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Proper dental care linked to reduced risk of respiratory infections in ICU patients

CHICAGO, Ill., USA (October 22, 2014) – New research shows vulnerable patients in the Intensive Care Unit (ICU) who received enhanced oral care from a dentist were at significantly less risk for developing a lower respiratory tract infection (LRTI), like ventilator-associated pneumonia, during their stay. The study was published in the November issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America (SHEA).

"Bacteria causing healthcare-associated infections often start in the oral cavity," said Fernando Bellissimo-Rodrigues, MD, lead author of the study. "This study suggests that having a dentist provide weekly care as part the ICU team may improve outcomes for vulnerable patients in this setting."

Brazilian researchers utilized an observer-blind randomized clinical trial design to analyze data from 254 adult patients who stayed in a general ICU for at least 48 hours. Patients were randomized to receive enhanced dental care provided by a dentist, or to receive routine oral hygiene performed by the ICU nurse staff.

Enhanced dental care included teeth brushing, tongue scraping, removal of calculus, atraumatic restorative treatment of caries, tooth extraction and topical application of chlorhexidine corresponding to each patients‘ needs four to five times a week. Comparatively, regular treatment consisted of mechanical cleansing using gauze followed by topical application of chlorhexidine three times a day.

Patients provided enhanced dental care were 56 percent less likely to develop a respiratory tract infection during their ICU stay compared to the control patient group. Researchers note that enhanced dental treatment, including oral antisepsis routinely performed in ICUs could be more effective in reducing the oral bacteria and help prevent migration of these bacteria into the lungs.

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Wanessa Bellissimo-Rodrigues, Mayra Menegueti, Gilberto Gaspar, Edson Nicolini, Maria Auxiliadora-Martins, Anibal Basile-Filho, Roberto Martinez, Fernando Bellissimo-Rodrigues. "Effectiveness of a dental care intervention in the prevention of lower respiratory tract nosocomial infections among intensive care patients: a randomized clinical trial." Infection Control and Hospital Epidemiology [35:11] (November 2014).

Published through a partnership between the Society for Healthcare Epidemiology of America and The University of Chicago Press, Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 13 out of 158 journals in its discipline in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.

SHEA is a global professional society representing more than 2,000 physicians and other healthcare professionals with expertise and passion for healthcare epidemiology and infection prevention to improve patient care in all healthcare settings. SHEA’s mission is to prevent and control healthcare-associated infections and advance the field of healthcare epidemiology. The society advances its mission through advocacy, science and research, expert guidelines and guidance on key issues, the exchange of knowledge, and high-quality education. SHEA focuses resources on promoting antimicrobial stewardship, ensuring a safe healthcare environment, encouraging transparency in public reporting related to HAIs, focused efforts on prevention and more.

Visit SHEA online at http://www.shea-online.org

Society for Healthcare Epidemiology of America, 22.10.2014 (tB).