The association between oral bacteria, the cough reflex and pneumonia in patients with acute stroke and suspected dysphagia

• Published in: Journal of oral rehabilitation 2020-03, Vol.47 (3), p.386-394
• Main Authors: Perry, Sarah E., Huckabee, Maggie‐Lee, Tompkins, Geoffrey, Milne, Trudy
• Format: Article
• Language: English
• Subjects: Aspiration Pneumonia; Bacteria; Complications; Cough; CVA; Deglutition Disorders; Dentistry; Dysphagia; Humans; Oral hygiene; Pathogens; Patients; Pneumonia; Pneumonia, Aspiration; qPCR; Reflex; Respiratory diseases; Risk factors; Saliva; Stroke
• ISSN: 0305-182X; 1365-2842
• DOI: 10.1111/joor.12903

Objective To establish how oral bacteria are related to cough sensitivity and pneumonia in a clinical stroke population. Background Stroke patients are at risk of colonisation by respiratory pathogens due, in part, to sudden discontinuation of effective oral hygiene. When combined with reduced cough reflex sensitivity, aspiration of contaminated oropharyngeal contents and can lead to pneumonia. Relationships between oral bacteria, cough sensitivity and pneumonia have not been established. Materials and methods A total of 102 patients with acute stroke underwent saliva sampling and cough reflex testing at admission to hospital, discharge and one month. A qPCR assay compared levels of bacteria in saliva. Pneumonia events were recorded. Results Relative levels of bacteria were lowest at admission to hospital (6.04 × 10−6). There was a slight (non‐significant) increase in bacterial levels at discharge (1.69 × 10−2, P = .73). By one month, bacterial levels had significantly increased (9.17 × 10−2) relative to admission [P