Dental care of critical patients and its influence on the modulation of the oral bacterial microbioma
- Conditions
- Pneumonia Ventilator-AssociatedDysbiosisC01.248
- Registration Number
- RBR-8mb3ws4
- Lead Sponsor
- niversidade do Oeste de Santa Catarina
- Brief Summary
Introduction: Critical illness is associated with a state of catabolic stress, leading to dysbiosis in which patients become more susceptible to nosocomial infections, bringing a significant impact on health. The oral cavity is a complex environment and offers several distinct habitats for colonization, being considered an ideal microbial incubator. Objective: Evaluating the interference of dental treatment in the modulation of the oral bacterial microbiome of critically ill patients. Method: Patients were divided into two groups, the control group (n = 10) received oral hygiene according to the institution's protocol performed by the nursing team, while the monitoring group (n = 9) received dental care, in addition to oral hygiene care of nursing. Three samples of biological material were collected from each patient every 72 hours, then DNA extraction was performed and the bacteria present in the samples were identified based on the DNA sequencing of the V3-V4 regions of the ribosomal16S RNA (16SrRNA) gene. The identification of Operational Taxonomic Units (OTUs) were evaluated using the FastQC software (version 0.11.5) and a comparative analysis of the microbiome community was performed. Results: It was observed that the monitoring group showed a 45.4% reduction in the nosocomial infection rate (p <0.00) and the number of days of the orotracheal tube when compared to the control group. Differential abundance analysis shows that species such as Prevotella melaninogenica (p = 0.023), Peptrosteptococcus stomatis (p = 0.034), Staphylococcus epidermidis (p = 0.016) and Vellionella dispar (p = 0.032) were more abundant in the control group samples. The monitoring group had fewer specific OTUs than the control group, indicating an improvement in the modulation of the oral microbiota. Conclusion: The analysis of the oral saliva samples showed no statistically significant difference in the microbial communities between the groups, however the monitoring group showed a reduction in a wealth index after the third day, which demonstrates that there was a negative effect on the microbial community in the patients receiving follow-up showing that dental treatment improves the oral condition of critically ill patients by controlling the presence of nosocomial microorganisms such as Klebsiella sp, E. coli, Serratiae sp., S. epidermidis. And the metagenome directly assists in the characterization of the microbiome and rapid identification of pathogens allowing customized pharmaceutical applications.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Data analysis completed
- Sex
- Not specified
- Target Recruitment
- Not specified
patients admitted to the Intensive Care Unit; on mechanical ventilation; older than 18 years
patients who had a current diagnosis and/or salivary gland disorders (Sjogren's syndrome, salivary gland tumor, parotitis); cancer patients regardless of the stage of the disease, psychiatric patients,; postoperative discharge within the first 24 hours; patients admitted from other institutions already on mechanical ventilation and oral and maxillofacial trauma
Study & Design
- Study Type
- Intervention
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method