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Xu H, Zhang R, Zhang X, Cheng Y, Lv L, Lin L. Microbiological Profile of Patients with Aspiration Pneumonia Identified by Combined Detection Methods. Infect Drug Resist 2024; 17:2077-2088. [PMID: 38813526 PMCID: PMC11135560 DOI: 10.2147/idr.s461935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/12/2024] [Indexed: 05/31/2024] Open
Abstract
Purpose Aspiration pneumonia (AP) challenges public health globally. The primary aim of this study was to ascertain the microbiological profile characteristics of patients with AP evaluated by combined detection methods, including conventional microbiological tests (CMTs), chips for complicated infection detection (CCID), and metagenomic next-generation sequencing (mNGS). Patients and Methods From June 2021 to March 2022, a total of thirty-nine patients with AP or community-acquired pneumonia with aspiration risk factors (AspRF-CAP) from 3 hospitals were included. Respiratory specimens, including bronchoalveolar lavage fluid (BALF), sputum, and tracheal aspirate, were collected for microorganism detection. Results Patients with AP were more inclined to be older, to have a shorter duration from illness onset to admission, to have a higher prevalence of different underlying diseases, particularly diabetes mellitus, chronic heart disease, and cerebrovascular disease, and to have a higher CURB-65 score (all P < 0.05). A total of 213 and 31 strains of microorganisms were detected in patients with AP and AspRF-CAP, respectively. The most common pathogens in AP were Corynebacterium striatum (17/213, 7.98%), Pseudomonas aeruginosa (15/213, 7.04%), Klebsiella pneumoniae (15/213, 7.04%), and Candida albicans (14/213, 6.57%). Besides, the most common pathogens in AspRF-CAP were Candida albicans (5/31, 16.13%), Pseudomonas aeruginosa (3/31, 9.68%) and Klebsiella pneumoniae (3/31, 9.68%). Moreover, Klebsiella pneumoniae (7/67, 10.45%) and Candida glabrata (5/67, 7.46%) were the most common pathogens among the 9 non-survived patients with AP. Conclusion The prevalent pathogens detected in cases of AP were Corynebacterium striatum, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Candida albicans. Early combined detection methods for patients with AP enhance the positive detection rate of pathogens and potentially expedites the initiation of appropriate antibiotic therapeutic strategies.
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Affiliation(s)
- Hui Xu
- Department of Geriatrics, Peking University First Hospital, Beijing, People’s Republic of China
| | - Ruixue Zhang
- Department of Geriatrics, Peking University First Hospital, Beijing, People’s Republic of China
| | - Xiaoxue Zhang
- Department of Geriatrics, Peking University First Hospital, Beijing, People’s Republic of China
| | - Yueguang Cheng
- Department of Emergency, Beijing Jingmei Group General Hospital, Beijing, People’s Republic of China
| | - Liping Lv
- Department of Interventional Pulmonology, Anhui Chest Hospital, Hefei, People’s Republic of China
| | - Lianjun Lin
- Department of Geriatrics, Peking University First Hospital, Beijing, People’s Republic of China
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Nomura Y, Morozumi T, Saito A, Yoshimura A, Kakuta E, Suzuki F, Nishimura F, Takai H, Kobayashi H, Noguchi K, Takahashi K, Tabeta K, Umeda M, Minabe M, Fukuda M, Sugano N, Hanada N, Yoshinari N, Sekino S, Takashiba S, Sato S, Nakamura T, Sugaya T, Nakayama Y, Ogata Y, Numabe Y, Nakagawa T. Prospective Longitudinal Changes in the Periodontal Inflamed Surface Area Following Active Periodontal Treatment for Chronic Periodontitis. J Clin Med 2021; 10:jcm10061165. [PMID: 33802109 PMCID: PMC7998532 DOI: 10.3390/jcm10061165] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 02/27/2021] [Accepted: 03/08/2021] [Indexed: 12/13/2022] Open
Abstract
Periodontal disease is a chronic inflammatory disease of the periodontal tissue. The periodontal inflamed surface area (PISA) is a proposed index for quantifying the inflammatory burden resulting from periodontitis lesions. This study aimed to investigate longitudinal changes in the periodontal status as evaluated by the PISA following the active periodontal treatment. To elucidate the prognostic factors of PISA, mixed-effect modeling was performed for clinical parameters, tooth-type, and levels of periodontal pathogens as independent variables. One-hundred-twenty-five patients with chronic periodontitis who completed the active periodontal treatment were followed-up for 24 months, with evaluations conducted at 6-month intervals. Five-times repeated measures of mean PISA values were 130+/−173, 161+/−276, 184+/−320, 175+/−417, and 209+/−469 mm2. Changes in clinical parameters and salivary and subgingival periodontal pathogens were analyzed by mixed-effect modeling. Plaque index, clinical attachment level, and salivary levels of Porphyromonas gingivalis were associated with changes in PISA at the patient- and tooth-level. Subgingival levels of P. gingivalis and Prevotella intermedia were associated with changes in PISA at the sample site. For most patients, changes in PISA were within 10% of baseline during the 24-month follow-up. However, an increase in the number of bleeding sites in a tooth with a deep periodontal pocket increased the PISA value exponentially.
