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Oral care and oropharyngeal and tracheal colonization by Gram-negative pathogens in children
Background: Critical care nursing interventions to oral care can reduce microorganisms in the oropharynx available for translocation. Objectives: To analyse the effect of 0·12% chlorhexidine digluconate on the colonization of oropharyngeal and tracheal secretions by Gram‐negative pathogens in mechan...
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| Published in: | Nursing in critical care 2012-05, Vol.17 (3), p.115-122 |
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| container_title | Nursing in critical care |
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| creator | Kusahara, Denise Miyuki Friedlander, Lais Tambelli Peterlini, Maria Angélica Sorgini Pedreira, Mavilde Luz Gonçalves |
| description | Background: Critical care nursing interventions to oral care can reduce microorganisms in the oropharynx available for translocation.
Objectives: To analyse the effect of 0·12% chlorhexidine digluconate on the colonization of oropharyngeal and tracheal secretions by Gram‐negative pathogens in mechanically ventilated children.
Methods: A randomized, controlled and double‐blinded study was performed in the paediatric intensive care unit (PICU) of a Brazilian university hospital. Exclusion criteria included child age under 28 days, pneumonia diagnosis at admission, use of tracheostomy, PICU length of stay (LOS) less than 48 h and refusal to participate. Children were randomly allocated to the interventional group (IG), in which oral care with chlorhexidine was administered, or to the placebo group (PG), which received oral care without antiseptic use. The data were analysed through Pearson's χ2 test, Fisher's exact and ANOVA tests with significance levels set at 0·05.
Results: The demographic characteristics of the 74 children were not statistically different between groups. No between‐group differences in oropharyx colonization by Gram‐negative pathogens were identified (p = 0·316). Pathogens were isolated in the tracheal secretions of two (10·0%) children in the PG and four (19·0%) children in the IG (p = 0·355).
Conclusion: The use of chlorhexidine did not significantly influence the colonization of oropharyngeal and tracheal secretions by Gram‐negative pathogens of the studied sample.
Relevance to clinical practice: This study demonstrated no influence of a specific antiseptic agent on colonization profile of mechanically ventilated children in PICU. Further research in this field is necessary to promote evidence‐based nursing practice on oral care of critically ill children. |
| doi_str_mv | 10.1111/j.1478-5153.2012.00494.x |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1020854523</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1015094541</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4734-c8ede0101d9697fbd713254b85aaf7c19235057bcaa785a617ebd084d20f5b783</originalsourceid><addsrcrecordid>eNqNkTtv2zAUhYkiRZOm_QsFxyxS-BSloUNitE6APIakzVKAoKgrW65MOqTc2v31oeLUs7nw8vA7l4-DEKYkp2mcL3IqVJlJKnnOCGU5IaIS-eYdOtlvHKWaFyyjhKpj9DHGBSGMSMk_oGPGRKUqKk_Qr_tgemxNAGxcg33wq7kJWzeDJI_KEIydjwvre--6f2bovMP1Fk-DWWYOZkn4A3hlhrmfgYu4c9jOu74J4D6h963pI3x-m0_Rj-_fHidX2c399HpycZNZobjIbAkNkHTPpioq1daNopxJUZfSmFZZWjEuiVS1NUYlraAK6oaUomGklbUq-Sk62_VdBf-8hjjoZRct9L1x4NdR0_TwUgrJ-AEorQpKU9NDUEkqIQVNaLlDbfAxBmj1KnTL9I8J0mNieqHHYPQYjB4T06-J6U2yfnk7ZV0vodkb_0eUgK874G_Xw_bgxvruejJJVfJnO38XB9js_Sb81oXiSuqnu6l-oreXtz8l0Q_8BR69ssA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1015094541</pqid></control><display><type>article</type><title>Oral care and oropharyngeal and tracheal colonization by Gram-negative pathogens in children</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>Kusahara, Denise Miyuki ; Friedlander, Lais Tambelli ; Peterlini, Maria Angélica Sorgini ; Pedreira, Mavilde Luz Gonçalves</creator><creatorcontrib>Kusahara, Denise Miyuki ; Friedlander, Lais Tambelli ; Peterlini, Maria Angélica Sorgini ; Pedreira, Mavilde Luz Gonçalves</creatorcontrib><description>Background: Critical care nursing interventions to oral care can reduce microorganisms in the oropharynx available for translocation.
Objectives: To analyse the effect of 0·12% chlorhexidine digluconate on the colonization of oropharyngeal and tracheal secretions by Gram‐negative pathogens in mechanically ventilated children.
