Loading…
The association between oral bacteria, the cough reflex and pneumonia in patients with acute stroke and suspected dysphagia
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...
Saved in:
| Published in: | Journal of oral rehabilitation 2020-03, Vol.47 (3), p.386-394 |
|---|---|
| Main Authors: | , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c3573-e5f5101174a5db5fed15a9783f5d4cbb7134f012cd3850caec6f543ce78524703 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c3573-e5f5101174a5db5fed15a9783f5d4cbb7134f012cd3850caec6f543ce78524703 |
| container_end_page | 394 |
| container_issue | 3 |
| container_start_page | 386 |
| container_title | Journal of oral rehabilitation |
| container_volume | 47 |
| creator | Perry, Sarah E. Huckabee, Maggie‐Lee Tompkins, Geoffrey Milne, Trudy |
| description | 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 |
| doi_str_mv | 10.1111/joor.12903 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2313361256</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2313361256</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3573-e5f5101174a5db5fed15a9783f5d4cbb7134f012cd3850caec6f543ce78524703</originalsourceid><addsrcrecordid>eNp90UFP2zAUB3BrAo3CuOwDTJa4oIkwPztO0iOqGAMhVZo6iVvkOC_UXWpntqOu4stjWuCww97Fl5__enp_Qj4Du4Q031bO-UvgUyY-kAmIQma8yvkBmTDBZAYVfzgixyGsGGOVkOVHciSgmFYSxIQ8LZZIVQhOGxWNs7TBuEG01HnV00bpiN6oCxoT0258XFKPXY9_qbItHSyOa2eNosbSIf1HGwPdmLikSo8RaYje_cadDWMYMKW1tN2GYakejfpEDjvVBzx9fU_Ir-_Xi9mP7H5-czu7us902lZkKDsJDKDMlWwb2WELUk3LSnSyzXXTlCDyjgHXragk0wp10clcaCwryfOSiRNyvs8dvPszYoj12gSNfa8sujHUXIAQBXBZJHr2D1250du0XVKSTwtRlDKpr3ulvQshHaQevFkrv62B1S-V1C-V1LtKEv7yGjk2a2zf6VsHCcAebEyP2_9E1Xfz-c996DPe1Zey</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2352963675</pqid></control><display><type>article</type><title>The association between oral bacteria, the cough reflex and pneumonia in patients with acute stroke and suspected dysphagia</title><source>Wiley</source><creator>Perry, Sarah E. ; Huckabee, Maggie‐Lee ; Tompkins, Geoffrey ; Milne, Trudy</creator><creatorcontrib>Perry, Sarah E. ; Huckabee, Maggie‐Lee ; Tompkins, Geoffrey ; Milne, Trudy</creatorcontrib><description>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 < .001] and discharge [P < .001]. Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli are not typically found in healthy mouths, yet were detected in 22% of patients during hospitalisation. Combined bacterial levels measured at one month was associated with pneumonia (P = .004) but there was no relationship to cough sensitivity.
Conclusion
Acute stroke patients were at increased risk of colonisation from respiratory pathogens throughout their recovery. The presence of these pathogens in saliva at one month was associated with adverse respiratory events. Data support the development of protocols to explore risk factors and sequelae of microbiological changes in stroke.</description><identifier>ISSN: 0305-182X</identifier><identifier>EISSN: 1365-2842</identifier><identifier>DOI: 10.1111/joor.12903</identifier><identifier>PMID: 31698513</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>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</subject><ispartof>Journal of oral rehabilitation, 2020-03, Vol.47 (3), p.386-394</ispartof><rights>2019 John Wiley & Sons Ltd</rights><rights>2019 John Wiley & Sons Ltd.</rights><rights>Copyright © 2020 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3573-e5f5101174a5db5fed15a9783f5d4cbb7134f012cd3850caec6f543ce78524703</citedby><cites>FETCH-LOGICAL-c3573-e5f5101174a5db5fed15a9783f5d4cbb7134f012cd3850caec6f543ce78524703</cites><orcidid>0000-0003-4728-0911 ; 0000-0002-8586-8612</orcidid></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/31698513$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Perry, Sarah E.</creatorcontrib><creatorcontrib>Huckabee, Maggie‐Lee</creatorcontrib><creatorcontrib>Tompkins, Geoffrey</creatorcontrib><creatorcontrib>Milne, Trudy</creatorcontrib><title>The association between oral bacteria, the cough reflex and pneumonia in patients with acute stroke and suspected dysphagia</title><title>Journal of oral rehabilitation</title><addtitle>J Oral Rehabil</addtitle><description>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 < .001] and discharge [P < .001]. Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli are not typically found in healthy mouths, yet were detected in 22% of patients during hospitalisation. Combined bacterial levels measured at one month was associated with pneumonia (P = .004) but there was no relationship to cough sensitivity.
