Pathogenic oral bacteria in hospitalised patients with dysphagia: The silent epidemic.
Merryl J Weimers, Mershen Pillay
PMID 34342488WHAT IT FOUND
In 40 hospitalised patients with dysphagia, 62.5% carried bacteria not normally found in the mouth and all had oral hygiene problems; worse swallowing scores were linked to more pathogenic bacteria.
Check oral care during dysphagia management.
Key findings
01Every participant had at least one oral hygiene problem, with a mean of 4.25, a median of 4 and a maximum of 7 issues.
02Only 15 participants had normal oral flora, while 62.5% had organisms that were not part of the resident oral flora.
03Lower MASA scores, indicating more severe dysphagia, were associated with an increased likelihood of pathogenic oral bacteria.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study included only 40 participants, selected by convenience and purposive sampling, so the findings may not represent all hospitalised patients with dysphagia. It was done in one private sub-acute rehabilitation hospital in South Africa, so patients with private medical aids may differ from patients in government facilities. The study was cross-sectional and measured oral hygiene and bacteria at one time point; it did not report pneumonia or other respiratory outcomes. Cervical auscultation and pulse oximetry were used only as adjuncts because, on their own, they provide contestable data about swallowing or respiratory function. The Oral Health Assessment Tool was adapted and rescored from the original, so its findings may not be directly comparable with studies using the original tool. Oral hygiene problems were often silent: 83% of participants had no signs of oral or dental pain and none reported pain verbally, so patients may not raise these issues themselves.
The easy way to misread this
Do not read this as proof that poor oral hygiene caused pneumonia or that oral care prevents it. The study described 40 patients at one time, did not report pneumonia outcomes, and used a small convenience sample from one private hospital.