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Vucelić V, Bratić V, Negovetić Vranić D, Tambić Andrašević A, Degoricija V, Mihaljević Z, Ramić S, Piteša Košutić I, Šimunović L, Špiljak B, Brailo V. Understanding and Practices of Oral Hygiene in the Intensive Care Units: Perspectives of Medical Staff at Two University Hospital Centers. Acta Stomatol Croat 2024; 58:85-93. [PMID: 38562223 PMCID: PMC10981905 DOI: 10.15644/asc58/1/8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
Objective This study assesses the knowledge, practices, and attitudes of medical staff in intensive care units (ICUs) regarding oral hygiene care for critically ill, bedridden patients. Material and methods A cross-sectional study included 65 employees from the Intensive Care Units of the Sestre Milosrdnice Clinical Hospital Centre (CHC SM) and the Clinic for Anesthesiology and Intensive Care at the University Clinical Hospital Centre Zagreb (CHC ZG). A self-administered questionnaire was used to assess knowledge, methods, frequency, and attitudes towards oral care for mechanically ventilated patients. The data were examined through descriptive statistical methods, presented in terms of proportions (percentages). For the purpose of comparing the feedback across the two hospital centers and different educational backgrounds, the Chi-square and Fisher's exact tests were employed. Results Results of a survey of 65 participants (18 from CHC SM and 47 from CHC ZG) revealed a notable disparity in oral hygiene knowledge, with graduate nurses displaying the highest proportion of adequate knowledge (100%) and regular nurses showing the least (30.3%) (p<.001). Although the execution of oral care practices did not vary significantly among the groups, graduate nurses performed oral care more frequently (80% vs. baccalaureate technicians 33.33% and nurses 57.6%, three or more times a day) and demonstrated better proficiency in both mechanical (p=.005) and chemical (p<.001) biofilm management compared to their counterparts. No significant difference was observed in the delivery of oral care to orotracheally intubated patients across different educational levels (p=.127). However, a marked difference was noted in the perception of being adequately trained for such care, with nurses feeling less prepared (12.1%, p<.001). Despite these variances, all respondents recognized the importance of oral hygiene, thus showing a strong dedication to oral health care. Conclusions: This study highlights variability in ICU oral hygiene practices and points to the importance of standardized care protocols and improved training for healthcare staff.
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Affiliation(s)
- Vesna Vucelić
- Intensive Care Unit of the University Department of Medicine, Clinical Hospital Centre “Sestre milosrdnice”
| | - Vesna Bratić
- Clinic for Anesthesiology and Intensive Care, University Clinical Hospital Centre Zagreb
| | - Dubravka Negovetić Vranić
- University of Zagreb, School of Dental Medicine, Zagreb, Croatia
- Clinic for Dentistry, University Clinical Hospital Centre Zagreb
| | - Arjana Tambić Andrašević
- University of Zagreb, School of Dental Medicine, Zagreb, Croatia
- Department of Clinical Microbiology, University Hospital for Infectious Diseases “Dr. Fran Mihaljević”, Zagreb, Croatia
| | - Vesna Degoricija
- Intensive Care Unit of the University Department of Medicine, Clinical Hospital Centre “Sestre milosrdnice”
- University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Zlatan Mihaljević
- Department of Clinical Microbiology, Clinical Hospital Centre “Sestre milosrdnice”
| | - Snježana Ramić
- Department of Oncological Pathology and Clinical Cytology “Ljudevit Jurak”, University Department of Pathology, Clinical Hospital Centre “Sestre milosrdnice”
| | - Ivana Piteša Košutić
- Intensive Care Unit of the University Department of Medicine, Clinical Hospital Centre “Sestre milosrdnice”
| | - Luka Šimunović
- University of Zagreb, School of Dental Medicine, Zagreb, Croatia
| | - Bruno Špiljak
- University of Zagreb, School of Dental Medicine, Zagreb, Croatia
| | - Vlaho Brailo
- University of Zagreb, School of Dental Medicine, Zagreb, Croatia
- Clinic for Dentistry, University Clinical Hospital Centre Zagreb
