title: Acute stroke predisposes to oral gram-negative bacilli -- a cause of aspiration pneumonia?
abstract: OBJECTIVE
  To assess any change in the oral flora in the mouths of stroke patients during the acute and rehabilitation phases and to determine whether this is related to episodes of aspiration pneumonia and clinical outcome.
  
  
  METHODS
  This observational study was carried out in hospital wards in a University teaching hospital. The subjects were patients immediately post-stroke and during the rehabilitation period, acute admissions and a group of healthy volunteers. An assessment of dentition and swallow in the presence or absence of oral aerobic gram-negative bacilli (AGNB) was correlated.
  
  
  RESULTS
  Of the acute stroke patients 52% had an unsafe swallow. AGNB carriage was documented in 34% of the acute stroke group. Of the 11 patients who died 55% had AGNB, 73% had an unsafe swallow and 36% had a combination of both.
  
  
  CONCLUSIONS
  AGNB is a common finding in acute stroke patients. It is not a consequence of age or acute hospitalisation and is associated with an unsafe swallow and a higher mortality.
authors.affiliation: Department of Dental Sciences, University of Liverpool, UK.
authors.forename: B
authors.initials: B
authors.lastname: Millns
authors.forename: M
authors.initials: M
authors.lastname: Gosney
authors.forename: C I A
authors.initials: CI
authors.lastname: Jack
authors.forename: M V
authors.initials: MV
authors.lastname: Martin
authors.forename: A E
authors.initials: AE
authors.lastname: Wright
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000209:etiology*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology; D017063:Outcome Assessment, Health Care; D011015:Pneumonia, Aspiration / Q000382:microbiology*; D011446:Prospective Studies; D013280:Stomatitis / Q000382:microbiology*; D020521:Stroke / Q000150:complications*