Oral Microbes in Hospital-Acquired Pneumonia: Practice and Research Implications.
Kimberly Paige Rathbun, Annette M Bourgault, Mary Lou Sole
PMID 35640896WHAT IT FOUND
Hospitalized adults with pneumonia commonly had oral microbes such as Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli.
Nurses should provide consistent oral care and hand hygiene, but no single oral care regimen was identified for all patients.
Key findings
01In non-ventilated hospital-acquired pneumonia, oral colonization with gram-positive and gram-negative bacteria was similar, and combined oropharyngeal colonization with Escherichia coli, Pseudomonas aeruginosa, MRSA and Staphylococcus aureus was reported with an odds ratio of 9.48 for developing pneumonia.
02In ventilator-associated pneumonia, oral colonization was more often gram-negative than gram-positive, and common organisms included Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa, MRSA and Staphylococcus aureus.
03Oral care was described as preventive for hospital-acquired pneumonia, but the review did not identify a single oral care standard effective for all hospitalized patients.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only 10 articles, and most were nonexperimental or descriptive, so it cannot show that oral care changed pneumonia outcomes. Many included studies were more than 5 years ago, and most focused on ventilator-associated pneumonia, so current non-ventilated pneumonia patterns may differ. Several studies had small sample sizes, and one study was specific to chronic periodontitis, limiting generalizability. The review did not include recent oral care research for intubated patients because that was not its focus.
The easy way to misread this
Do not read this as proof that a specific oral care product prevents pneumonia in every hospitalized patient. The review found associations between oral microbes and pneumonia, and it did not isolate a standard oral care regimen. Chlorhexidine findings were mixed.