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Alfano A, Riddle K, Nordstrom K, Buterakos R, Keiser M. The Impact of Nursing Education on Ventilator-Associated Pneumonia Prevention Bundle to Reduce Incidence of Infection: A Quality Improvement Project. Dimens Crit Care Nurs 2024; 43:40-46. [PMID: 38059712 DOI: 10.1097/dcc.0000000000000615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Ventilator-associated pneumonia (VAP) is a health care-acquired infection that leads to poor patient outcomes, increased length of hospital stay, exhaustion of health care resources, and unnecessary increases in health care costs. OBJECTIVES This project was designed to educate registered nurses on the importance of an evidence-based VAP prevention bundle that reduces the overall incidence of VAP infections. METHODS Patients (N = 146) were enrolled in this quasi-experimental project that took place in a 14-bed neuro trauma surgical burn intensive care unit (ICU) at a level 1 trauma center. Data were collected from the chart review of patients admitted to the neuro trauma surgical burn ICU prior to and after nursing education intervention. The difference in VAP rate and enhanced nursing knowledge were the primary outcome measures. RESULTS Data suggest improvement in several patient outcomes. Ventilator days were shortened from 17.45 days to 13.42 days (P = .085), and ICU length of stay decreased from 24.77 days to 17.62 days (P = .035). Patient laboratory data show improved white blood cell values (P < .001), less oxygen requirements (P < .001), and fewer patients meeting the diagnostic criteria for VAP (P = .073). DISCUSSION Results suggest there were no statistically significant changes in the knowledge of registered nurses or oral care bundle compliance; however, improvements in patient data following the provider education suggest that continued education to nursing staff will have a positive impact on reducing hospital stay and significant costs associated with a VAP infection.
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Elmahdi A, Eisa M, Omer E. Aspiration pneumonia in enteral feeding: A review on risks and prevention. Nutr Clin Pract 2023; 38:1247-1252. [PMID: 37227191 DOI: 10.1002/ncp.11020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/02/2023] [Accepted: 04/30/2023] [Indexed: 05/26/2023] Open
Abstract
Enteral feeding plays a critical role in the management of hospitalized patients, especially in intensive care units. In addition to delivering important nutrients, it also maintains the integrity of the gut and microbiota. Enteral feeding is also associated with complications and adverse events, some are related to access placement, metabolic and electrolytes disturbances, and aspiration pneumonia. In tube-fed patients, aspiration pneumonia has a prevalence ranging from 4% to 95% with a mortality rate of 17%-62%. Our review has not showed any significant difference in the incidence of aspiration pneumonia between gastric and postpyloric feeding and, given the ease of gastric access, we therefore suggest using gastric feeding as an initial strategy for the delivery of nutrition unless postpyloric access is otherwise indicated for other clinical reasons.
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Affiliation(s)
- Alsiddig Elmahdi
- Internal Medicine, Virginia Commonwealth University Health Systems, Richmond, Virginia, USA
| | - Mohamed Eisa
- Allegheny Center for Digestive Health, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
| | - Endashaw Omer
- Division of Gastroenterology, Hepatology, and Nutrition, University of Louisville School of Medicine, Louisville, Kentucky, USA
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Croft K, Dallal-York J, Miller S, Anderson A, Donohue C, Jeng E, Plowman EK. Provision of Oral Care in the Cardiothoracic Intensive Care Unit: Survey of Nursing Staff Training, Confidence, Methods, Attitudes, and Perceived Barriers. J Contin Educ Nurs 2023; 54:313-321. [PMID: 37390307 DOI: 10.3928/00220124-20230620-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
BACKGROUND Poor oral health is associated with adverse outcomes in critical care settings. Although provision of oral care is a fundamental aspect of nursing practice, both formal training and practice among nursing staff remain unclear. METHOD Cardiothoracic intensive care unit nurses were recruited to complete a 16-item survey regarding training, confidence, methods, prioritization, and barriers to provision of oral care. RESULTS A total of 108 nurses participated (70% response rate). Formal training in oral care was reported by 38%, most frequently reported as less than 1 hour (53%) in duration. Of the respondents, 70% reported confidence in providing oral care. Nine methods and 16 products were identified, with variability in the frequency of provision. Prioritization of oral care was rated most frequently as moderate (53%), with 28% reporting barriers. CONCLUSION Despite limited formal training, surveyed nurses reported confidence in providing oral care. Methods, frequency, and prioritization were variable. Both development of formal curricula and evaluation of adherence to standardized protocols for oral care are warranted. [J Contin Educ Nurs. 2023;54(7):313-321.].