Methods: A randomized, controlled and double‐blinded study was performed in the paediatric intensive care unit (PICU) of a Brazilian university hospital. Exclusion criteria included child age under 28 days, pneumonia diagnosis at admission, use of tracheostomy, PICU length of stay (LOS) less than 48 h and refusal to participate. Children were randomly allocated to the interventional group (IG), in which oral care with chlorhexidine was administered, or to the placebo group (PG), which received oral care without antiseptic use. The data were analysed through Pearson's χ2 test, Fisher's exact and ANOVA tests with significance levels set at 0·05.
Results: The demographic characteristics of the 74 children were not statistically different between groups. No between‐group differences in oropharyx colonization by Gram‐negative pathogens were identified (p = 0·316). Pathogens were isolated in the tracheal secretions of two (10·0%) children in the PG and four (19·0%) children in the IG (p = 0·355).
Conclusion: The use of chlorhexidine did not significantly influence the colonization of oropharyngeal and tracheal secretions by Gram‐negative pathogens of the studied sample.
Relevance to clinical practice: This study demonstrated no influence of a specific antiseptic agent on colonization profile of mechanically ventilated children in PICU. Further research in this field is necessary to promote evidence‐based nursing practice on oral care of critically ill children.</description><identifier>ISSN: 1362-1017</identifier><identifier>EISSN: 1478-5153</identifier><identifier>DOI: 10.1111/j.1478-5153.2012.00494.x</identifier><identifier>PMID: 22497915</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Administration, Oral ; Age ; Anti-Infective Agents, Local - administration & dosage ; Antiseptics ; Brazil ; Child ; Child, Preschool ; Children ; Chlorhexidine ; Chlorhexidine - administration & dosage ; Colonization ; Data processing ; Demography ; Double-Blind Method ; Female ; Gram-Negative Bacteria - growth & development ; Gram-Negative Bacteria - pathogenicity ; Gram-Negative Bacterial Infections - diagnosis ; Gram-Negative Bacterial Infections - drug therapy ; Hospitals ; Humans ; Immunoglobulins ; Infant ; Infection control ; Intensive care ; Intensive care units ; Intensive Care Units, Pediatric ; Length of Stay ; Male ; Microbial Sensitivity Tests ; Microorganisms ; Mouth - drug effects ; Mouth - microbiology ; Nursing ; Oral hygiene ; Oral Hygiene - methods ; Oropharynx ; Oropharynx - drug effects ; Oropharynx - microbiology ; Paediatric nursing ; Paediatrics ; Pathogens ; Pediatrics ; Pneumonia ; Pneumonia, Ventilator-Associated - prevention & control ; Secretions ; Trachea - drug effects ; Trachea - microbiology ; tracheostomy ; Translocation ; Ventilator-associated pneumonia</subject><ispartof>Nursing in critical care, 2012-05, Vol.17 (3), p.115-122</ispartof><rights>2012 The Authors. Nursing in Critical Care © 2012 British Association of Critical Care Nurses</rights><rights>2012 The Authors. Nursing in Critical Care © 2012 British Association of Critical Care Nurses.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4734-c8ede0101d9697fbd713254b85aaf7c19235057bcaa785a617ebd084d20f5b783</citedby><cites>FETCH-LOGICAL-c4734-c8ede0101d9697fbd713254b85aaf7c19235057bcaa785a617ebd084d20f5b783</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22497915$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kusahara, Denise Miyuki</creatorcontrib><creatorcontrib>Friedlander, Lais Tambelli</creatorcontrib><creatorcontrib>Peterlini, Maria Angélica Sorgini</creatorcontrib><creatorcontrib>Pedreira, Mavilde Luz Gonçalves</creatorcontrib><title>Oral care and oropharyngeal and tracheal colonization by Gram-negative pathogens in children</title><title>Nursing in critical care</title><addtitle>Nurs Crit Care</addtitle><description>Background: Critical care nursing interventions to oral care can reduce microorganisms in the oropharynx available for translocation.
Objectives: To analyse the effect of 0·12% chlorhexidine digluconate on the colonization of oropharyngeal and tracheal secretions by Gram‐negative pathogens in mechanically ventilated children.
Methods: A randomized, controlled and double‐blinded study was performed in the paediatric intensive care unit (PICU) of a Brazilian university hospital. Exclusion criteria included child age under 28 days, pneumonia diagnosis at admission, use of tracheostomy, PICU length of stay (LOS) less than 48 h and refusal to participate. Children were randomly allocated to the interventional group (IG), in which oral care with chlorhexidine was administered, or to the placebo group (PG), which received oral care without antiseptic use. The data were analysed through Pearson's χ2 test, Fisher's exact and ANOVA tests with significance levels set at 0·05.
Results: The demographic characteristics of the 74 children were not statistically different between groups. No between‐group differences in oropharyx colonization by Gram‐negative pathogens were identified (p = 0·316). Pathogens were isolated in the tracheal secretions of two (10·0%) children in the PG and four (19·0%) children in the IG (p = 0·355).
