Oral health and the presence of infectious microorganisms in hospitalized patients: a preliminary observational study

Tongue pressure during swallowing is an independent risk factor for aspiration pneumonia in middle-aged and older hospitalized patients: An observational study

AIM

To evaluate oral frailty features present in hospitalized older patients with aspiration pneumonia.

METHODS

We enrolled hospitalized patients aged ≥50 years and classified them into three groups: the community-acquired, aspiration, and non-community-acquired pneumonia groups. Oral frailty was defined as meeting three or more criteria from the following: choking, and decreased occlusal force, masticatory function, tongue-lip motor function, tongue pressure, and tongue pressure during swallowing.

RESULTS

Of 168 patients enrolled, the incidence of aspiration pneumonia was 23.9% (17/71) in patients admitted with pneumonia as the primary diagnosis. The occlusal force and masticatory function were significantly poorer and tongue pressure and tongue pressure during swallowing were significantly lower in the aspiration pneumonia group than in the other two groups. A higher number of chronic comorbidities, poor oral health, and lower tongue pressure during swallowing were significantly associated with aspiration pneumonia. A tongue pressure during swallowing of <10.32 kPa might be a cutoff point for predicting the risk of aspiration pneumonia.

CONCLUSIONS

Hospitalized patients aged ≥50 years with multiple comorbidities, poor oral hygiene, and oral frailty during swallowing are at a higher risk of developing aspiration pneumonia, especially when their tongue pressure during swallowing is <10.32 kPa. Aspiration pneumonia is a preventable disease. Healthcare professionals should incorporate tongue pressure measurements or other screening tools into routine clinical practice to facilitate the early detection of this condition and intervention. Geriatr Gerontol Int 2024; 24: 351-357.

Oral health in individuals with cystic fibrosis: A cross-sectional study

Cystic Fibrosis (CF) is an autosomal recessive disease characterized by the production of thick and viscous mucus progressively affecting various organs and systems, with recurrent respiratory infections. The aim of this study was to learn about the oral health characteristics in CF patients.

METHODOLOGY

Data, such as sociodemographic, general and oral health, were collected from the medical records of CF patients aged 0 to 18 years old. The number of patients with tooth decay, prevalence of developmental defects of enamel (DDE), classification of dental occlusion, sialometry, salivary pH and oral microbial profile and respiratory secretions evaluations were recorded.

RESULTS

Most patients had pancreatic insufficiency (84.2%), malnutrition (60%), respiratory problems (75.4%) and genotyping of the F508del (66.7%). Regarding the medications used, 96.5% used vitamins and electrolyte replacement, 84,02% used pancreatic enzymes, 64.9% used dornase alfa and 47% were using antibiotics. The percentage of patients with tooth decay was 19.3%, 47% had DDE, low salivary flow and basic salivary pH. The most prevalent microorganisms found on tongue biofilm and respiratory secretions were SA and PA. There was a positive association between the presence of bacteria and fungi found on both the tongue and respiratory secretions. The presence of fungi on the tongue biofilm was significantly associated with the use of antibiotics.

CONCLUSIONS

These findings underscore the importance of dentists focusing on prevention and on the specific needs of the patient as well.

High oral carriage of multidrug resistant Gram-negative bacilli in adolescents: the SOPKARD-Junior study

Introduction

The colonization of the oral cavity by potentially pathogenic antimicrobial-resistant bacteria in adolescents and its consequences is very poorly understood. The present study focused on the occurrence of oral colonization by Gram-negative bacilli (GNB) and their multidrug resistance, including the production of extended-spectrum β-lactamases (ESBLs) and carbapenemases, among healthy adolescents and risk factors associated with GNB colonization.

Materials and methods

This study was conducted as part of "A program for the early detection of risk factors for lifestyle diseases SOPKARD-Junior" (SOPKARD-Junior). Oral samples were collected from 182 adolescents from four public elementary schools in Sopot, Poland, aged 13-14 years. Bacterial strains were identified by the MALDI-TOF MS method. Screening of antimicrobial resistance was performed using a disk diffusion method. The NG-Test® CARBA-5 was used to detect and differentiate the five most widely distributed carbapenemases. Demographic and clinical data were collected and statistical analysis of risk factors was performed.

Results

A total of 68 out of 182 (37.4%) healthy adolescents was documented oral colonization with Gram-negative bacilli, including 50/182 (27.5%) multidrug resistant (MDR-GNB) strains. Over 60% of oral carriage concerned three main genera Enterobacter spp., Pseudomonas spp., and Serratia spp., which were detected in 22.1%, 19.1%, and 19.1% of participants, respectively. Citrobacter spp., Escherichia coli, Klebsiella spp., Hafnia spp., Aeromonas spp., Acinetobacter spp., and Stenotrophomonas spp. were also isolated. The antimicrobial resistance to ampicillin (100%), ceftazidime (69.1%), meropenem (60.3%), gentamycin (60.3%), piperacillin/tazobactam (52.9%), and piperacillin (45.6%) were the most common. Among 73.5% GNB strains multidrug resistance was observed, including all Pseudomonas spp. strains. Among MDR-GNB, 30.4% were resistant to four groups of antibiotics, half of the MDR Pseudomonas spp. strains were resistant to 10 groups of antibiotics. Extended-spectrum β-lactamases were produced by Enterobacter cloacae, Klebsiella spp., and Serratia spp. (7.4%). Colonization by ESBLs-positive GNB strains was significantly associated with recurrent respiratory infections, nasal congestion, and bronchitis (p<0.05).

Conclusion

Our study revealed high oral carriage of multi-drug resistant Gram-negative bacilli in healthy adolescents and the association of ESBL-producing strains with respiratory infections. Further studies on oral colonization with GNB are necessary due to the possibility of distinct infections and the acquisition of antibiotic resistance by resident microbiota.