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Jahanshir M, Nobahar M, Ghorbani R, Malek F. Effect of clove mouthwash on the incidence of ventilator-associated pneumonia in intensive care unit patients: a comparative randomized triple-blind clinical trial. Clin Oral Investig 2023:10.1007/s00784-023-04972-w. [PMID: 36961592 PMCID: PMC10036978 DOI: 10.1007/s00784-023-04972-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/19/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVES Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections in intensive care units (ICUs), and the use of mouthwash is the most widely used method to prevent its incidence. The aim of this study was to investigate effect of clove mouthwash on the incidence of VAP in the ICU. MATERIALS AND METHODS This comparative, randomized, triple-blind, clinical trial was conducted on 168 eligible ICU patients at Kosar Hospital in Semnan, Iran, during 2021-2022, who were divided into intervention and control groups using random blocks. The intervention group received clove extract mouthwash at 6.66% concentration, and the control group received chlorhexidine 0.2% twice a day for 5 days (routine care). Data were collected using a demographic questionnaire, and disease severity was measured based on the Acute Physiology and Chronic Health Evaluation II (APACHE II) score, oral health status was examined using the Beck Oral Assessment Scale (BOAS), and VAP diagnosis was made based on the Modified Clinical Pulmonary Infection Score (MCPIS). RESULTS Before the intervention, there was no significant difference in disease severity (p = 0.412) and oral health status (p = 0.239) between the patients in the two groups. After the intervention, 20.2% of the patients in the intervention group and 41.7% of those in the control group acquired VAP. The risk of VAP was 2.06 times higher in the control group than in the intervention group (p = 0.005, 95% CI: 1.26-3.37, RR = 2.06), but the severity of VAP did not differ significantly between the patients in the two groups (p = 0.557). CONCLUSION The findings showed that clove mouthwash reduces the incidence of VAP significantly. CLINICAL RELEVANCE Clove mouthwash can be used as a simple and low-cost method to prevent VAP in ICU patients.
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Affiliation(s)
- Mojgan Jahanshir
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Monir Nobahar
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran.
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.
- Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Postal Code: 3513138111, Iran.
| | - Raheb Ghorbani
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Farhad Malek
- Department of Internal Medicine, Kosar Hospital, Semnan University of Medical Sciences, Semnan, Iran
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Zirk M, Lentzen MP, Brost E, Schick V, Zöller JE, Zinser M. Surgical side infections of the tracheostomy - A retrospective cohort study of patients with head and neck cancer in intensive care. J Craniomaxillofac Surg 2022; 50:811-816. [PMID: 36336544 DOI: 10.1016/j.jcms.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 12/06/2021] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
This study was conducted to reveal the relevant risk factors for surgical site infections (SSI) of the tracheostomy in ICU tracheostomy patients with oncologic history. Retrospectively, medical and ICU records of patients who received open tracheostomy in a uniform manner were investigated. Of 187 consecutive patients in total, patients with a peri/post-operative antibiotic prophylaxis (POABP) experienced significantly more Organ-Space SSI, whereas patients with a POABP developed less Superficial Incisional SSI and Deep Incisional SSI. Neck Dissection (p = 0.025), especially the more levels are included, and POABP (p = 0.005) have a significant impact on the occurrence of an SSI of the tracheostomy. Deep incisional SSI significantly prolonged a patient's dependency on a ventilator (p = 0.045, M = 3.92, SD = 4.718). The difference between Superficial Incisional, Deep Incisional and Organ-Space SSI should be taken in consideration regarding risk evaluation and treatment. Furthermore, a gram-negative facultative anaerobic biofilm should be taken into consideration in treatment options and thus an escalation regarding antibiotic treatment as a POABP. For fulminant SSI of the tracheostomy the use of piperacillin/tazobactam or 3rd generation cephalosporines or carbapenems is recommendable.
