ArticlePloS one2015
Dental and microbiological risk factors for hospital-acquired pneumonia in non-ventilated older patients.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 4 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Quantification of Removable Prosthesis Plaque Area Coverage Among Adult Patients: A Systematic Review and Meta-Analysis.Clinical and experimental dental research · 2026Pooled it
- Definitions of hospital-acquired pneumonia in trauma research: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Pooled it
- Association between removable prosthesis-wearing and pneumonia: a systematic review and meta-analysis.BMC oral health · 2024Pooled it
- Predisposing Factors of Nosocomial Infections in Hospitalized Patients in the United Kingdom: Systematic Review.JMIR public health and surveillance · 2023Pooled it
- STRESS ULCER PROPHYLAXIS AS A RISK FACTOR FOR TRACHEAL COLONIZATION AND HOSPITAL-ACQUIRED PNEUMONIA IN INTENSIVE CARE PATIENTS: IMPACT ON LATENCY TIME FOR PNEUMONIA.Acta clinica Croatica · 2019Trial
- Oral Microbiome Changes During Hospitalization in Older Adults Not Receiving Mechanical Ventilation.American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2025Observational
- Probable Non-Ventilator-Associated Hospital-Acquired Pneumonia: A Case Report.Critical care nurse · 2024Article
- Impaired oral health: a required companion of bacterial aspiration pneumonia.Frontiers in rehabilitation sciences · 2024Review
- Oral health and the presence of infectious microorganisms in hospitalized patients: a preliminary observational study.Annals of medicine · 2022Observational
- Oral Microbes in Hospital-Acquired Pneumonia: Practice and Research Implications.Critical care nurse · 2022Review
- The role of the microbiota in the management of intensive care patients.Annals of intensive care · 2022Review
- Presence of non-oral bacteria in the oral cavity.Archives of microbiology · 2021Review
- Network meta-analysis from a pairwise meta-analysis design: to assess the comparative effectiveness of oral care interventions in preventing ventilator-associated pneumonia in critically ill patients.Clinical oral investigations · 2021Review
- [Pneumonia in old age].Der Pneumologe · 2021Review
- Suppressive effects of 2-methacryloyloxyethyl phosphorylcholine (MPC)-polymer on the adherence ofHeliyon · 2020Article
- Non-oral, aerobic, Gram-negative bacilli in the oral cavity of Thai HIV-positive patients on Highly-active anti-retrovirus therapy medication.Journal of investigative and clinical dentistry · 2019Article
- Differences in microbial etiology between hospital-acquired pneumonia and ventilator-associated pneumonia: a single-center retrospective study in Guang Zhou.Infection and drug resistance · 2019Article
- Complications and Pharmacologic Interventions of Invasive Positive Pressure Ventilation During Critical Illness.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2018Review
- Oropharyngeal Microbiota in Frail Older Patients Unaffected by Time in Hospital.Frontiers in cellular and infection microbiology · 2018Article
- Multisite Evaluation of Toothbrushes and Microbial Growth in the Hospital Setting.Clinical nurse specialist CNSObservational
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
methodsWe obtained a time series of tongue/throat swabs from 90 patients with lower limb fracture, aged 65-101 in a general hospital in the North East of England between April 2009-July 2010. We used novel real-time multiplex PCR assays to detect S. aureus, MRSA, E. coli, P. aeruginosa, S. pneumoniae, H. influenza and Acinetobacter spp. We collected data on dental/denture plaque (modified Quigley-Hein index) and outcomes of clinician-diagnosed HAP.
resultsThe crude incidence of HAP was 10% (n = 90), with mortality of 80% at 90 days post discharge. 50% of cases occurred within the first 25 days. HAP was not associated with being dentate, tooth number, or heavy dental/denture plaque. HAP was associated with prior oral carriage with E. coli/S. aureus/P.aeruginosa/MRSA (p = 0.002, OR 9.48 95% CI 2.28-38.78). The incidence of HAP in those with carriage was 35% (4% without), with relative risk 6.44 (95% CI 2.04-20.34, p = 0.002). HAP was associated with increased length of stay (Fishers exact test, p=0.01), with mean 30 excess days (range -11.5-115). Target organisms were first detected within 72 hours of admission in 90% participants, but HAP was significantly associated with S. aureus/MRSA/P. aeruginosa/E. coli being detected at days 5 (OR 4.39, 95%CI1.73-11.16) or 14 (OR 6.69, 95%CI 2.40-18.60).
conclusionsPatients with lower limb fracture who were colonised orally with E. coli/ S. aureus/MRSA/P. aeruginosa after 5 days in hospital were at significantly greater risk of HAP (p = 0.002).
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