Prevalence of potential bacterial respiratory pathogens in the oral cavity of hospitalised individuals

Objective: To assess the prevalence of oral colonisation by bacterial respiratory pathogens in hospitalised patients. Methods: Thirty patients undergoing myocardium revascularisation surgery were evaluated. At baseline (pre-operative phase), full-mouth clinical periodontal assessment was performed. Saliva and biofilm samples were obtained from subjects at baseline and at the post-operative phase, after orotracheal extubation. DNA was extracted from samples and species of Acinetobacter, Pseudomonas, Staphylococcus aureus and Dialister pneumosintes were detected by PCR or culture (for staphylococci isolates). Results: Most of the subjects were males, with history of hypertension and smoking. Thirteen were edentulous (ED) and 17 were dentate (DE), with moderate chronic periodontitis. The most prevalent bacteria in saliva were Staphylococcus spp. (85.7%), Pseudomonas spp. (83.8%), and Acinetobacter spp. (53.3%). There was a trend for D. pneumosintes to be more frequently detected in DE (43.7%) than ED (11.5%) patients. In plaque samples, DE with >14 teeth showed a higher prevalence of Pseudomonas spp. (100%) than individuals with <= 14 teeth (69.1%; p = 0.048). Conversely, P. aeruginosa was more prevalent in subjects with fewer teeth (35.5%) than with >14 teeth (5.7%; p = 0.037). All staphylococci isolates were coagulase-negative, and about 11% were positive for the mecA gene. These mecA-positive isolates showed a tendency to increase in all samples, whereas P. aeruginosa reduced after surgery. A strong correlation between the presence of Acinetobacter spp. and Pseudomonas spp. was observed (rho = 0.886, p < 0.05). Conclusions: The oral cavity of hospitalised patients harbours high frequencies of bacterial respiratory pathogens, supporting its potential role as a reservoir for these species. (C) 2009 Elsevier Ltd. All rights reserved.