Conclusion: The use of chlorhexidine did not significantly influence the colonization of oropharyngeal and tracheal secretions by Gram‐negative pathogens of the studied sample.
Relevance to clinical practice: This study demonstrated no influence of a specific antiseptic agent on colonization profile of mechanically ventilated children in PICU. Further research in this field is necessary to promote evidence‐based nursing practice on oral care of critically ill children.</description><subject>Administration, Oral</subject><subject>Age</subject><subject>Anti-Infective Agents, Local - administration & dosage</subject><subject>Antiseptics</subject><subject>Brazil</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Chlorhexidine</subject><subject>Chlorhexidine - administration & dosage</subject><subject>Colonization</subject><subject>Data processing</subject><subject>Demography</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Gram-Negative Bacteria - growth & development</subject><subject>Gram-Negative Bacteria - pathogenicity</subject><subject>Gram-Negative Bacterial Infections - diagnosis</subject><subject>Gram-Negative Bacterial Infections - drug therapy</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Immunoglobulins</subject><subject>Infant</subject><subject>Infection control</subject><subject>Intensive care</subject><subject>Intensive care units</subject><subject>Intensive Care Units, Pediatric</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Microbial Sensitivity Tests</subject><subject>Microorganisms</subject><subject>Mouth - drug effects</subject><subject>Mouth - microbiology</subject><subject>Nursing</subject><subject>Oral hygiene</subject><subject>Oral Hygiene - methods</subject><subject>Oropharynx</subject><subject>Oropharynx - drug effects</subject><subject>Oropharynx - microbiology</subject><subject>Paediatric nursing</subject><subject>Paediatrics</subject><subject>Pathogens</subject><subject>Pediatrics</subject><subject>Pneumonia</subject><subject>Pneumonia, Ventilator-Associated - prevention & control</subject><subject>Secretions</subject><subject>Trachea - drug effects</subject><subject>Trachea - microbiology</subject><subject>tracheostomy</subject><subject>Translocation</subject><subject>Ventilator-associated pneumonia</subject><issn>1362-1017</issn><issn>1478-5153</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNqNkTtv2zAUhYkiRZOm_QsFxyxS-BSloUNitE6APIakzVKAoKgrW65MOqTc2v31oeLUs7nw8vA7l4-DEKYkp2mcL3IqVJlJKnnOCGU5IaIS-eYdOtlvHKWaFyyjhKpj9DHGBSGMSMk_oGPGRKUqKk_Qr_tgemxNAGxcg33wq7kJWzeDJI_KEIydjwvre--6f2bovMP1Fk-DWWYOZkn4A3hlhrmfgYu4c9jOu74J4D6h963pI3x-m0_Rj-_fHidX2c399HpycZNZobjIbAkNkHTPpioq1daNopxJUZfSmFZZWjEuiVS1NUYlraAK6oaUomGklbUq-Sk62_VdBf-8hjjoZRct9L1x4NdR0_TwUgrJ-AEorQpKU9NDUEkqIQVNaLlDbfAxBmj1KnTL9I8J0mNieqHHYPQYjB4T06-J6U2yfnk7ZV0vodkb_0eUgK874G_Xw_bgxvruejJJVfJnO38XB9js_Sb81oXiSuqnu6l-oreXtz8l0Q_8BR69ssA</recordid><startdate>201205</startdate><enddate>201205</enddate><creator>Kusahara, Denise Miyuki</creator><creator>Friedlander, Lais Tambelli</creator><creator>Peterlini, Maria Angélica Sorgini</creator><creator>Pedreira, Mavilde Luz Gonçalves</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>7QL</scope><scope>C1K</scope></search><sort><creationdate>201205</creationdate><title>Oral care and oropharyngeal and tracheal colonization by Gram-negative pathogens in children</title><author>Kusahara, Denise Miyuki ; Friedlander, Lais Tambelli ; Peterlini, Maria Angélica Sorgini ; Pedreira, Mavilde Luz Gonçalves</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4734-c8ede0101d9697fbd713254b85aaf7c19235057bcaa785a617ebd084d20f5b783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Administration, Oral</topic><topic>Age</topic><topic>Anti-Infective Agents, Local - administration & dosage</topic><topic>Antiseptics</topic><topic>Brazil</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Chlorhexidine</topic><topic>Chlorhexidine - administration & dosage</topic><topic>Colonization</topic><topic>Data processing</topic><topic>Demography</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Gram-Negative Bacteria - growth & development</topic><topic>Gram-Negative Bacteria - pathogenicity</topic><topic>Gram-Negative Bacterial Infections - diagnosis</topic><topic>Gram-Negative Bacterial Infections - drug therapy</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Immunoglobulins</topic><topic>Infant</topic><topic>Infection control</topic><topic>Intensive care</topic><topic>Intensive care units</topic><topic>Intensive Care Units, Pediatric</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Microbial Sensitivity Tests</topic><topic>Microorganisms</topic><topic>Mouth - drug effects</topic><topic>Mouth - microbiology</topic><topic>Nursing</topic><topic>Oral hygiene</topic><topic>Oral