Pilot study for risk assessment of aspiration pneumonia based on oral bacteria levels and serum biomarkers

Nishizawa, Tomotaka; Niikura, Yuichi; Akasaka, Keiichi; Watanabe, Masato; Kurai, Daisuke; Amano, Masashi; Ishii, Haruyuki; Matsushima, Hidekazu; Yamashita, Naomi; Takizawa, Hajime

doi:10.1186/s12879-019-4327-2

Cited by 30 publications

(26 citation statements)

References 40 publications

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“…This may be attributed to the increased risk of pneumonia due to decreased swallowing function and poor oral hygiene. 12,18 In a study of hospitalised patients, the risk of mortality was significantly higher in those with a swallowing disorder than in normal patients. A similar result was obtained for community-dwelling older people in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Separate analysis of oral health factors revealed that decreased swallowing function was most strongly associated with mortality. This may be attributed to the increased risk of pneumonia due to decreased swallowing function and poor oral hygiene 12,18 . In a study of hospitalised patients, the risk of mortality was significantly higher in those with a swallowing disorder than in normal patients 19 .…”

Section: Discussionmentioning

confidence: 99%

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Association of oral health factors related to oral function with mortality in older Japanese

et al. 2020

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Oral health is closely related to systemic diseases, including cardiovascular disease (CVD), pneumonia and malnutrition. [1][2][3] Many studies have reported that worsening oral health, such as dental caries, periodontal disease and tooth loss, is related to mortality. 4,5 A study of middle-aged and older men reported that the number of teeth was significantly inversely associated with all-cause mortality among all participants, and the number of teeth was significantly inversely associated with all-cause, CVD and cancer mortality among middle-aged participants. 6 Individuals with poor oral health, such as severe gingival and dental diseases, or edentulous individuals had a higher risk of mortality compared with those with good oral health. 4 Having few teeth or few occlusal supports leads to chewing disability and swallowing dysfunction. 7,8 It has recently been reported that deficits in oral functions, such as chewing and swallowing, are

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association of oral health factors related to oral function with mortality in older Japanese

et al. 2020

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“…Poor oral health in combination with dysphagia has been identified in particular in stroke and geriatric patients as a risk factor for aspiration pneumonia [ 206 , 207 ]. In addition to periodontitis, gingivitis, plaque formation and caries, respiratory pathogens such as Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella oxytoca, Pseudomonas aeruginosa and Escherichia coli have frequently been detected in the oral cavity of these patients [ 208 ].…”

Section: Therapymentioning

confidence: 99%

Diagnosis and treatment of neurogenic dysphagia – S1 guideline of the German Society of Neurology

Dziewas

Allescher

Aroyo

et al. 2021

Neurol. Res. Pract.

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Introduction Neurogenic dysphagia defines swallowing disorders caused by diseases of the central and peripheral nervous system, neuromuscular transmission, or muscles. Neurogenic dysphagia is one of the most common and at the same time most dangerous symptoms of many neurological diseases. Its most important sequelae include aspiration pneumonia, malnutrition and dehydration, and affected patients more often require long-term care and are exposed to an increased mortality. Based on a systematic pubmed research of related original papers, review articles, international guidelines and surveys about the diagnostics and treatment of neurogenic dysphagia, a consensus process was initiated, which included dysphagia experts from 27 medical societies. Recommendations This guideline consists of 53 recommendations covering in its first part the whole diagnostic spectrum from the dysphagia specific medical history, initial dysphagia screening and clinical assessment, to more refined instrumental procedures, such as flexible endoscopic evaluation of swallowing, the videofluoroscopic swallowing study and high-resolution manometry. In addition, specific clinical scenarios are captured, among others the management of patients with nasogastric and tracheotomy tubes. The second part of this guideline is dedicated to the treatment of neurogenic dysphagia. Apart from dietary interventions and behavioral swallowing treatment, interventions to improve oral hygiene, pharmacological treatment options, different modalities of neurostimulation as well as minimally invasive and surgical therapies are dealt with. Conclusions The diagnosis and treatment of neurogenic dysphagia is challenging and requires a joined effort of different medical professions. While the evidence supporting the implementation of dysphagia screening is rather convincing, further trials are needed to improve the quality of evidence for more refined methods of dysphagia diagnostics and, in particular, the different treatment options of neurogenic dysphagia. The present article is an abridged and translated version of the guideline recently published online (https://www.awmf.org/uploads/tx_szleitlinien/030-111l_Neurogene-Dysphagie_2020-05.pdf).

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“…For assessing nutritional condition, participants were classi ed as BMI < 20 (undernutrition) or ≥20 (not undernutrition) according to the criteria for Asian elderly aged 70 years or older in The Global Leadership Initiative on Malnutrition (GLIM) [38]. For OHAT, the participants were divided into low and high OHAT groups based on a cutoff value of 5 (OHAT > 5 and OHAT ≤ 5), after referring to the median of the participants in this study and a previous study [39].…”

Section: Statistical Analysesmentioning

confidence: 99%

Associations of streptococci and fungi amounts in the oral cavity with nutritional and oral health status in institutionalized elders: a cross sectional study

Sato

Yano

Shimoyama

et al. 2021

Preprint

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Background:Disruption of the indigenous microflora is likely to relate with frailty caused by undernutrition. However, relationship between undernutrition and oral flora, especially normal indigenous bacteria, is not obvious. The aim of this study was to elucidate the associations of nutritional and oral health conditions with bacteria and fungi prevalence in oral cavity of older individuals.Methods:Forty-one institutionalized older individuals with an average age ± standard deviation of 84.6 ± 8.3 years were enrolled in this study. Body mass index (BMI) and Oral health assessment tool (OHAT) were used to represent nutritional and oral health status. Amounts of total bacteria, streptococci, and fungi in oral specimens collected from the tongue dorsum were determined by quantitative polymerase chain reaction (PCR) assay results. Results:There found a significant correlation between BMI and streptococcal amount (ρ=0.526, p<0.001). In addition, the undernutrition group (BMI <20) showed a significantly lower average number of oral streptococci (p=0.003). In logistic regression models, streptococcal amount was the significant variable accounting for “not undernutrition” [odds ratio 5.68 and 95% confidential interval (CI) was 1.64-19.7 (p=0.06)]. On the other hand, participants with poor oral health condition (OHAT ≥5) harbored significantly higher level of fungi (p=0.028). Conclusion:Oral streptococci were associated with systemic nutritional condition and oral fungi were associated with oral health condition. Thus, it is necessary to examine oral indigenous bacteria as well as etiological microorganisms in order to understand the relationship of frailty with oral microflora in older individuals.

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Pilot study for risk assessment of aspiration pneumonia based on oral bacteria levels and serum biomarkers

Cited by 30 publications

References 40 publications

Association of oral health factors related to oral function with mortality in older Japanese

Association of oral health factors related to oral function with mortality in older Japanese

Diagnosis and treatment of neurogenic dysphagia – S1 guideline of the German Society of Neurology

Associations of streptococci and fungi amounts in the oral cavity with nutritional and oral health status in institutionalized elders: a cross sectional study

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