title: Antimicrobial effects of chlorhexidine, matrica drop mouthwash (chamomile extract), and normal saline on hospitalized patients with endotracheal tubes.
abstract: BACKGROUND
  The functions and use of mouthwashes are variable depending on their type. Oral care in patients with endotracheal tubes is important to prevent side effects such as pneumonia. The aim of this study was to determine the antimicrobial effects of chlorhexidine, drop of Matrica mouthwash (chamomile extract), and normal saline on hospitalized patients with endotracheal tube in an intensive care unit (ICU).
  
  
  METHODS
  In this clinical trial, 39 patients admitted to the ICU were selected by convenience sampling, were matched based on age and sex, and randomly assigned to three groups (chlorhexidine, Matrica, saline). Mouth washing was performed every 8 to 48 hours. The samples were taken at time zero (before the intervention) and 48 hours after the intervention for bacterial culture. Antibacterial activity of each mouthwash on microorganisms was measured based on the growth ofStaphylococcus aureus,Pneumococcal,Enterococcus,Pseudomonas, andEscherichia coli. The obtained data were then analyzed using Chi-square and Fisher's exact tests with the Statistical Package for the Social Sciences Package version 18.
  
  
  RESULTS
  Chlorhexidine mouthwash was more effective in preventing colonization of bacteria in the mouth (point probability = 0.06) in comparison with chamomile and saline mouthwashes. Nevertheless, none of the tested mouthwashes were able to remove pathogens, includingStaphylococcus aureus,Pseudomonas,Klebsiella, andAcinetobacter.
  
  
  CONCLUSIONS
  0.2% chlorhexidine mouthwash has a significant effect on the bacterial colonization rate in comparison with Matrica and normal saline mouthwashes in ICU hospitalized patients with endotracheal tube.
authors.affiliation: Department of Nursing, School of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Azimi
authors.affiliation: Nursing Research Centre, Golestan University of Medical Sciences, Gorgan, Iran.
authors.forename: Leila
authors.initials: L
authors.lastname: Jouybari
authors.affiliation: Department of Anesthesiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Moghadam
authors.affiliation: Department of Microbiology, Golestan University of Medical Sciences, Gorgan, Iran.
authors.forename: Ezatolah
authors.initials: E
authors.lastname: Ghaemi
authors.affiliation: Department of Biostatistics, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran.
authors.forename: Naser
authors.initials: N
authors.lastname: Behnampoor
authors.affiliation: Nursing Research Centre, Golestan University of Medical Sciences, Gorgan, Iran.
authors.forename: Akram
authors.initials: A
authors.lastname: Sanagoo
authors.affiliation: Department of Nursing, School of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran.
authors.forename: Moslem
authors.initials: M
authors.lastname: Hesam
keywords: Chlorhexidine mouthwash; ICU; Matrica; normal saline; pathogenic microorganisms