Imakiire Akira, Soutome Sakiko, Miura Kei-Ichiro, Ito Nanako, Higaki Mirai, Obayashi Fumitaka, Koizumi Koichi, Yanamoto Souichi, Yamada Tomohiro, Umeda Masahiro
Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JPN.
Department of Oral and Maxillofacial Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JPN.
Cureus. 2024 Oct 23;16(10):e72240. doi: 10.7759/cureus.72240. eCollection 2024 Oct.
One of the causes of ventilator-associated pneumonia (VAP) is the aspiration of fluid-containing pathogenic bacteria into the lower respiratory tract. The purpose of this study was to determine whether oral povidone-iodine (PV-I) application reduces bacterial counts in the fluid on the cuff of an endotracheal intubation tube. Patients intubated and managed with tracheostomy for oral cancer surgery were divided into two groups. The PV-I group received a single topical application of PV-I in the oral cavity. The brushing group underwent tooth brushing with suction and cleaning. Before the intervention, and at one, two, three, and six hours after intervention, samples were taken from the mouth and the cuff to determine viable bacterial counts using the delayed real-time polymerase chain reaction method, which quantifies only viable bacteria. Seven patients in the PV-I group and six in the brushing group were included in the study. The brushing group showed an increase in bacterial counts in both the oral cavity and on the cuff up to six hours post intervention. In contrast, the PV-I group showed significantly lower bacterial counts from one to six hours post intervention, both in the oral cavity and on the cuff. These results indicate that topical PV-I application reduces the number of bacteria entering the lower respiratory tract and may help prevent VAP.
呼吸机相关性肺炎（VAP）的病因之一是含有致病细菌的液体误吸至下呼吸道。本研究的目的是确定口腔应用聚维酮碘（PV-I）是否能减少气管内插管套囊上液体中的细菌数量。接受口腔癌手术并进行气管切开插管管理的患者被分为两组。PV-I组在口腔局部应用一次PV-I。刷牙组进行带吸引和清洁的刷牙操作。在干预前以及干预后1小时、2小时、3小时和6小时，从口腔和套囊采集样本，使用仅对活菌进行定量的延迟实时聚合酶链反应方法测定活菌数量。PV-I组7例患者和刷牙组6例患者纳入研究。刷牙组在干预后6小时内口腔和套囊上的细菌数量均增加。相比之下，PV-I组在干预后1至6小时口腔和套囊上的细菌数量均显著降低。这些结果表明，局部应用PV-I可减少进入下呼吸道的细菌数量，可能有助于预防VAP。
