Reducing ventilator-associated pneumonia through advanced oral-dental care: A 48-month study

American Journal of Critical Care

Volumn 18, Issue 6, 2009, Pages 523-532

  Garcia, Robert ^a   Jendresky, Linda ^b   Colbert, Larry ^c   Bailey, Althea ^c   Zaman, Mohammed ^c   Majumder, Mujbur ^c  

^a STONY BROOK UNIVERSITY MEDICAL CENTER   (United States)

^b Schneiders Childrens Hospital   (United States)

^c Infection control coordinator ^*  (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AGED; APACHE; ARTICLE; ATTITUDE TO HEALTH; CLINICAL TRIAL; FEMALE; HEALTH CARE QUALITY; HUMAN; INTENSIVE CARE UNIT; LENGTH OF STAY; MALE; METHODOLOGY; MICROBIOLOGY; MIDDLE AGED; MOUTH HYGIENE; ORGANIZATION AND MANAGEMENT; OROPHARYNX; PRACTICE GUIDELINE; STOMACH; TOOTH PLAQUE; UNIVERSITY HOSPITAL; VENTILATOR ASSOCIATED PNEUMONIA;

ACADEMIC MEDICAL CENTERS; AGED; APACHE; DENTAL PLAQUE; FEMALE; GUIDELINE ADHERENCE; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE; HUMANS; INTENSIVE CARE UNITS; LENGTH OF STAY; MALE; MIDDLE AGED; ORAL HYGIENE; OROPHARYNX; PNEUMONIA, VENTILATOR-ASSOCIATED; PRACTICE GUIDELINES AS TOPIC; PROCESS ASSESSMENT (HEALTH CARE); STOMACH;

EID: 74049087192     PISSN: 10623264     EISSN: None     Source Type: Journal    
DOI: 10.4037/ajcc2009311     Document Type: Article

References (58)

