Oral Rehabilitation 4/F, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong.
Am J Infect Control. 2013 Feb;41(2):149-54. doi: 10.1016/j.ajic.2012.02.020. Epub 2012 Jul 17.
Despite the role of the oral cavity as a reservoir of opportunistic pathogens for infection in patients following stroke, the evaluation of the effects of oral hygiene interventions has been largely neglected.
This randomized clinical trial included 102 patients undergoing hospital-based rehabilitation for stroke. Patients were randomized to one of 3 groups: oral hygiene instruction (OHI) only; OHI and 0.2% chlorhexidine mouth rinse twice daily; or OHI, 0.2% chlorhexidine mouth rinse twice daily, and assisted brushing twice weekly. Oral samples were obtained at baseline and after 3 weeks for detection of Staphylococcus aureus, aerobic and facultatively anaerobic gram-negative bacilli, and yeasts.
Almost three-quarters (72.8%) of the patients harbored oral anaerobic gram-negative bacilli at baseline, and more than half had detectable S aureus (56.8%) and yeasts (59.3%). Percentage frequencies and viable counts of pathogens remained relatively stable during the course of the clinical trial, and no significant differences were observed among the 3 patient groups.
In our study cohort, there was no significant difference in the effectiveness of the 3 different oral hygiene interventions on the prevalence or viable counts of oral opportunistic pathogens.
尽管口腔是中风患者感染机会致病菌的储存库，但对口腔卫生干预措施的效果评估在很大程度上被忽视了。
本随机临床试验纳入了 102 名正在接受住院康复治疗的中风患者。患者被随机分为 3 组：仅接受口腔卫生指导（OHI）；每天接受 OHI 和 0.2%洗必泰含漱液 2 次；或 OHI、0.2%洗必泰含漱液 2 次和每周辅助刷牙 2 次。在基线和 3 周后采集口腔样本，用于检测金黄色葡萄球菌、需氧和兼性厌氧革兰氏阴性杆菌和酵母菌。
近四分之三（72.8%）的患者在基线时携带口腔厌氧革兰氏阴性杆菌，超过一半的患者可检测到金黄色葡萄球菌（56.8%）和酵母菌（59.3%）。在临床试验过程中，病原体的百分比频率和活菌计数相对稳定，3 组患者之间没有观察到显著差异。
在我们的研究队列中，3 种不同口腔卫生干预措施对口腔机会致病菌的流行率或活菌计数的有效性没有显著差异。
