1: Dental Plaque May Provide a Pathway to Pneumonia in Ventilated Patients
Ventilator-associated pneumonia (VAP) is the most common infection
acquired by critical-care hospital patients on ventilators. In fact, the infection develops in 9% to 24% of patients who are on a ventilator for more than 48 hours. Perhaps most startling is that 13% of patients who acquire VAP will die from the infection.
As such, healthcare practitioners are always looking for new ways to prevent the development of this infection. One way to do this is to identify the possible contributing factors of VAP. To this end, researchers have identified a new culprit: dental plaque.
In a recent study, researchers obtained samples from biofilms in endotracheal tubes, non-directed bronchial lavages, and dental plaque for 12 ventilated adult patients. Oral hygiene for each patient was assessed at the beginning of the study, and basic dental care was administered while the patient was ventilated through the use of a mechanical toothbrush.
After analyzing the samples using metataxonomics, the researchers found the presence of microbes in all of the samples—in endotracheal tubes and non-directed bronchial lavages as well as in dental plaque. Perhaps more importantly, the patients’ dental plaque were found to be harboring bacteria not normally residing in healthy mouths but which are known to cause respiratory infections.
Although the researchers were unsure of how the bacteria are able to migrate downward into the respiratory tract, they theorized that organisms colonizing in dental plaque are directly aspirated into the lungs from the mouth. In addition, microbes may also be growing inside of the endotracheal tube and are then breathed in by the patient.
The study stresses the importance of good oral hygiene among patients who are ventilated, particularly those who are ventilated for a long period of time. In addition, a recent statement from the Infectious Disease Society of America asserted that good oral hygiene through regular visits to the dentist may, in fact, decrease the risk of pneumonia, since dental cleanings rid the mouth of bacteria before they can invade the lungs.
More on the association between dental plaque and VAP is available here
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