1. Edwards JR, Peterson KD, Andrus ML, et al. National Healthcare Safety Network (NHSN) Report, data summary for 2006 through 2007, issued November 2008. Am J Infect Control. 2008;36:609-626.
2. Piazza O, Iasiello A, PapaIanni C, et al. Incidence of antimicrobial-resistant ventilator-associated pneumonia: an eigh-teen-month survey. Panminerva Med. 2005;47(4):265-267.
3. Safdar N, Dezfulian C, Collard HR, Saint S. Clinical and economic consequences of ventilator-associated pneumonia: a systematic review. Crit Care Med. 2005;33:2184-2193.
4. Bercault N, Boulain T. Mortality rate attributable to ventilator-associated pneumonia in an adult intensive care unit: a prospective case control study. Crit Care Med. 2001;29: 2303-2309.
5. Morehead RS, Pinto SJ. Ventilator-associated pneumonia. Arch Intern Med. 2000;160:1926-1936.
6. Kollef MH, Siver P, Murphy DM, Trovillion E. The effect of late-onset ventilator-pneumonia in determining mortality. Chest. 1995;108:1655-1662.
7. Fagon JY, Chastre J, Hance AJ, Montravers P, Novara A, Gilbert C. Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay. Am J Med. 1993:94:281-288.
8. Warren DK, Shukla SJ, Olsen MA, et al. Outcome and attributable cost of ventilator-associated pneumonia among intensive care unit patients in a suburban medical center. Crit Care Med. 2003;31:1312-1317.
9. Rello J, Ollendorf DA, Oster G, et al. Epidemiology and outcomes of VAP in a large US database. Chest. 2002;122: 2115-2121.
10. Cocanour CS, Ostrosky-Zeichner L, Peninger M, et al. Cost of ventilator-associated pneumonia in a shock trauma intensive care unit. Surg Inf. 2005;6:65-72.
11. Kollef MH, Shorr A, Tabak YP, et al. Epidemiology and outcomes of health-care-associated pneumonia: results from a large US database of culture-positive pneumonia. Chest. 2005;128:3854-3862.
12. 2004. Centers for Disease Control and Prevention, Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Healthcare-Associated Pneumonia, Atlanta, GA: Centers for Disease Control and Prevention 2004
13. Institute for Healthcare Improvement. Getting Started Kit: Prevent Ventilator-Associated Pneumonia, How-to Guide http://www.ihi.org/IHI/Programs/Campaign/Campaign.htm? TabId=2#PreventVentilator-AssociatedPneumonia. Accessed June 9 2009.
14. Flanders SA, Collard HR, Saint S. Nosocomial pneumonia: state of the science. Am J Infect Control. 2006;34:84-93.
15. Garcia R. A review of the possible role of oral and dental colonization on the occurrence of health care-associated pneumonia: underappreciated risk and a call for interventions. Am J Infect Control. 2005;33:527-541.
16. Safdar N, Crnich CJ, Maki DG. The pathogenesis of ventilator-associated pneumonia: its relevance to developing effective strategies for prevention. Respir Care. 2005;50: 725-739.
17. Food and Drug Administration, Department of Health and Human Services. Oral health products for over-the-counter human use: tentative final monograph for oral antiseptic drug products Fed Reg 59 (9 February 1994) 6084-6124.
18. Senol G, Kirakli C, Halilcolar H. In vitro antibacterial activities of oral care products against ventilator-associated pneumonia pathogens. Am J Infect Control. 2007;35:531-535.
19. Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM. CDC definitions for nosocomial infections APIC Infection Control and Applied Epidemiology: Principles and Practice In: Olmsted RN, ed St Louis, MO: Mosby 1996 A-1-A-20
20. Crnich CJ, Safdar N, Maki DG. The role of the intensive care unit environment in the pathogenesis and prevention of ventilator-associated pneumonia. Respir Care. 2005;50: 813-836.
21. Shay K, Scannapieco FA, Terpenning MS, Smith BJ, Taylor GW. Nosocomial pneumonia and oral health. Spec Care Dentist. 2005;25:179-187.
22. Craven DE. Preventing ventilator-associated pneumonia in adults: sowing seeds of change. Chest. 2006;130:251-260.
23. Scannapieco FA. Pneumonia in nonambulatory patients: the role of oral bacteria and oral hygiene. J Am Dent Assoc. 2006;137(suppl 2):21S-25S.
24. Rello J, Loulenti D, Blot S, et al. Oral care practices in intensive care units: a survey of 59 European ICUs. Intensive Care Med. 2007;33(6):1066-1070.
25. Kerver AJ, Rommes JH, Mevissen-Verhage EA, et al. Colonization and infection in surgical intensive care patients: a prospective study. Intensive Care Med. 1987;13:347-351.
26. Ulrich C, Harinck-de Weerd JE, Bakker NC, Jacz K, Dornbos L, de Ridder VA. Selective decontamination of the digestive tract with norfloxacin in the prevention of ICU-acquired infections: a prospective randomized study. Intensive Care Med. 1989;15(7):424-431.
27. Heyland D, Mandell LA. Gastric colonization by gramnegative bacilli and nosocomial pneumonia in the intensive care unit patient: evidence for causation. Chest. 1992;101: 187-193.
28. Garrouste-Orgeas M, Chevret S, Arlet G, et al. Oropharyngeal or gastric colonization and nosocomial pneumonia in adult intensive care unit patients: a prospective study based on genomic DNA analysis. Am J Respir Crit Care Med. 1997;156:1647-1655.
29. Pittet D, Eggimann P, Rubinovich B. Prevention of ventilatorassociated pneumonia by oral decontamination: just another SDD study? Am J Respir Crit Care Med. 2001;164: 338-339.
30. DeRiso AJ II, Ladowski JS, Dillon TA, Justice JW, Peterson AC. Chlorhexidine gluconate 0.12% oral rinse reduces the incidence of total nosocomial respiratory infection and nonprophylactic systemic antibiotic use in patients undergoing heart surgery. Chest. 1996;109:1556-1561.
