Periodontopathogenic bacteria in subglottic samples from patients undergoing elective intubation for general anesthesia: A pilot study.

Autor: Morillo CMR; Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil., Saraiva L; Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil., Romito GA; Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil., Pannuti CM; Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil., Oliveira HP; Division of Anesthesiology, School of Medicine, University of São Paulo, São Paulo, Brazil., Peres MPSM; Dental Care Unity, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil., Carmona MJC; Division of Anesthesiology, School of Medicine, University of São Paulo, São Paulo, Brazil., Villar CC; Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Journal of periodontology [J Periodontol] 2021 Aug; Vol. 92 (8), pp. e94-e102. Date of Electronic Publication: 2021 Mar 06.
DOI: 10.1002/JPER.19-0570
Abstrakt: Background: Translocation of periodontal pathogens into the respiratory tract could either cause pneumonia or disrupt local defense mechanisms, predisposing the host to infection by respiratory pathogens. The objective of this pilot study was to evaluate the levels of periodontopathogenic bacteria in subglottic samples of intubated and mechanically ventilated patients and the impact of oral decontamination with chlorhexidine (CHX) on subglottic levels of these microorganisms.
Methods: Patients scheduled to undergo elective surgical procedures requiring endotracheal intubation and mechanical ventilation for at least 3 hours were included. Following full-mouth periodontal examination, patients were randomly assigned to groups that rinsed preoperatively with 0.12% CHX or 0.9% saline (control). After 3 hours of orotracheal intubation, subglottic contents were collected. Quantification of Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis), and Tannerella forsythia (T. forsythia) in subglottic samples was determined using quantitative real-time polymerase chain reaction. Data were analyzed by Fisher Exact Probability, unpaired Student's t and Mann-Whitney tests.
Results: Of the 69 patients included, 43 completed study participation. There were no differences between control and CHX groups in subglottic detection rates and abundance levels of P. gingivalis (P = 0.59), T. forsythia (P = 0.83) and A. actinomycetemcomitans (P = 0.07). Moreover, our data indicate that periodontal health has no impact on subglottic levels of P. gingivalis, T. forsythia, and A. actinomycetemcomitans.
Conclusions: Periodontal pathogens were detected in subglottic samples of intubated and mechanically ventilated patients. Moreover, a single CHX rinse prior to endotracheal intubation may have no effect on subglottic contamination by P. gingivalis, T. forsythia, and A. actinomycetemcomitans.
(© 2021 American Academy of Periodontology.)
Databáze: MEDLINE
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