Evidence map›Paper›PMID 41634618›Full record

Trial reportBMC infectious diseases2026

Effect of probiotic colonization on oral hygiene and ventilator-associated pneumonia in ICU patients: a triple-blind randomized controlled trial.

Ahmad Salehi, Farzad Ebrahimzadeh, Ali Behzadfar, Maryam Hashemi, Sajad Yarahmadi

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ahmad SalehiStudent Research Committee, School of Nursing and Midwifery, USERN Office, Lorestan University of Medical Sciences, Khorramabad, Iran.
Farzad EbrahimzadehNutritional Health Research Center, Department of Biostatistics and Epidemiology, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran.
Ali BehzadfarAnesthesiology Research Center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Maryam HashemiNutritional Health Research Center, Shohadaye Ashayer Hospital, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
Sajad YarahmadiSocial Determinants of Health Research Center, Shahid Madani Hospital, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran. s.yarahmadi000@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMechanically ventilated patients are highly susceptible to poor oral hygiene and ventilator-associated pneumonia, mainly due to pathogenic bacterial colonization in the oral cavity. While antiseptic mouthwashes are commonly used, they may disrupt natural oral microbiota. Probiotics offer a potential alternative by promoting beneficial microbial colonization, enhancing oral hygiene, and reducing the risk of infection. This study aimed to evaluate the effect of probiotic colonization on oral hygiene and the incidence of ventilator-associated pneumonia in mechanically ventilated patients.

methodsThis triple-blind randomized controlled trial was conducted in the intensive care units (ICUs) of Shohada-ye Ashayer Hospital, Khorramabad, Iran. Eighty mechanically ventilated patients admitted to the ICU were randomly assigned to either an intervention or a control group using a simple randomization method. The intervention group received two daily doses of 250 mg of Streptococcus salivarius probiotic solution, administered orally for five consecutive days, while the control group received a placebo. Data collection tools included a demographic and clinical characteristics questionnaire, the Beck Oral Assessment Scale, and the Clinical Pulmonary Infection Score. Assessments were performed at baseline and on day six after the intervention. Data were analyzed using SPSS version 26, employing generalized linear models for comparative analysis of outcomes.

resultsBaseline demographic and clinical characteristics were comparable (p > 0.05), except for a lower Glasgow coma scale in the intervention arm (5.5 ± 1.3 vs. 6.4 ± 1.3, p = 0.003), which was adjusted for in subsequent analyses. Oral health status significantly improved in the intervention group compared with deterioration in controls (−1.82 ± 1.57 vs. +1.03 ± 1.66; adjusted F = 55.75, p < 0.001). Likewise, the clinical pulmonary infection score decreased in the intervention group but increased in the control group (−0.67 ± 1.29 vs. +1.35 ± 1.58; adjusted F = 30.27, p < 0.001). The proportion of patients at moderate to high risk of developing ventilator-associated pneumonia increased in the control group from 45% to 70%, whereas it decreased in the intervention group from 60% to 50%.

conclusionThe findings of this randomized trial show that the use of Streptococcus salivarius was associated with improvement in oral hygiene scores and reduction in Clinical Pulmonary Infection Score values among mechanically ventilated ICU patients. These outcomes indicate that probiotic-based oral care may help enhance oral health and reduce the estimated risk of ventilator-associated pneumonia. Further research with broader samples can clarify the clinical impact of this approach.

trial registrationThe trial was registered in the Iranian Registry of Clinical Trials (IRCT20241019063429N1) in 2024-11-27.

Indexed as

Oral HygienePneumonia, Ventilator-AssociatedProbioticsAdultAgedFemaleHumansIntensive Care UnitsIranMaleMiddle AgedRespiration, ArtificialStreptococcus salivariusInfection preventionIntensive careOral hygieneProbioticsStreptococcus salivariusVentilator-associated pneumonia

Identifiers

PMID41634618
PMCPMC12958620

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.