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Affiliation(s)
- Yoshiaki Nomura
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan; (Y.N.); (N.H.)
| | - Toshiya Morozumi
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka 238-8580, Japan;
- Correspondence: ; Tel.: +81-46-822-8855
| | - Atsushi Saito
- Department of Periodontology, Tokyo Dental College, Tokyo 101-0061, Japan;
| | - Atsutoshi Yoshimura
- Department of Periodontology and Endodontology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan;
| | - Erika Kakuta
- Department of Oral Microbiology, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan;
| | - Fumihiko Suzuki
- Division of Dental Anesthesiology, Department of Oral Surgery, Ohu University School of Dentistry, Koriyama 963-8611, Japan;
| | - Fusanori Nishimura
- Section of Periodontology, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan;
| | - Hideki Takai
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Matsudo 271-8587, Japan; (H.T.); (Y.N.); (Y.O.)
| | - Hiroaki Kobayashi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan;
| | - Kazuyuki Noguchi
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan; (K.N.); (T.N.)
| | - Keiso Takahashi
- Division of Periodontics, Department of Conservative Dentistry, Ohu University School of Dentistry, Koriyama 963-8611, Japan;
| | - Koichi Tabeta
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8514, Japan;
| | - Makoto Umeda
- Department of Periodontology, Osaka Dental University, Hirakata 573-1121, Japan;
| | - Masato Minabe
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka 238-8580, Japan;
| | - Mitsuo Fukuda
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya 464-8650, Japan;
| | - Naoyuki Sugano
- Department of Periodontology, Nihon University School of Dentistry, Tokyo 101-8310, Japan;
| | - Nobuhiro Hanada
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan; (Y.N.); (N.H.)
| | - Nobuo Yoshinari
- Department of Periodontology, School of Dentistry, Matsumoto Dental University, Shiojiri 399-0781, Japan;
| | - Satoshi Sekino
- Department of Periodontology, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo 102-8159, Japan; (S.S.); (Y.N.)
| | - Shogo Takashiba
- Department of Pathophysiology-Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8525, Japan;
| | - Soh Sato
- Department of Periodontology, School of life Dentistry at Niigata, The Nippon Dental University, Niigata 951-8580, Japan;
| | - Toshiaki Nakamura
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan; (K.N.); (T.N.)
| | - Tsutomu Sugaya
- Division of Periodontology and Endodontology, Department of Oral Health Science, Hokkaido University Graduate School of Dental Medicine, Sapporo 060-8586, Japan;
| | - Yohei Nakayama
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Matsudo 271-8587, Japan; (H.T.); (Y.N.); (Y.O.)
| | - Yorimasa Ogata
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Matsudo 271-8587, Japan; (H.T.); (Y.N.); (Y.O.)
| | - Yukihiro Numabe
- Department of Periodontology, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo 102-8159, Japan; (S.S.); (Y.N.)
| | - Taneaki Nakagawa
- Department of Dentistry and Oral Surgery, School of Medicine, Keio University, Tokyo 160-8582, Japan;
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Nomura Y, Ishii Y, Chiba Y, Suzuki S, Suzuki A, Suzuki S, Morita K, Tanabe J, Yamakawa K, Ishiwata Y, Ishikawa M, Sogabe K, Kakuta E, Okada A, Otsuka R, Hanada N. Does Last Year's Cost Predict the Present Cost? An Application of Machine Leaning for the Japanese Area-Basis Public Health Insurance Database. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020565. [PMID: 33445431 PMCID: PMC7827468 DOI: 10.3390/ijerph18020565] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/15/2020] [Accepted: 01/07/2021] [Indexed: 12/21/2022]
Abstract
The increasing healthcare cost imposes a large economic burden for the Japanese government. Predicting the healthcare cost may be a useful tool for policy making. A database of the area-basis public health insurance of one city was analyzed to predict the medical healthcare cost by the dental healthcare cost with a machine learning strategy. The 30,340 subjects who had continued registration of the area-basis public health insurance of Ebina city during April 2017 to September 2018 were analyzed. The sum of the healthcare cost was JPY 13,548,831,930. The per capita healthcare cost was JPY 446,567. The proportion of medical healthcare cost, medication cost, and dental healthcare cost was 78%, 15%, and 7%, respectively. By the results of the neural network model, the medical healthcare cost proportionally depended on the medical healthcare cost of the previous year. The dental healthcare cost of the previous year had a reducing effect on the medical healthcare cost. However, the effect was very small. Oral health may be a risk for chronic diseases. However, when evaluated by the healthcare cost, its effect was very small during the observation period.
