients. We selected 18 dentate and 18 edentulous patients from 78 eligible ICU patients. Oral clinical examination including probing depth, clinical attachment level, gingival index , and plaque index was performed by a single examiner, followed by oral and ET sampling and processing by quantitative polymerase chain reaction (total bacterial load, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythia). Data were statistically analyzed by Mann-Whitney U, two-way analysis of variance (p < 0.05). Among dentate, there was no correlation between clinical parameters and ET bacterial levels. Both dentate and edentulous patients showed similar ET bacterial levels. Dentate patients showed no correlation between oral and ET bacterial levels, while edentulous patients showed positive correlations between oral and ET levels of A. actinomycetemcomitans, P. gingivalis, and T. forsythia. Periodontal pathogens can colonize ET and the oral cavity of ICU patients. Periodontal pathogen profiles tend to be similar between dentate and edentulous ICU patients. In ICU patients, oral cavity represents a source of ET contamination. Although accompanied by higher oral bacterial levels, teeth do not seem to influence ET bacterial profiles.

A prática da odontologia hospitalar no Brasil: uma revisão integrativa da literatura

“…As much as 17 (60.7%) [3][4][5][6][7]10,18,19,[21][22][23][26][27]29,33 studies were published between 2014 and 2017, 4 (14.3%) 2,16,30,32 in 2011, 3 (10.7%) 24,25,28 in 2010, 2 (7.1%) 17,20 in 2013, and 1 (3.6%) in 2008 and 1 in 2012. 15,31 Most of the studies were conducted in São Paulo state, with 7 (25%) 2,15,17,19,22,24,26 publications, followed by the states of Santa Catarina (n=4, 14.3%), 7,25,28,32 Paraná (n=3, 10.7%) 6,13,30 and Mato Grosso (n=2, 5.6%).…”

“…18,23 The states of Bahia, Goiás, Mato Grosso do Sul, Minas Gerais, Pará, Paraíba, Pernambuco, Piauí, Rio Grande do Norte and Rio Grande do Sul had 1 (2.8%) publication each, accounting to 28% of the sample. [3][4][5]10,14,16,20,27,29,31,21,33 Two (5.6%) studies did not mention where they had been carried out.…”

“…In order to identify the scenario of hospital dentistry in Brazil through published studies, it was found that 6 (21.4%) [13][14][15]17,23,26 studies had a control group; 17 (60.7%) [4][5][6]16,18,19,[20][21][22]24,[27][28][29][30][31][32][33] were related to patients' oral health profile and 5 (17.9%) 2,3,7,10,25 were questionnaire-based studies of which 4 3,7,10 involved only patients and 1 25 involved patients, caregivers and healthcare professionals.…”

“…Among the studies addressing the patients' oral health profile, 8 (47%) 4,6,22,24,27,29,30,32 were performed with patients admitted to conventional hospital beds, 6 (35.3%) 16,18,19,21,31,33 with ICU patients, 2 5,28 (11.8%) with patients admitted to ICUs and conventional hospital beds and 1 (5.9%) 20 did not mention. Twelve (70%) [4][5][6]16,18,19,22,28,29,[31][32][33] of the studies addressing the oral health profile were carried out with adult patients only, 2 hygiene kits while in hospital stays, how often daily they performed oral hygiene and whether it was done by the patients themselves or by their companions.…”

“…Twelve (70%) [4][5][6]16,18,19,22,28,29,[31][32][33] of the studies addressing the oral health profile were carried out with adult patients only, 2 hygiene kits while in hospital stays, how often daily they performed oral hygiene and whether it was done by the patients themselves or by their companions. 2,3,16,25 In addition to the lack of oral hygiene orientation, these patients had poor access to oral health care, as some of them reported that the last visit to the dentist had occurred 12 months prior to hospitalization, mainly to caries and periodontal disease.…”