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Affiliation(s)
- Matthias Zirk
- Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Germany, Head of Department: Prof. Dr. Dr. Joachim E. Zöller.
| | - Max-Philipp Lentzen
- Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Germany, Head of Department: Prof. Dr. Dr. Joachim E. Zöller
| | - Eliane Brost
- Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Germany, Head of Department: Prof. Dr. Dr. Joachim E. Zöller
| | - Volker Schick
- Department of Anaesthesiology and Intensive Care Medicine (Head: Prof. Dr. Bernd W. Böttiger), University Hospital of Cologne, Faculty of Medicine and University Hospital of Cologne, Germany
| | - Joachim E Zöller
- Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Germany, Head of Department: Prof. Dr. Dr. Joachim E. Zöller
| | - Max Zinser
- Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Germany, Head of Department: Prof. Dr. Dr. Joachim E. Zöller
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Singh P, Arshad Z, Srivastava VK, Singh GP, Gangwar RS. Efficacy of Oral Care Protocols in the Prevention of Ventilator-Associated Pneumonia in Mechanically Ventilated Patients. Cureus 2022; 14:e23750. [PMID: 35518542 PMCID: PMC9064705 DOI: 10.7759/cureus.23750] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2022] [Indexed: 11/05/2022] Open
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Kapoor K, Wilhelm D, Neumeister C, Götz MR, Schwantes U, Bleckert G, Gerstenmaier L, Jambrecina A. Treatment of Oropharyngeal Symptoms: A Prospective, Single-Dose, Placebo-Controlled, Randomized Clinical Trial. OPEN ACCESS JOURNAL OF CLINICAL TRIALS 2022. [DOI: 10.2147/oajct.s331883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Özdemir S, Türk G. The effect of different concentrations of chlorhexidine on microbial colonization: A double-blinded randomized controlled study. Int J Nurs Pract 2021; 28:e13025. [PMID: 34687483 DOI: 10.1111/ijn.13025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 09/08/2021] [Accepted: 09/25/2021] [Indexed: 11/28/2022]
Abstract
AIM Study aims were to determine the most effective chlorhexidine concentration to be used in reducing microbial colonization in patients under mechanical ventilation and to examine the effect of oral care using different concentrations on the integrity of the oral mucous membranes. DESIGN This research was a randomized controlled double-blinded experimental study. METHOD The sample of study consisted of the 116 adult patients who remained intubated. Oral care was given to patients 4 times/day as per nurse protocol. Every morning during for 4 days, the intraoral mucosa of all groups of patients was assessed. Microbial colonization samples from oral mucosa were taken in the morning before oral care. A determination of the species of microorganisms in these samples was made. RESULTS A statistically significant difference was found with regard to the reproduction of microorganisms between the oral mucosa samples taken from patients using 2% and 1% chlorhexidine solutions (P < 0.001). In the cultures taken from patients on the first and fourth days of intubation, a total of 36 different microorganisms were seen to be reproducing. CONCLUSION It was concluded that the most effective oral solution for the prevention of microbial colonization in patients under mechanical ventilation was chlorhexidine 1%.
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Affiliation(s)
- Sercan Özdemir
- Anesthesia Intensive Care Unit, Nazilli State Hospital, Aydın, Turkey
| | - Gülengün Türk
- Faculty of Nursing, Fundamentals of Nursing Department, Aydın Adnan Menderes University, Aydın, Turkey
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Haghighat A, Mohammadi I, Tahani B, Teimoori F. Knowledge, attitude, and expertise of nurses in intensive care unit regarding oral and dental care in hospitalized patients. Dent Res J (Isfahan) 2021; 18:83. [PMID: 34760074 PMCID: PMC8554478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/23/2021] [Accepted: 05/22/2021] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND The purpose of this study was conducted to evaluate the knowledge, attitude, and practice of intensive care unit (ICU) nurses about oral and dental care in hospitalized patients. MATERIALS AND METHODS In this descriptive-analytic study, the statistical population included 214 nurses working in the ICU of the affiliated hospitals of Isfahan University in 1394. The level of knowledge, attitude, and practice of ICU nurses was assessed using questionnaires whose justifiability and stability were verified at the beginning of the study with a pilot study. Data were entered into SPSS software and tested by t-test, Spearman, one-way variance, and least significant difference test. The significance level was < 0.05. RESULTS The data of this study showed that the score of knowledge and performance in male nurses was significantly different from female nurses. There was a significant relationship between nurse's education and their knowledge score (P < 0.001). Furthermore, the performance score of nurses working in different parts was different too (P < 0.001). CONCLUSION The findings showed that the knowledge and performance of female nurses about oral care were higher than men, but the attitude of the two sexes is almost the same. Nurses with lower educational degree had less knowledge, but their attitude and performance did not differ. The performance score of nurses working in ICU was different, but they had similar knowledge and attitudes.
