title: Relationship between oral bacteria count and pneumonia onset in elderly nursing home residents.
abstract: OBJECTIVE
  Oral bacteria, which are a source of infection for aspiration pneumonia, were examined in frail older adults with the aim of establishing a standard bacteria count that indicates the risk of pneumonia onset in this group.
  
  
  METHODS
  A survey of bacteria count in the saliva using a simple instrument for measurement of the number of oral bacteria, along with factors including swallowing function and nutritional status, was carried out in 691 elderly individuals requiring care (137 men; mean age 82.6 ± 8.3 years; 554 women; mean age 88.0 ± 7.1 years; total mean age 86.7 ± 7.8 years) at 16 nursing homes in Japan. All participants gave their consent for inclusion in the present study. During a 6-month follow-up period, participants who developed pneumonia were identified, and relationships between the factors measured at the start of the period and pneumonia onset were examined.
  
  
  RESULTS
  During the 6-month follow-up period, 33 participants (4.8%; 5 men, 28 women; mean age 88.3 ± 7.4 years) developed pneumonia. Pneumonia onset was significantly associated with reduced activities of daily living, swallowing dysfunction and undernourishment. Logistic regression analysis identified a saliva bacteria count of 10(8.5)  colony-forming units/mL as an independent explanatory factor for pneumonia onset (P = 0.012, RR = 3.759).
  
  
  CONCLUSIONS
  Oral bacteria count of 10(8.5)  colony-forming units/mL saliva in an elderly person requiring care was identified as a risk factor for pneumonia onset.
authors.affiliation: Division of Clinical Oral Rehabilitation, The Nippon Dental University Graduate School of Life Dentistry at Tokyo, Japan; Division of Rehabilitation for Speech and Swallowing Disorders, Nippon Dental University Tama Oral Rehabilitation Clinic, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kikutani
authors.forename: Fumiyo
authors.initials: F
authors.lastname: Tamura
authors.forename: Haruki
authors.initials: H
authors.lastname: Tashiro
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Yoshida
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Konishi
authors.forename: Ryo
authors.initials: R
authors.lastname: Hamada
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D058491:Bacterial Load; D015331:Cohort Studies; D005260:Female; D016330:Frail Elderly; D006801:Humans; D007564:Japan; D008297:Male; D009055:Mouth / Q000382:microbiology*; D009735:Nursing Homes; D009752:Nutritional Status; D011015:Pneumonia, Aspiration / Q000453:epidemiology* / Q000382:microbiology*; D012307:Risk Factors; D012463:Saliva / Q000382:microbiology
keywords: aspiration pneumonia; oral bacteria count; oral health care