Hygiene - methods</topic><topic>Oropharynx</topic><topic>Oropharynx - drug effects</topic><topic>Oropharynx - microbiology</topic><topic>Paediatric nursing</topic><topic>Paediatrics</topic><topic>Pathogens</topic><topic>Pediatrics</topic><topic>Pneumonia</topic><topic>Pneumonia, Ventilator-Associated - prevention & control</topic><topic>Secretions</topic><topic>Trachea - drug effects</topic><topic>Trachea - microbiology</topic><topic>tracheostomy</topic><topic>Translocation</topic><topic>Ventilator-associated pneumonia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kusahara, Denise Miyuki</creatorcontrib><creatorcontrib>Friedlander, Lais Tambelli</creatorcontrib><creatorcontrib>Peterlini, Maria Angélica Sorgini</creatorcontrib><creatorcontrib>Pedreira, Mavilde Luz Gonçalves</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Nursing in critical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kusahara, Denise Miyuki</au><au>Friedlander, Lais Tambelli</au><au>Peterlini, Maria Angélica Sorgini</au><au>Pedreira, Mavilde Luz Gonçalves</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Oral care and oropharyngeal and tracheal colonization by Gram-negative pathogens in children</atitle><jtitle>Nursing in critical care</jtitle><addtitle>Nurs Crit Care</addtitle><date>2012-05</date><risdate>2012</risdate><volume>17</volume><issue>3</issue><spage>115</spage><epage>122</epage><pages>115-122</pages><issn>1362-1017</issn><eissn>1478-5153</eissn><abstract>Background: Critical care nursing interventions to oral care can reduce microorganisms in the oropharynx available for translocation.
Objectives: To analyse the effect of 0·12% chlorhexidine digluconate on the colonization of oropharyngeal and tracheal secretions by Gram‐negative pathogens in mechanically ventilated children.
Methods: A randomized, controlled and double‐blinded study was performed in the paediatric intensive care unit (PICU) of a Brazilian university hospital. Exclusion criteria included child age under 28 days, pneumonia diagnosis at admission, use of tracheostomy, PICU length of stay (LOS) less than 48 h and refusal to participate. Children were randomly allocated to the interventional group (IG), in which oral care with chlorhexidine was administered, or to the placebo group (PG), which received oral care without antiseptic use. The data were analysed through Pearson's χ2 test, Fisher's exact and ANOVA tests with significance levels set at 0·05.
Results: The demographic characteristics of the 74 children were not statistically different between groups. No between‐group differences in oropharyx colonization by Gram‐negative pathogens were identified (p = 0·316). Pathogens were isolated in the tracheal secretions of two (10·0%) children in the PG and four (19·0%) children in the IG (p = 0·355).
Conclusion: The use of chlorhexidine did not significantly influence the colonization of oropharyngeal and tracheal secretions by Gram‐negative pathogens of the studied sample.
Relevance to clinical practice: This study demonstrated no influence of a specific antiseptic agent on colonization profile of mechanically ventilated children in PICU. Further research in this field is necessary to promote evidence‐based nursing practice on oral care of critically ill children.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>22497915</pmid><doi>10.1111/j.1478-5153.2012.00494.x</doi><tpages>8</tpages></addata></record> |
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| ispartof | Nursing in critical care, 2012-05, Vol.17 (3), p.115-122 |
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| subjects | Administration, Oral Age Anti-Infective Agents, Local - administration & dosage Antiseptics Brazil Child Child, Preschool Children Chlorhexidine Chlorhexidine - administration & dosage Colonization Data processing Demography Double-Blind Method Female Gram-Negative Bacteria - growth & development Gram-Negative Bacteria - pathogenicity Gram-Negative Bacterial Infections - diagnosis Gram-Negative Bacterial Infections - drug therapy Hospitals Humans Immunoglobulins Infant Infection control Intensive care Intensive care units Intensive Care Units, Pediatric Length of Stay Male Microbial Sensitivity Tests Microorganisms Mouth - drug effects Mouth - microbiology Nursing Oral hygiene Oral Hygiene - methods Oropharynx Oropharynx - drug effects Oropharynx - microbiology Paediatric nursing Paediatrics Pathogens Pediatrics Pneumonia Pneumonia, Ventilator-Associated - prevention & control Secretions Trachea - drug effects Trachea - microbiology tracheostomy Translocation Ventilator-associated pneumonia |
| title | Oral care and oropharyngeal and tracheal colonization by Gram-negative pathogens in children |
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