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Affiliation(s)
- Yoshiaki Nomura
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan; (M.I.); (K.S.); (R.O.); (N.H.)
- Correspondence:
| | - Yoshimasa Ishii
- Ebina Dental Association, Kanagawa 243-0421, Japan; (Y.I.); (Y.C.); (S.S.); (A.S.); (S.S.); (K.M.); (J.T.); (K.Y.); (Y.I.)
| | - Yota Chiba
- Ebina Dental Association, Kanagawa 243-0421, Japan; (Y.I.); (Y.C.); (S.S.); (A.S.); (S.S.); (K.M.); (J.T.); (K.Y.); (Y.I.)
| | - Shunsuke Suzuki
- Ebina Dental Association, Kanagawa 243-0421, Japan; (Y.I.); (Y.C.); (S.S.); (A.S.); (S.S.); (K.M.); (J.T.); (K.Y.); (Y.I.)
| | - Akira Suzuki
- Ebina Dental Association, Kanagawa 243-0421, Japan; (Y.I.); (Y.C.); (S.S.); (A.S.); (S.S.); (K.M.); (J.T.); (K.Y.); (Y.I.)
| | - Senichi Suzuki
- Ebina Dental Association, Kanagawa 243-0421, Japan; (Y.I.); (Y.C.); (S.S.); (A.S.); (S.S.); (K.M.); (J.T.); (K.Y.); (Y.I.)
| | - Kenji Morita
- Ebina Dental Association, Kanagawa 243-0421, Japan; (Y.I.); (Y.C.); (S.S.); (A.S.); (S.S.); (K.M.); (J.T.); (K.Y.); (Y.I.)
| | - Joji Tanabe
- Ebina Dental Association, Kanagawa 243-0421, Japan; (Y.I.); (Y.C.); (S.S.); (A.S.); (S.S.); (K.M.); (J.T.); (K.Y.); (Y.I.)
| | - Koji Yamakawa
- Ebina Dental Association, Kanagawa 243-0421, Japan; (Y.I.); (Y.C.); (S.S.); (A.S.); (S.S.); (K.M.); (J.T.); (K.Y.); (Y.I.)
| | - Yasuo Ishiwata
- Ebina Dental Association, Kanagawa 243-0421, Japan; (Y.I.); (Y.C.); (S.S.); (A.S.); (S.S.); (K.M.); (J.T.); (K.Y.); (Y.I.)
| | - Meu Ishikawa
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan; (M.I.); (K.S.); (R.O.); (N.H.)
| | - Kaoru Sogabe
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan; (M.I.); (K.S.); (R.O.); (N.H.)
| | - Erika Kakuta
- Department of Oral Microbiology, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan;
| | - Ayako Okada
- Department of Operative Dentistry, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan;
| | - Ryoko Otsuka
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan; (M.I.); (K.S.); (R.O.); (N.H.)
| | - Nobuhiro Hanada
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan; (M.I.); (K.S.); (R.O.); (N.H.)
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Effect of Mucosal Brushing on the Serum Levels of C-Reactive Protein for Patients Hospitalized with Acute Symptoms. ACTA ACUST UNITED AC 2020; 56:medicina56100549. [PMID: 33086612 PMCID: PMC7603140 DOI: 10.3390/medicina56100549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 12/26/2022]
Abstract
This study was based in a hospital setting. Patients with acute symptoms face a life-threatening crisis and often have systemic complications during the convalescence stage. During the acute stage, oral function does not work and oral hygiene status deteriorates. A gauze or sponge brush is generally used to wipe the oral cavity; however, this process does not clean the oral cavity enough. Effective oral care requires better methods. Patients participating in this study were all hospitalized by ambulance and with acute symptoms. During the convalescence stage, patients were assigned application of mucosal brushing or wiping by gauze or sponge brush by order of hospitalization. The effects were evaluated by the number of bacteria on the tongue surface, serum C-reactive protein (CRP) and body temperature. Changes in bacterial count, body temperature, and CRP were effectively reduced in the mucosal brushing group compared to the wiping by gauze or sponge brush group. Based on mixed effect modeling, the coefficient of mucosal brushing for CRP was −2.296 and for body temperature was −0.067 and statistically significant. This simple method can effectively prevent systemic complication of inpatients with deteriorated oral conditions. This method may also be effective for the elderly in nursing homes or perioperative oral-care management.
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