Stan jamy ustnej u pacjentów oddziału intensywnej terapii – doniesienie wstępne

Agnieszka Droździk¹, Zbigniew Hamerlak², Barbara Galińska¹, Jadwiga Banach¹

Summary
Background. Sepsis and ventilator-associated pneumonia (VAP) are the most common infections in intensive care patients. In recent years it has become evident that oropharyngeal colonisation with Gram-negative bacteria may play an important role in the development of VAP and sepsis. The aim of the study was to assess the oral mucosal status and frequency of anaerobic oropharyngeal colonisation in 50 ICU patients in whom the oral cavity was cleaned four times a day with a 3% hydrogen peroxidate and 10% lactic acid mixture. Methods. All patients were assessed by a dental surgeon and rated according to the 4-degree WHO scale for stomatitis. Cultures were taken from the mucosa and the patients were allocated to four groups: A+ - with anaerobic colonisation, A- - anaerobic free, C+ - with stomatitis, C- without stomatitis. Results. 30% of patients were colonised by anaerobic bacteria (Prevotella sp., Actinomyces odontolyticus and Lactobacillus acidophilus). 87% of the colonised patients were intubated and 47% suffered from periodontitis. Stomatitis was found in 42% of all patients, and unsatisfactory dental status was found in 66% of patients with stomatitis. Conclusions. Anaerobic colonisation is more frequent in patients with periodontitis and can attribute to the development of VAP, when left untreated.

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