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Affiliation(s)
- Abbas Haghighat
- Department of Oral and Maxillofacial Surgery, Dental Implant Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Iman Mohammadi
- Department of Oral and Maxillofacial Surgery, Dental Implant Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahareh Tahani
- Department of Oral Public Health, Dental Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farshad Teimoori
- Department of Oral and Maxillofacial Surgery, Isfahan, Iran,Address for correspondence: Dr. Farshad Teimoori, Department of Oral and Maxillofacial Surgery, Dental School, Isfahan University of Medical Science, Isfahan, Iran. E-mail:
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Cooper AS. Oral Hygiene Care to Prevent Ventilator-Associated Pneumonia in Critically Ill Patients. Crit Care Nurse 2021; 41:80-82. [PMID: 34333609 DOI: 10.4037/ccn2021314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Adam S Cooper
- Adam S. Cooper is Director of Nursing Continuous Improvement and Affiliate Nursing Quality and Director of the UCSF JBI Centre for Synthesis and Implementation, UCSF Health, San Francisco, California. He is also a member of the Cochrane Nursing Care Field
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Teimoori F, Haghighat A, Mohammadi I, Tahani B. Knowledge, attitude, and expertise of nurses in intensive care unit regarding oral and dental care in hospitalized patients. Dent Res J (Isfahan) 2021. [DOI: 10.4103/1735-3327.328751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Liu W, Jiao Y, Xing H, Hai Y, Li H, Zhang K, Zhao Y, Yang Y, Xu B, Bai H, Bao H, Zhang S, Guo T. Active surveillance of ventilator-associated pneumonia in the intensive care unit and establishment of the risk grading system and effect evaluation. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:617. [PMID: 31930018 PMCID: PMC6944584 DOI: 10.21037/atm.2019.11.25] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/22/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND To discuss ventilator-associated pneumonia (VAP) patient's clinical characteristic and related factors in the intensive care unit (ICU), and to establish a risk grading system for VAP patients in the ICU in order to provide a reference for VAP prevention. METHODS A total of 1,513 patients in eight ICUs who received mechanical ventilation between June 2015 and June 2018 were randomized and into two groups, with 908 patients in the model group and 605 patients in the verification group. The model group was used to analyze the influencing factors of VAP and establish a risk grading system, while the verification group was used to verify the risk grading system. A receiver operating characteristic (ROC) curve was used to evaluate the predictive effect of the grading system. RESULTS During the 3-year study period, of the 1,513 total patients, 188 patients were infected with VAP, leading to an incidence rate of 12.43% (188/1,513) and an infection rate of 15.23‰ (188/12,347). ICU length of stay, mechanical ventilation days, frequency of oral care, unused subglottic secretion drainage, tracheotomy, APACHE II score, and combined antibiotics use were risk factors of VAP infection for patients who received mechanical ventilation in the modeling group (P<0.05). In a VAP risk-grading system established based on risk factors, the high, medium and low-grade patients had a statistically significantly different VAP infection rate in the model group, and patients with a high grade had a higher risk of VAP infection. Patients' data in the model and verification groups were used to draw a ROC curve which showed a good predictive effect. CONCLUSIONS This study establishes and verifies the VAP risk grading system for patients who receive mechanical ventilation. It is helpful in high-risk patient surveillance and in reducing and preventing VAP infection.
