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

Khadka, S, Khan, S ORCID: 0000-0002-6695-4013, King, A ORCID: 0000-0003-1792-0965, Goldberg, LR ORCID: 0000-0002-8217-317X, Crocombe, L ORCID: 0000-0002-3916-0058 and Bettiol, S ORCID: 0000-0002-4355-4498 2021 , 'Poor oral hygiene, oral microorganisms and aspiration pneumonia risk in older people in residential aged care: a systematic review' , Age and Ageing, vol. 50, no. 1 , pp. 80-87 , doi: 10.1093/ageing/afaa102.

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Abstract

Backgroundaspiration pneumonia increases hospitalisation and mortality of older people in residential aged care.Objectivesdetermine 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 SourcesPUBMED/MEDLINE, CINAHL, EMBASE, COCHRANE, PROQUEST, Google Scholar, Web of Science.Study Eligibility Criteriapublished between January 2001 and December 2019 addressing oral microorganisms, aspiration pneumonia, oral health and treatment.Participantspeople 60 years and older in residential aged care.Study Appraisal and Synthesis Methodsthe Newcastle–Ottawa Scale and the Standard Protocol Items: Recommendations for Intervention Trials checklist.Resultstwelve 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.Limitationsmore 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 Findingspathogenic 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.

Item Type: Article
Authors/Creators:Khadka, S and Khan, S and King, A and Goldberg, LR and Crocombe, L and Bettiol, S
Keywords: oral health, aspiration pneumonia, older people, residential aged care
Journal or Publication Title: Age and Ageing
Publisher: Oxford Univ Press
ISSN: 0002-0729
DOI / ID Number: 10.1093/ageing/afaa102
Copyright Information:

© The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.

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