Oral Health, Oral Microbiota, and Incidence of Stroke-Associated Pneumonia—A Prospective Observational Study
Stroke-associated pneumonia is a major cause for poor outcomes in the post-acute phase after stroke. Several studies have suggested potential links between neglected oral health and pneumonia. Therefore, the aim of this prospective observational study was to investigate oral health and microbiota an...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-11-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2020.528056/full |
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| author | Fabian Cieplik Alma Maria Wiedenhofer Alma Maria Wiedenhofer Alma Maria Wiedenhofer Verena Pietsch Verena Pietsch Verena Pietsch Karl-Anton Hiller Andreas Hiergeist Andrea Wagner Dobri Baldaranov Ralf A. Linker Jonathan Jantsch Wolfgang Buchalla Felix Schlachetzki André Gessner |
| author_facet | Fabian Cieplik Alma Maria Wiedenhofer Alma Maria Wiedenhofer Alma Maria Wiedenhofer Verena Pietsch Verena Pietsch Verena Pietsch Karl-Anton Hiller Andreas Hiergeist Andrea Wagner Dobri Baldaranov Ralf A. Linker Jonathan Jantsch Wolfgang Buchalla Felix Schlachetzki André Gessner |
| author_sort | Fabian Cieplik |
| collection | DOAJ |
| description | Stroke-associated pneumonia is a major cause for poor outcomes in the post-acute phase after stroke. Several studies have suggested potential links between neglected oral health and pneumonia. Therefore, the aim of this prospective observational study was to investigate oral health and microbiota and incidence of pneumonia in patients consecutively admitted to a stroke unit with stroke-like symptoms. This study involved three investigation timepoints. The baseline investigation (within 24 h of admission) involved collection of demographic, neurological, and immunological data; dental examinations; and microbiological sampling (saliva and subgingival plaque). Further investigation timepoints at 48 or 120 h after baseline included collection of immunological data and microbiological sampling. Microbiological samples were analyzed by culture technique and by 16S rRNA amplicon sequencing. From the 99 patients included in this study, 57 were diagnosed with stroke and 42 were so-called stroke mimics. From 57 stroke patients, 8 (14%) developed pneumonia. Stroke-associated pneumonia was significantly associated with higher age, dysphagia, greater stroke severity, embolectomy, nasogastric tubes, and higher baseline C-reactive protein (CRP). There were trends toward higher incidence of pneumonia in patients with more missing teeth and worse oral hygiene. Microbiological analyses showed no relevant differences regarding microbial composition between the groups. However, there was a significant ecological shift over time in the pneumonia patients, probably due to antibiotic treatment. This prospective observational study investigating associations between neglected oral health and incidence of SAP encourages investigations in larger patient cohorts and implementation of oral hygiene programs in stroke units that may help reducing the incidence of stroke-associated pneumonia. |
| first_indexed | 2024-12-13T17:55:02Z |
| format | Article |
| id | doaj.art-06abaf11e0ca4b06b4d982f9c5ba2b71 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-13T17:55:02Z |
| publishDate | 2020-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-06abaf11e0ca4b06b4d982f9c5ba2b712022-12-21T23:36:23ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-11-011110.3389/fneur.2020.528056528056Oral Health, Oral Microbiota, and Incidence of Stroke-Associated Pneumonia—A Prospective Observational StudyFabian Cieplik0Alma Maria Wiedenhofer1Alma Maria Wiedenhofer2Alma Maria Wiedenhofer3Verena Pietsch4Verena Pietsch5Verena Pietsch6Karl-Anton Hiller7Andreas Hiergeist8Andrea Wagner9Dobri Baldaranov10Ralf A. Linker11Jonathan Jantsch12Wolfgang Buchalla13Felix Schlachetzki14André Gessner15Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, GermanyDepartment of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, GermanyInstitute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, GermanyDepartment of Neurology, University of Regensburg, Regensburg, GermanyDepartment of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, GermanyInstitute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, GermanyDepartment of Neurology, University of Regensburg, Regensburg, GermanyDepartment of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, GermanyInstitute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, GermanyDepartment of Neurology, University of Regensburg, Regensburg, GermanyDepartment of Neurology, University of Regensburg, Regensburg, GermanyDepartment of Neurology, University of Regensburg, Regensburg, GermanyInstitute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, GermanyDepartment of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, GermanyDepartment of Neurology, University of Regensburg, Regensburg, GermanyInstitute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, GermanyStroke-associated pneumonia is a major cause for poor outcomes in the post-acute phase after stroke. Several studies have suggested potential links between neglected oral health and pneumonia. Therefore, the aim of this prospective observational study was to investigate oral health and microbiota and incidence of pneumonia in patients consecutively admitted to a stroke unit with stroke-like symptoms. This study involved three investigation timepoints. The baseline investigation (within 24 h of admission) involved collection of demographic, neurological, and immunological data; dental examinations; and microbiological sampling (saliva and subgingival plaque). Further investigation timepoints at 48 or 120 h after baseline included collection of immunological data and microbiological sampling. Microbiological samples were analyzed by culture technique and by 16S rRNA amplicon sequencing. From the 99 patients included in this study, 57 were diagnosed with stroke and 42 were so-called stroke mimics. From 57 stroke patients, 8 (14%) developed pneumonia. Stroke-associated pneumonia was significantly associated with higher age, dysphagia, greater stroke severity, embolectomy, nasogastric tubes, and higher baseline C-reactive protein (CRP). There were trends toward higher incidence of pneumonia in patients with more missing teeth and worse oral hygiene. Microbiological analyses showed no relevant differences regarding microbial composition between the groups. However, there was a significant ecological shift over time in the pneumonia patients, probably due to antibiotic treatment. This prospective observational study investigating associations between neglected oral health and incidence of SAP encourages investigations in larger patient cohorts and implementation of oral hygiene programs in stroke units that may help reducing the incidence of stroke-associated pneumonia.https://www.frontiersin.org/articles/10.3389/fneur.2020.528056/fulloral healthoral microbiotastrokestroke carepneumoniastroke-associated pneumonia |
| spellingShingle | Fabian Cieplik Alma Maria Wiedenhofer Alma Maria Wiedenhofer Alma Maria Wiedenhofer Verena Pietsch Verena Pietsch Verena Pietsch Karl-Anton Hiller Andreas Hiergeist Andrea Wagner Dobri Baldaranov Ralf A. Linker Jonathan Jantsch Wolfgang Buchalla Felix Schlachetzki André Gessner Oral Health, Oral Microbiota, and Incidence of Stroke-Associated Pneumonia—A Prospective Observational Study Frontiers in Neurology oral health oral microbiota stroke stroke care pneumonia stroke-associated pneumonia |
| title | Oral Health, Oral Microbiota, and Incidence of Stroke-Associated Pneumonia—A Prospective Observational Study |
| title_full | Oral Health, Oral Microbiota, and Incidence of Stroke-Associated Pneumonia—A Prospective Observational Study |
| title_fullStr | Oral Health, Oral Microbiota, and Incidence of Stroke-Associated Pneumonia—A Prospective Observational Study |
| title_full_unstemmed | Oral Health, Oral Microbiota, and Incidence of Stroke-Associated Pneumonia—A Prospective Observational Study |
| title_short | Oral Health, Oral Microbiota, and Incidence of Stroke-Associated Pneumonia—A Prospective Observational Study |
| title_sort | oral health oral microbiota and incidence of stroke associated pneumonia a prospective observational study |
| topic | oral health oral microbiota stroke stroke care pneumonia stroke-associated pneumonia |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2020.528056/full |
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