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Affiliation(s)
- Weiping Liu
- Department of Nosocomial Infection Control, Inner Mongolia People's Hospital, Hohhot 010017, China
| | - Yueying Jiao
- Department of Nosocomial Infection Control, Inner Mongolia People's Hospital, Hohhot 010017, China
| | - Huimin Xing
- Department of Nosocomial Infection Control, Inner Mongolia People's Hospital, Hohhot 010017, China
| | - Yunting Hai
- Department of Nosocomial Infection Control, Inner Mongolia People's Hospital, Hohhot 010017, China
| | - Haoxue Li
- Department of Nosocomial Infection Control, Inner Mongolia People's Hospital, Hohhot 010017, China
| | - Kai Zhang
- Department of Nosocomial Infection Control, Inner Mongolia People's Hospital, Hohhot 010017, China
| | - Yuping Zhao
- Department of Nosocomial Infection Control, Inner Mongolia People's Hospital, Hohhot 010017, China
| | - Yongfang Yang
- Department of Nosocomial Infection Control, Inner Mongolia People's Hospital, Hohhot 010017, China
| | - Binbin Xu
- Department of Nosocomial Infection Control, Inner Mongolia People's Hospital, Hohhot 010017, China
| | - Haibo Bai
- Department of Nosocomial Infection Control, Inner Mongolia People's Hospital, Hohhot 010017, China
| | - Huan Bao
- Department of Nosocomial Infection Control, Inner Mongolia People's Hospital, Hohhot 010017, China
| | - Shuai Zhang
- Department of Nosocomial Infection Control, Inner Mongolia People's Hospital, Hohhot 010017, China
| | - Tianhui Guo
- Department of Nosocomial Infection Control, Inner Mongolia People's Hospital, Hohhot 010017, China
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Osakabe L, Utsumi A, Saito B, Okamatsu Y, Kinouchi H, Nakamaki T, Hironaka S. Influence of Oral Anaerobic Bacteria on Hematopoietic Stem Cell Transplantation Patients: Oral Mucositis and General Condition. Transplant Proc 2018; 49:2176-2182. [PMID: 29149979 DOI: 10.1016/j.transproceed.2017.09.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 09/22/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Oral mucositis (OM) caused by infection facilitated by myelosuppression and immunosuppression can be controlled through oral care. We investigated changes in oral anaerobic bacterial flora during the onset of OM with hematopoietic stem cell transplantation (HSCT). METHODS This study included 19 patients who underwent HSCT. All received professional oral care before initiating the preparative regimen. We assessed OM, oral health and obtained microbial samples from the oral cavity during 5 assessment points: before initiating the preparative regimen; the day before HSCT (day 1); and at 7, 14, and 30 days after HSCT. Microbial species were identified by using a mass spectrometer. RESULTS The number of patients with serious OM increased initially after HSCT and decreased thereafter. Many Streptococcus species were identified before HSCT, but these gradually decreased and were replaced by coagulase-negative staphylococci. An increase in Candida species after HSCT and the identification of Enterococcus species were significantly associated with OM. Nutritional status recovery and prognosis were significantly worse in patients who developed OM. CONCLUSIONS To the best of our knowledge, this study is the first which shows that anaerobic bacteria were identified in patients' oral flora before and after HSCT by using a mass spectrometer. These results indicate that Enterococcus species and Candida species may have been associated with OM. OM affected the patients' improvement in nutritional status and their prognosis. We concluded that it is important to provide more complete oral care instructions and interventions to prevent these bacterial infections.
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Affiliation(s)
- L Osakabe
- Department of Special Needs Dentistry, Division of Hygiene and Oral Health, Showa University School of Dentistry, Tokyo, Japan
| | - A Utsumi
- Department of Special Needs Dentistry, Division of Hygiene and Oral Health, Showa University School of Dentistry, Tokyo, Japan.
| | - B Saito
- Department of Medicine, Division of Hematology, Showa University School of Medicine, Tokyo, Japan
| | - Y Okamatsu
- Dentistry and Oral Surgery, Showa University Hospital, Tokyo, Japan; Division of Community Based Comprehensive Dentistry, Department of Special Needs Dentistry, Showa University School of Dentistry, Tokyo, Japan
| | - H Kinouchi
- Dentistry and Oral Surgery, Showa University Hospital, Tokyo, Japan
| | - T Nakamaki
- Department of Medicine, Division of Hematology, Showa University School of Medicine, Tokyo, Japan
| | - S Hironaka
- Department of Special Needs Dentistry, Division of Hygiene and Oral Health, Showa University School of Dentistry, Tokyo, Japan
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