机械通气成人的口腔护理与菌血症风险。
Oral care and bacteremia risk in mechanically ventilated adults.
机构信息
University of Texas Health Science Center at Houston School of Nursing, Houston, Texas 77030, USA.
出版信息
Heart Lung. 2010 Nov-Dec;39(6 Suppl):S57-65. doi: 10.1016/j.hrtlng.2010.04.009. Epub 2010 Jul 3.
OBJECTIVE
Transient bacteremia occurs in healthy populations from toothbrushing. With the high incidence of bacteremia in the intensive care unit and toothbrushing as an oral care method, this study examined the incidence and clinical significance of transient bacteremia from toothbrushing in mechanically ventilated adults.
METHODS
Prospective pre- and post-test with all subjects (N = 30) receiving a toothbrushing intervention twice per day (up to 48 hours). The planned microbial analysis used DNA typing to identify organisms from oral and blood cultures collected immediately before, 1 minute, and 30 minutes after the interventions.
RESULTS
Seventeen percent of subjects had oral cultures that were positive for selected pathogens before the first toothbrushing intervention. None of the subjects had evidence of transient bacteremia by positive quantitative blood cultures before or after the toothbrushing interventions. Patient characteristics were not statistically significant predictors for systemic inflammatory response syndrome, length of hospital stay, or length of intubation.
CONCLUSION
The toothbrushing intervention did not induce transient bacteremia in this patient population.
目的
健康人群在刷牙时会发生一过性菌血症。重症监护病房菌血症的发病率较高，而刷牙是一种口腔护理方法，因此本研究检测了机械通气成人刷牙引起的一过性菌血症的发生率和临床意义。
方法
对所有受试者（N=30）进行前瞻性预-后测试，每天接受两次刷牙干预（最长 48 小时）。计划的微生物分析使用 DNA 分型技术，从干预前、干预后 1 分钟和 30 分钟采集的口腔和血液培养物中鉴定出微生物。
结果
17%的受试者在第一次刷牙干预前口腔培养物中就有选定的病原体呈阳性。在刷牙干预前后，没有受试者的定量血培养阳性提示有一过性菌血症。患者特征在统计学上不是全身炎症反应综合征、住院时间或插管时间的显著预测因素。
结论
在本患者人群中，刷牙干预并未引起一过性菌血症。
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