Zhu H W, McMillan A S, McGrath C, Li L S W, Samaranayake L P
Oral Rehabilitation, Faculty of Dentistry, University of Hong Kong, and Department of Rehabilitation Medicine, Tung Wah Hospital, Sheung Wan, Hong Kong.
Oral Dis. 2008 Jan;14(1):60-6. doi: 10.1111/j.1601-0825.2006.01347.x.
To investigate prospectively the qualitative and quantitative changes in oral carriage of yeasts and coliforms in southern Chinese people suffering from stroke.
In 56 elderly people suffering from stroke in a rehabilitation unit of a general medical hospital in Hong Kong, oral microbiological sampling using a combined imprint culture, oral rinse approach and clinical assessment was made during the acute stroke phase, on hospital discharge and 6 months later.
The oral carriage of yeasts increased significantly during acute stroke (P<0.05), whereas coliform carriage did not. A reduction in oral carriage of yeasts was found on hospital discharge and 6 months later and in coliforms at the 6-month assessment (P<0.05). Candida albicans and Klebsiella pneumoniae were the predominant yeast and coliform respectively. Stroke-related difficulty in tooth brushing and denture wearing were associated with higher oral yeast carriage (P<0.05). We also report here for the first time that the use of aspirin was associated with lower oral yeast carriage in people suffering from stroke.
Oral yeast carriage was closely linked to the level of stroke-related functional disability that improved over time but had not totally resolved 6 months after hospital discharge. The oral reservoir of yeasts and coliforms in people suffering from stroke is noteworthy by care providers as K. pneumoniae may cause aspiration pneumonia.
前瞻性调查中国南方中风患者口腔中酵母菌和大肠菌群的定性和定量变化。
在香港一家综合医院康复科的56名老年中风患者中，在急性中风期、出院时和6个月后，采用联合印迹培养、口腔冲洗方法和临床评估进行口腔微生物采样。
急性中风期间酵母菌的口腔携带率显著增加（P<0.05），而大肠菌群携带率没有增加。出院时和6个月后酵母菌的口腔携带率降低，6个月评估时大肠菌群携带率降低（P<0.05）。白色念珠菌和肺炎克雷伯菌分别是主要的酵母菌和大肠菌群。中风相关的刷牙困难和佩戴假牙与较高的口腔酵母菌携带率相关（P<0.05）。我们还首次报告，阿司匹林的使用与中风患者较低的口腔酵母菌携带率相关。
口腔酵母菌携带率与中风相关功能残疾程度密切相关，随着时间推移有所改善，但出院6个月后仍未完全解决。护理人员应注意中风患者口腔中的酵母菌和大肠菌群，因为肺炎克雷伯菌可能导致吸入性肺炎。
