Poor oral hygiene, oral microorganisms and aspiration pneumonia risk in older people in residential aged care: a systematic review.


Journal

Age and ageing
ISSN: 1468-2834
Titre abrégé: Age Ageing
Pays: England
ID NLM: 0375655

Informations de publication

Date de publication:
08 01 2021
Historique:
received: 15 01 2020
revised: 04 04 2020
pubmed: 18 7 2020
medline: 29 7 2021
entrez: 18 7 2020
Statut: ppublish

Résumé

aspiration pneumonia increases hospitalisation and mortality of older people in residential aged care. determine potentially pathogenic microorganisms in oral specimens of older people with aspiration pneumonia and the effect of professional oral care in reducing aspiration pneumonia risk. PUBMED/MEDLINE, CINAHL, EMBASE, COCHRANE, PROQUEST, Google Scholar, Web of Science. published between January 2001 and December 2019 addressing oral microorganisms, aspiration pneumonia, oral health and treatment. people 60 years and older in residential aged care. the Newcastle-Ottawa Scale and the Standard Protocol Items: Recommendations for Intervention Trials checklist. twelve studies (four cross-sectional, five cohort and three intervention) reported colonisation of the oral cavity of older people by microorganisms commonly associated with respiratory infections. Aspiration pneumonia occurred less in people who received professional oral care compared with no such care. Isolation of Candida albicans, Staphylococcus aureus, methicillin-resistant S. aureus and Pseudomonas aeruginosa was related to mortality due to aspiration pneumonia. An interesting finding was isolation of Escherichia coli, a gut bacterium. more information may be present in publications about other co-morbidities that did not meet inclusion criteria. A high degree of heterogeneity prevented a meta-analysis. Issues included sampling size, no power and effect size calculations; different oral health assessments; how oral specimens were analysed and how aspiration pneumonia was diagnosed. pathogenic microorganisms colonising the oral microbiome are associated with aspiration pneumonia in older people in residential care; professional oral hygiene care is useful in reducing aspiration pneumonia risk.

Sections du résumé

BACKGROUND
aspiration pneumonia increases hospitalisation and mortality of older people in residential aged care.
OBJECTIVES
determine potentially pathogenic microorganisms in oral specimens of older people with aspiration pneumonia and the effect of professional oral care in reducing aspiration pneumonia risk.
DATA SOURCES
PUBMED/MEDLINE, CINAHL, EMBASE, COCHRANE, PROQUEST, Google Scholar, Web of Science.
STUDY ELIGIBILITY CRITERIA
published between January 2001 and December 2019 addressing oral microorganisms, aspiration pneumonia, oral health and treatment.
PARTICIPANTS
people 60 years and older in residential aged care.
STUDY APPRAISAL AND SYNTHESIS METHODS
the Newcastle-Ottawa Scale and the Standard Protocol Items: Recommendations for Intervention Trials checklist.
RESULTS
twelve studies (four cross-sectional, five cohort and three intervention) reported colonisation of the oral cavity of older people by microorganisms commonly associated with respiratory infections. Aspiration pneumonia occurred less in people who received professional oral care compared with no such care. Isolation of Candida albicans, Staphylococcus aureus, methicillin-resistant S. aureus and Pseudomonas aeruginosa was related to mortality due to aspiration pneumonia. An interesting finding was isolation of Escherichia coli, a gut bacterium.
LIMITATIONS
more information may be present in publications about other co-morbidities that did not meet inclusion criteria. A high degree of heterogeneity prevented a meta-analysis. Issues included sampling size, no power and effect size calculations; different oral health assessments; how oral specimens were analysed and how aspiration pneumonia was diagnosed.
CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS
pathogenic microorganisms colonising the oral microbiome are associated with aspiration pneumonia in older people in residential care; professional oral hygiene care is useful in reducing aspiration pneumonia risk.

Identifiants

pubmed: 32677660
pii: 5868064
doi: 10.1093/ageing/afaa102
doi:

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

81-87

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Auteurs

Sangeeta Khadka (S)

Centre for Rural Health, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia.

Shahrukh Khan (S)

Centre for Rural Health, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia.
School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Faculty of Health, Deakin University, Geelong, Australia.
Nursing Services, Alfred Health, Melbourne, Victoria, Australia.

Anna King (A)

Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia.

Lynette R Goldberg (LR)

Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia.

Leonard Crocombe (L)

Centre for Rural Health, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia.

Silvana Bettiol (S)

School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia.

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Classifications MeSH