Effect of oral hygiene interventions on opportunistic pathogens in patients after stroke

Abstract

Background: Despite the role of the oral cavity as a reservoir of opportunistic pathogens for infection in patients following stroke, the evaluation of the effects of oral hygiene interventions has been largely neglected.

Methods: This randomized clinical trial included 102 patients undergoing hospital-based rehabilitation for stroke. Patients were randomized to one of 3 groups: oral hygiene instruction (OHI) only; OHI and 0.2% chlorhexidine mouth rinse twice daily; or OHI, 0.2% chlorhexidine mouth rinse twice daily, and assisted brushing twice weekly. Oral samples were obtained at baseline and after 3 weeks for detection of Staphylococcus aureus, aerobic and facultatively anaerobic gram-negative bacilli, and yeasts.

Results: Almost three-quarters (72.8%) of the patients harbored oral anaerobic gram-negative bacilli at baseline, and more than half had detectable S aureus (56.8%) and yeasts (59.3%). Percentage frequencies and viable counts of pathogens remained relatively stable during the course of the clinical trial, and no significant differences were observed among the 3 patient groups.

Conclusions: In our study cohort, there was no significant difference in the effectiveness of the 3 different oral hygiene interventions on the prevalence or viable counts of oral opportunistic pathogens.

Trial registration: ClinicalTrials.gov NCT01265043.