Conclusion
Acute stroke patients were at increased risk of colonisation from respiratory pathogens throughout their recovery. The presence of these pathogens in saliva at one month was associated with adverse respiratory events. Data support the development of protocols to explore risk factors and sequelae of microbiological changes in stroke.</description><subject>Aspiration Pneumonia</subject><subject>Bacteria</subject><subject>Complications</subject><subject>Cough</subject><subject>CVA</subject><subject>Deglutition Disorders</subject><subject>Dentistry</subject><subject>Dysphagia</subject><subject>Humans</subject><subject>Oral hygiene</subject><subject>Pathogens</subject><subject>Patients</subject><subject>Pneumonia</subject><subject>Pneumonia, Aspiration</subject><subject>qPCR</subject><subject>Reflex</subject><subject>Respiratory diseases</subject><subject>Risk factors</subject><subject>Saliva</subject><subject>Stroke</subject><issn>0305-182X</issn><issn>1365-2842</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp90UFP2zAUB3BrAo3CuOwDTJa4oIkwPztO0iOqGAMhVZo6iVvkOC_UXWpntqOu4stjWuCww97Fl5__enp_Qj4Du4Q031bO-UvgUyY-kAmIQma8yvkBmTDBZAYVfzgixyGsGGOVkOVHciSgmFYSxIQ8LZZIVQhOGxWNs7TBuEG01HnV00bpiN6oCxoT0258XFKPXY9_qbItHSyOa2eNosbSIf1HGwPdmLikSo8RaYje_cadDWMYMKW1tN2GYakejfpEDjvVBzx9fU_Ir-_Xi9mP7H5-czu7us902lZkKDsJDKDMlWwb2WELUk3LSnSyzXXTlCDyjgHXragk0wp10clcaCwryfOSiRNyvs8dvPszYoj12gSNfa8sujHUXIAQBXBZJHr2D1250du0XVKSTwtRlDKpr3ulvQshHaQevFkrv62B1S-V1C-V1LtKEv7yGjk2a2zf6VsHCcAebEyP2_9E1Xfz-c996DPe1Zey</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Perry, Sarah E.</creator><creator>Huckabee, Maggie‐Lee</creator><creator>Tompkins, Geoffrey</creator><creator>Milne, Trudy</creator><general>Wiley Subscription Services, Inc</general><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>7QP</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4728-0911</orcidid><orcidid>https://orcid.org/0000-0002-8586-8612</orcidid></search><sort><creationdate>202003</creationdate><title>The association between oral bacteria, the cough reflex and pneumonia in patients with acute stroke and suspected dysphagia</title><author>Perry, Sarah E. ; Huckabee, Maggie‐Lee ; Tompkins, Geoffrey ; Milne, Trudy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3573-e5f5101174a5db5fed15a9783f5d4cbb7134f012cd3850caec6f543ce78524703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aspiration Pneumonia</topic><topic>Bacteria</topic><topic>Complications</topic><topic>Cough</topic><topic>CVA</topic><topic>Deglutition Disorders</topic><topic>Dentistry</topic><topic>Dysphagia</topic><topic>Humans</topic><topic>Oral hygiene</topic><topic>Pathogens</topic><topic>Patients</topic><topic>Pneumonia</topic><topic>Pneumonia, Aspiration</topic><topic>qPCR</topic><topic>Reflex</topic><topic>Respiratory diseases</topic><topic>Risk factors</topic><topic>Saliva</topic><topic>Stroke</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Perry, Sarah E.</creatorcontrib><creatorcontrib>Huckabee, Maggie‐Lee</creatorcontrib><creatorcontrib>Tompkins, Geoffrey</creatorcontrib><creatorcontrib>Milne, Trudy</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of oral rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Perry, Sarah E.</au><au>Huckabee, Maggie‐Lee</au><au>Tompkins, Geoffrey</au><au>Milne, Trudy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The association between oral bacteria, the cough reflex and pneumonia in patients with acute stroke and suspected dysphagia</atitle><jtitle>Journal of oral rehabilitation</jtitle><addtitle>J Oral Rehabil</addtitle><date>2020-03</date><risdate>2020</risdate><volume>47</volume><issue>3</issue><spage>386</spage><epage>394</epage><pages>386-394</pages><issn>0305-182X</issn><eissn>1365-2842</eissn><abstract>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 < .001] and discharge [P < .001]. Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli are not typically found in healthy mouths, yet were detected in 22% of patients during hospitalisation. Combined bacterial levels measured at one month was associated with pneumonia (P = .004) but there was no relationship to cough sensitivity.
Conclusion
Acute stroke patients were at increased risk of colonisation from respiratory pathogens throughout their recovery. The presence of these pathogens in saliva at one month was associated with adverse respiratory events. Data support the development of protocols to explore risk factors and sequelae of microbiological changes in stroke.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31698513</pmid><doi>10.1111/joor.12903</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4728-0911</orcidid><orcidid>https://orcid.org/0000-0002-8586-8612</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0305-182X |
| ispartof | Journal of oral rehabilitation, 2020-03, Vol.47 (3), p.386-394 |
| issn | 0305-182X 1365-2842 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2313361256 |
| source | Wiley |
| 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 |
| title | The association between oral bacteria, the cough reflex and pneumonia in patients with acute stroke and suspected dysphagia |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-07T14%3A46%3A45IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20association%20between%20oral%20bacteria,%20the%20cough%20reflex%20and%20pneumonia%20in%20patients%20with%20acute%20stroke%20and%20suspected%20dysphagia&rft.jtitle=Journal%20of%20oral%20rehabilitation&rft.au=Perry,%20Sarah%20E.&rft.date=2020-03&rft.volume=47&rft.issue=3&rft.spage=386&rft.epage=394&rft.pages=386-394&rft.issn=0305-182X&rft.eissn=1365-2842&rft_id=info:doi/10.1111/joor.12903&rft_dat=%3Cproquest_cross%3E2313361256%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c3573-e5f5101174a5db5fed15a9783f5d4cbb7134f012cd3850caec6f543ce78524703%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2352963675&rft_id=info:pmid/31698513&rfr_iscdi=true |