Proton pump inhibitor medication is associated with colonisation of gut flora in the oropharynx.

Autor: Tranberg A; Division of Intensive and Perioperative Care, Skåne University Hospital, Lund, Sweden., Thorarinsdottir HR; Division of Intensive and Perioperative Care, Skåne University Hospital, Lund, Sweden., Holmberg A; Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden., Schött U; Division of Intensive and Perioperative Care, Skåne University Hospital, Lund, Sweden., Klarin B; Division of Intensive and Perioperative Care, Skåne University Hospital, Lund, Sweden.
Jazyk: angličtina
Zdroj: Acta anaesthesiologica Scandinavica [Acta Anaesthesiol Scand] 2018 Jul; Vol. 62 (6), pp. 791-800. Date of Electronic Publication: 2018 Mar 08.
DOI: 10.1111/aas.13094
Abstrakt: Background: The normal body exists in mutualistic balance with a large range of microbiota. The primary goal of this study was to establish whether there is an imbalance in the oropharyngeal flora early after hospital or ICU admittance, and whether flora differs between control, ward and critically ill patients. The secondary goal was to explore whether there are patient characteristics that can be associated with a disturbed oropharyngeal flora.
Methods: Oropharyngeal cultures were obtained from three different study groups: (1) controls from the community, (2) ward patients and (3) critically ill patients, the two latter within 24 h after admittance.
Results: Cultures were obtained from 487 individuals: 77 controls, 193 ward patients and 217 critically ill patients. Abnormal pharyngeal flora was more frequent in critically ill and ward patients compared with controls (62.2% and 10.4% vs. 1.3%, P < 0.001 and P = 0.010, respectively). Colonisation of gut flora in the oropharynx was more frequent in critically ill patients compared with ward patients or controls (26.3% vs. 4.7% and 1.3%, P < 0.001 and P < 0.001, respectively). Proton pump inhibitor medication was the strongest independent factor associated with the presence of gut flora in the oropharynx in both ward and critically ill patients (P = 0.030 and P = 0.044, respectively).
Conclusion: This study indicates that abnormal oropharyngeal flora is an early and frequent event in hospitalised patients and more so in the critically ill, compared to controls. Proton pump inhibitor medication is associated with colonisation of gut flora in the oropharynx.
(© 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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