31. Bonten MJ, Gaillard CA, van Tiel FH, Smeets HG, van der Geest S, Stobberingh EE. The stomach is not a source for colonization of the upper respiratory tract and pneumonia in ICU patients. Chest. 1994;105:878-884.
32. Brun-Buisson C, Legrand P, Rauss A, et al. Intestinal decontamination for control of nosocomial multiresistant gramnegative bacilli: study of an outbreak in an intensive care unit. Ann Intern Med. 1989;110:873-881.
33. Kantarova I, Svoboda P, Scheer P, et al. Stress ulcer prophylaxis in critically ill patients: a randomized controlled trial. Hepatogastroenterology. 2004;51:757-761.
34. Bonten MJ, Gaillard CA, van der Hulst R, et al. Intermittent enteral feeding: the influence on respiratory and digestive tract colonization in mechanically ventilated intensive-care patients. Am J Respir Crit Care Med. 1996;154:394-399.
35. van Nieuwenhoven CA, Vandenbroucke-Grauls C, van Tiel FH, et al. Feasibility and effects of the semirecumbent position to prevent ventilator-associated pneumonia: a randomized study. Crit Care Med. 2006;34:396-402.
36. Rodriguez-Roldan JM, Altuna-Cuesta A, Lopez A, et al. Prevention of nosocomial lung infection in ventilated patients: use of an antimicrobial nonabsorbable paste. Crit Care Med. 1990;18:1239-1242.
37. Pugin J, Auckenthaler R, Lew DP, Suter PM. Oropharyngeal decontamination decreases incidence of ventilator-associated pneumonia: a randomized, placebo-controlled, doubleblind clinical trial. JAMA. 1991;265:2704-2710.
38. Bergmans DC, Bonten MJ, Gaillard CA, et al. Prevention of ventilator-associated pneumonia by oral decontamination: a prospective, randomized, double-blind, placebo-controlled study. Am J Resp Crit Care Med. 2001;164:382-388.
39. DeRiso AJ II, Ladowski JS, Dillon TA, Justice JW, Peterson AC. Chlorhexidine gluconate 0.12% oral rinse reduces the incidence of total nosocomial respiratory infection and nonprophylactic systemic antibiotic use in patients undergoing heart surgery. Chest. 1996;109:1556-1561.
40. Koeman M, van der Ven AJ, Hak E, et al. Oral decontamination with chlorhexidine reduces the incidence of ventilator-associated pneumonia. Am J Respir Crit Care Med. 2006;173: 1348-1355.
41. Seguin P, Tanguy M, Laviolle B, Tirel O, Malledant Y. Effect of oropharyngeal decontamination by povidone-iodine on ventilator-associated pneumonia in patients with head trauma. Crit Care Med. 2006;34:1514-1519.
42. Fourrier F, Dovivier B, Boutigny H, Roussel-Delvallez M, Chopin C. Colonization of dental plaque: a source of nosocomial infections in intensive care unit patients. Crit Care Med. 1998;26:301-308.
43. Scannapieco FA, Stewart EM, Mylotte JM. Colonization of dental plaque by respiratory pathogens in medical intensive care patients. Crit Care Med. 1992;20:740-745.
44. Munro CL, Grap MJ, Elswick RK Jr, McKinney J, Sessler CN, Hummel RS 3rd. Oral health status and development of ventilator-associated pneumonia: a descriptive study. Am J Crit Care. 2006;15:453-460.
45. Fitch JA, Munro CL, Glass CA, Pellegrini JM. Oral care in the adult intensive care unit. Am J Crit Care. 1999:8:314-318.
46. Sumi Y, Miura H, Sumakawa M, Michiwaki Y, Sakagami N. Colonization of denture plaque by respiratory pathogens in dependent elderly. Gerodontology. 2002;19:25-29.
47. Craven DE. Epidemiology of ventilator-associated pneumonia. Chest. 2000;117:186S-187S.
48. Craven DE, Steger KA. Nosocomial pneumonia in mechanically ventilated adult patients: epidemiology and prevention in 1996. Semin Respir Infect. 1996;11:32-53.
49. Craven DE, Steger KA, Barber TW. Preventing nosocomial pneumonias: state of the art and perspectives for the 1990s. Am J Med. 1991;91:44S-52S.
50. McCrae W, Wallace P. Aspiration around high-volume, low pressure endotracheal cuff. Br Med J. 1981;283:1220.
51. Rello J, Diaz E, Roque M, Valles J. Risk factors for developing pneumonia within 48 hours of intubation. Am J Respir Crit Care Med. 1999;159:1742-1746.
52. Simmons-Trau D. ZAP VAP with back-to-basics approach. Nurs Crit Care. 2006;1:28-36.
53. Shay A, O'Malley P. Clinical outcomes of a ventilatorassociated pneumonia prevention program [abstract 12]. Association for Professionals in Infection Control and Epidemiology, 33rd Annual Conference & International Meeting, June 2006, Tampa, Florida.
54. Schleder B, Stott K, Lloyd RC. The effect of a comprehensive oral care protocol on patients at risk for ventilatorassociated pneumonia. J Adv Health Care. 2002;4:27-30.
55. Rhodes AB, Ross MR, Tiller TJ. The use of oral care kits as a strategy to reduce ventilator-associated pneumonia in a surgical intensive care unit [abstract 18-158]. Association for Professionals in Infection Control and Epidemiology, 33rd Annual Conference & International Meeting, June 2006, Tampa, Florida.
56. Institute for Healthcare Improvement. Hospitals enrolled in IHI's 100,000 Lives Campaign show that cases of ventilatorassociated pneumonia can drop to zero. http://www.ihi.org /IHI/Topics/CriticalCare/IntensiveCare/ImprovementStories /FSVAPGettingtoZeroandStayingThere.htm. Accessed 03/29/07.
57. Lipke V, Carman B. A two-hospital multidisciplinary approach towards the reduction of ventilator-associated pneumonia [abstract 18-166]. Association for Professionals in Infection Control and Epidemiology, 33rd Annual Conference & International Meeting, June 2006, Tampa, Florida.
58. Bryant K, Powell S, Camp L, Horton J. Integrating oral care into a process for prevention of pneumonia in patients with artificial airways [abstract 18-163]. Association for Professionals in Infection Control and Epidemiology, 33rd Annual Conference & International Meeting, June 2006, Tampa, Florida.