The University of Canterbury Rose Centre for Stroke Recovery & Research at St George's Medical Centre, Christchurch, New Zealand.
University of Canterbury, Christchurch, New Zealand.
J Oral Rehabil. 2020 Mar;47(3):386-394. doi: 10.1111/joor.12903. Epub 2019 Dec 2.
To establish how oral bacteria are related to cough sensitivity and pneumonia in a clinical stroke population.
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.
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.
Relative levels of bacteria were lowest at admission to hospital (6.04 × 10 ). There was a slight (non-significant) increase in bacterial levels at discharge (1.69 × 10 , P = .73). By one month, bacterial levels had significantly increased (9.17 × 10 ) 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.
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.
在临床脑卒中人群中，确定口腔细菌与咳嗽敏感性和肺炎之间的关系。
由于有效口腔卫生的突然中断，脑卒中患者有被呼吸道病原体定植的风险。当与咳嗽反射敏感性降低以及被污染的口咽内容物的吸入相结合时，可能会导致肺炎。口腔细菌、咳嗽敏感性和肺炎之间的关系尚未建立。
共有 102 名急性脑卒中患者在入院、出院和一个月时接受唾液采样和咳嗽反射测试。qPCR 检测比较了唾液中细菌的水平。记录肺炎事件。
细菌的相对水平在入院时最低（6.04×10 ）。出院时细菌水平略有（无统计学意义）升高（1.69×10 ，P=.73）。一个月时，细菌水平与入院时相比显著升高（9.17×10 ）[P<0.001]和出院时相比显著升高（9.17×10 ）[P<0.001]。铜绿假单胞菌、肺炎克雷伯菌和大肠杆菌通常不会在健康口腔中发现，但在住院期间 22%的患者中检测到。一个月时测量的综合细菌水平与肺炎有关（P=0.004），但与咳嗽敏感性无关。
急性脑卒中患者在整个恢复期都有来自呼吸道病原体定植的风险增加。这些病原体在一个月时唾液中的存在与不良的呼吸事件有关。数据支持制定方案，以探索中风患者微生物变化的危险因素和后果。
