Oral Condition and Oral Care of Patients with Aspiration Pneumonia and Microorganisms Detected in the Mouth and Sputum

Abstract

The oral condition, oral care, and microorganisms detected in the mouth and sputum were investigated in 9 patients with aspiration pneumonia (mean age 77 years) admitted to an acute care hospital. Seven patients had a past history of aspiration pneumonia. Coated tongue and dry mouth were noted in about half of the patients on admission and their oral conditions tended to be better on discharge. During admission, poor oral hygiene of these patients was noted since oral care was provided to most patients only once a day. Samples were collected from the oral cavity and sputum using an opportunistic microorganism test kit (BML) on admission, at 3 to 5 days after admission, and at discharge. Microorganisms detected in the mouth and/or sputum were: Candida spp. In 4 patients, MRSA in 3 patients, Serratia marcescens in 3 patients, Pseudomonas aeruginosa in 2 patients, and Klebsiella pneumoniae in 2 patients on admission; MRSA in 5 patients, Candida spp. In 2 patients, P. aeruginosa in 1 patient, K. Pneumoniae in 1 patient, and S. marcescens in 1 patient at 3 to 5 days after admission; and MRSA in 4 patients, P. aeruginosa in 2 patients, K. Pneumoniae in 2 patients, Candida spp. In 2 patients, and MSSA in 1 patient at discharge. MRSA was the most frequently detected organism, and the detection frequency increased from 3 patients on admission, to 5 patients at 3 to 5 days after admission, and 4 patients at discharge, suggesting hospital infection. Other microorganisms were detected in 6 patients at discharge, and most patients had a past history of aspiration pneumonia, suggesting the importance of more active intervention in oral care to avoid the recurrence of aspiration pneumonia. In addition, it is important to ensure adequate implementation of recommended infection control measures between acute care hospitals, long-term care facilities, and home care (regional medical liaison on infection control) to prevent the spread of antibiotic-resistant microorganisms. © 2008, Japanese Society for Infection Prevention and Control. All rights reserved.