title: Oral and endotracheal tubes colonization by periodontal bacteria: a case-control ICU study.
abstract: Periodontal infection is a possible risk factor for respiratory disorders; however, no studies have assessed the colonization of periodontal pathogens in endotracheal tubes (ET). This case-control study analyzed whether periodontal pathogens are able to colonize ET of dentate and edentulous patients in intensive care units (ICU) and whether oral and ET periodontal pathogen profiles have any correlation between these patients. We selected 18 dentate and 18 edentulous patients from 78 eligible ICU patients. Oral clinical examination including probing depth, clinical attachment level, gingival index , and plaque index was performed by a single examiner, followed by oral and ET sampling and processing by quantitative polymerase chain reaction (total bacterial load, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythia). Data were statistically analyzed by Mann-Whitney U, two-way analysis of variance (p < 0.05). Among dentate, there was no correlation between clinical parameters and ET bacterial levels. Both dentate and edentulous patients showed similar ET bacterial levels. Dentate patients showed no correlation between oral and ET bacterial levels, while edentulous patients showed positive correlations between oral and ET levels of A. actinomycetemcomitans, P. gingivalis, and T. forsythia. Periodontal pathogens can colonize ET and the oral cavity of ICU patients. Periodontal pathogen profiles tend to be similar between dentate and edentulous ICU patients. In ICU patients, oral cavity represents a source of ET contamination. Although accompanied by higher oral bacterial levels, teeth do not seem to influence ET bacterial profiles.
authors.affiliation: Dental School, University of Cuiaba, Avenida Beira Rio, Cuiabá, Mato Grosso, 78000, Brazil. aleporto@terra.com.br.
authors.forename: A N
authors.initials: AN
authors.lastname: Porto
authors.affiliation: Nucleus of Periodontal Research, Dental School, University of Taubate, São Paulo, Brazil.
authors.forename: S C
authors.initials: SC
authors.lastname: Cortelli
authors.affiliation: Dental School, University of Cuiaba, Avenida Beira Rio, Cuiabá, Mato Grosso, 78000, Brazil.
authors.forename: A H
authors.initials: AH
authors.lastname: Borges
authors.affiliation: Dental School, University of Cuiaba, Avenida Beira Rio, Cuiabá, Mato Grosso, 78000, Brazil.
authors.forename: F Z
authors.initials: FZ
authors.lastname: Matos
authors.affiliation: Nucleus of Periodontal Research, Dental School, University of Taubate, São Paulo, Brazil.
authors.forename: D R
authors.initials: DR
authors.lastname: Aquino
authors.affiliation: Nucleus of Periodontal Research, Dental School, University of Taubate, São Paulo, Brazil.
authors.forename: T B
authors.initials: TB
authors.lastname: Miranda
authors.affiliation: Periodontal Department, Dental School, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: F
authors.initials: F
authors.lastname: Oliveira Costa
authors.affiliation: Dental School, University of Cuiaba, Avenida Beira Rio, Cuiabá, Mato Grosso, 78000, Brazil.
authors.forename: A F
authors.initials: AF
authors.lastname: Aranha
authors.affiliation: Nucleus of Periodontal Research, Dental School, University of Taubate, São Paulo, Brazil.
authors.forename: J R
authors.initials: JR
authors.lastname: Cortelli
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D058491:Bacterial Load; D016022:Case-Control Studies; D003428:Cross Infection; D003430:Cross-Sectional Studies; D003774:Dental Plaque Index; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007440:Intubation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology*; D063868:Patient Outcome Assessment; D010512:Periodontal Index; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology / Q000382:microbiology; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000382:microbiology*; D018805:Sepsis / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult
references.citation: Circ J. 2014;78(4):950-4
references.pmid: 24500034
references.citation: Am J Med Sci. 1986 May;291(5):355-67
references.pmid: 3518453
references.citation: Respir Care. 2005 Jun;50(6):725-39; discussion 739-41
references.pmid: 15913465
references.citation: J Periodontol. 1996 Oct;67(10 Suppl):1114-22
references.pmid: 8910830
references.citation: Ann Periodontol. 1996 Nov;1(1):821-78
references.pmid: 9118282
references.citation: J Clin Microbiol. 2008 Apr;46(4):1322-9
references.pmid: 18287326
references.citation: Yonsei Med J. 2014 Jan;55(1):240-6
references.pmid: 24339313
references.citation: Curr Opin Infect Dis. 2007 Apr;20(2):190-7
references.pmid: 17496579
references.citation: J Hosp Infect. 2014 Jan;86(1):53-6
references.pmid: 24239244
references.citation: Clin Oral Investig. 2012 Dec;16(6):1589-97
references.pmid: 22246112
references.citation: Am J Crit Care. 2010 Mar;19(2):175-83
references.pmid: 20194614
references.citation: Oral Dis. 2007 Nov;13(6):508-12
references.pmid: 17944664
references.citation: Acta Clin Croat. 2014 Mar;53(1):72-8
references.pmid: 24974668
references.citation: Anaerobe. 2010 Jun;16(3):234-9
references.pmid: 20193770
references.citation: J Periodontol. 1999 Jul;70(7):793-802
references.pmid: 10440642
references.citation: Am J Crit Care. 2004 Jan;13(1):25-33; discussion 34
references.pmid: 14735645
references.citation: Acta Odontol Scand. 1964 Feb;22:121-35
references.pmid: 14158464
references.citation: Ann Periodontol. 1999 Dec;4(1):1-6
references.pmid: 10863370
references.citation: Scand J Caring Sci. 2016 Mar;30(1):129-34
references.pmid: 25962409
references.citation: J Bacteriol. 2010 Oct;192(19):5002-17
references.pmid: 20656903
references.citation: J Periodontol. 2015 Aug;86(8):984-94
references.pmid: 25811847
references.citation: Crit Care Med. 1991 Jun;19(6):763-9
references.pmid: 2055052
references.citation: J Med Life. 2013 Sep 15;6(3):244-8
references.pmid: 24155782
references.citation: J Microbiol Immunol Infect. 2010 Dec;43(6):491-7
references.pmid: 21195976
references.citation: Pediatr Infect Dis J. 2015 Jan;34(1):100-2
references.pmid: 25068288
references.citation: Crit Care Med. 1992 Jun;20(6):740-5
references.pmid: 1597025
references.citation: Ann Periodontol. 2003 Dec;8(1):54-69
references.pmid: 14971248
references.citation: J Prosthodont. 2008 Jul;17(5):348-56
references.pmid: 18355168