ArticleAntimicrobial resistance and infection control2023
Impact of tooth brushing on oral bacteriota and health care-associated infections among ventilated COVID-19 patients: an intervention study.
Article in Antimicrobial resistance and infection control, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 16 citations in OpenAlex.
- The effect of artificial saliva on the control of dry mouth: a semi-experimental study on COVID-19 patients under Non-invasive mechanical ventilation.BMC oral health · 2024Trial
- Integrating gut‑brain axis insights into bundled nutrition care for critically ill patients: From mechanisms to implementation (Review).Molecular medicine reports · 2026Review
- Effect of Antiseptic Mouthwash/Gargling Solutions on SARS-CoV-2 Viral Load: A Randomized Clinical Trial.medRxiv : the preprint server for health sciences · 2026Article
- Effectiveness of toothbrushing as a replacement for chlorhexidine in oral care, combined with head elevation for the prevention of ventilator-associated pneumonia in intensive care units: interrupted time-series analysis.Critical care (London, England) · 2026Article
- Evaluation of the Efficacy of UV-C Radiation in EliminatingMicroorganisms · 2025Article
- Association between toothbrushing behavior and cardiometabolic multimorbidity among middle aged and older adults in North China: a cross-section study.BMC oral health · 2024Article
- Oral Myco- and Bacteriobiota and Yeast Infections in Mechanically Ventilated COVID-19 Patients.Microorganisms · 2023Article
- Correction: Impact of tooth brushing on oral bacteriota and health care-associated infections among ventilated COVID-19 patients: an intervention study.Antimicrobial resistance and infection control · 2023Article
- Effect of oral care protocol with versus without chlorhexidine on mortality of mechanically ventilated patients: Prospective randomized controlled trial.Journal of anaesthesiology, clinical pharmacologyArticle
Corrections and comments
- Erratum issued
Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUp to 48% of ventilated coronavirus disease 2019 (COVID-19) patients develop ventilator-associated pneumonia (VAP) during hospitalization in an ICU. Dysbiotic oral microbiota can colonize the lower respiratory tract and lead to VAP. It is recommended to introduce oral care strategies in the ICU to prevent VAP. In this study, we observed the impact of an oral hygienic protocol with tooth brushing on cultivable oral bacteriota, the incidence of HAI and patient safety among mechanically ventilated COVID-19 patients in an ICU setting.
methodsIn this prospective cohort study, we recruited 56 adult COVID-19 patients who qualified for mechanical ventilation. Patients were divided into 2 groups depending on the oral care procedure: standard and extended oral procedures with tooth brushing. Oral bacteriota samples were taken first within 36 h and after 7 days of intubation. Microorganisms were identified by MALDI/TOF mass spectrometry. bacterial health care-associated infection (HAI) cases were retrospectively analyzed by etiology. A PFGE study was performed for Klebsiella pneumoniae to check for clonal spreading of strains from oral bacteriota samples and HAI cases.
resultsWe observed significant dysbiosis and a decrease in cultivable oral bacteriota diversity, with a high frequency of potentially pathogenic species, including Acinetobacter baumannii and K. pneumoniae. The HAI incidence rate was high (55.2/1000 patient-days), most commonly of K. pneumoniae and A. baumannii etiologies, which correlated with the presence of A. baumannii and K. pneumoniae in the oral samples. Strains isolated from VAP cases were the same as oral isolates in 8 cases. The procedure with tooth brushing led to less frequent identification of A. baumannii in oral samples (55.6% vs. 5.3%, p = 0.001); however, it did not decrease the incidence of HAIs.
conclusionsDysbiotic oral bacteriota is an important source of respiratory pathogens. The introduction of tooth brushing in oral hygiene protocols in an ICU setting was effective in decreasing the extent of oral bacteriota dysbiosis; however, it did not reduce the risk of HAIs or mortality.
trial registration1072.6120.333.2020.
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