Pseudomonas aeruginosa and the oropharyngeal ecosystem of tube-fed patients.
We evaluated whether elderly patients fed with nasogastric tubes (NGT) are predisposed to Pseudomonas aeruginosa colonization in the oropharynx. Fifty-three patients on NGT feeding and 50 orally fed controls with similar clinical characteristics were studied. The tongue dorsum was swabbed and cultured. P. aeruginosa was isolated in 18 (34%) of the NGT-fed group but in no controls (p<0.001). Other gram-negative bacteria were cultured from 34 (64%) of NGT-fed patients as compared with 4 (8%) of controls (p<0.001). Antibiotic susceptibility of the oropharyngeal P. aeruginosa isolates was compared with that of isolates from sputum cultures obtained from our hospital's bacteriologic laboratory. The oropharyngeal isolates showed a higher rate of resistance; differences were significant for amikacin (p<0.03). Scanning electron microscope studies showed a biofilm containing P. aeruginosa organisms. The pulsed-field gel electrophoresis profile of these organisms was similar to that of P. aeruginosa isolates from the oropharynx. NGT-fed patients may serve as vectors of resistant P. aeruginosa strains.
Leibovitz
Arthur
A
Tel-Aviv University, Israel. shmuelh@netvision.net.il
Dan
Michael
M
Zinger
Jonathan
J
Carmeli
Yehuda
Y
Habot
Beni
B
Segal
Rephael
R
D000368:Aged; D000369:Aged, 80 and over; D018441:Biofilms; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D016521:Electrophoresis, Gel, Pulsed-Field; D004750:Enteral Nutrition / Q000009:adverse effects*; D006801:Humans; D007441:Intubation, Gastrointestinal; D008134:Long-Term Care; D009960:Oropharynx / Q000382:microbiology*; D011446:Prospective Studies; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*