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. 2025 Feb 17;15(1):5776.
doi: 10.1038/s41598-025-90037-9.

Oral colonization of antimicrobial-resistant bacteria in home health care participants and their association with oral and systemic status

Saki Nishihama  1   2 , Miki Kawada-Matsuo  3   4 , Mi Nguyen-Tra Le  2   5 , Ayumi Fujii  2   6 , Azusa Haruta  7 , Toshiki Kajihara  5   8 , Yoshimasa Hashimoto  9 , Mineka Yoshikawa  7 , Tomonao Aikawa  6 , Kazuhiro Tsuga  7 , Hiroki Ohge  5   10 , Motoyuki Sugai  5   8 , Hideki Shiba  1 , Hitoshi Komatsuzawa  11   12
Affiliations

Oral colonization of antimicrobial-resistant bacteria in home health care participants and their association with oral and systemic status

Saki Nishihama et al. Sci Rep. .

Abstract

Antimicrobial-resistant bacteria (ARBs) are serious global threat because they make it difficult to treat infections with antibiotics. Recently, it has been demonstrated that ARBs are isolated from the oral cavities of elderly individuals in long-term care facilities. Because oral ARBs can cause systemic diseases such as bacteraemia and aspiration pneumonia, more attention must be given to protect the overall health of elderly people. To understand the prevalence of oral ARBs, more studies are needed in addition to previous studies. In this study, we investigated oral ARBs in elderly people receiving home health care (HHC) who had different lifestyles as residents in long-term care facilities. Among 98 HHC participants, Staphylococcus aureus, including 8 methicillin-resistant S. aureus (MRSA) strains, was isolated from 31 participants (31.7%), and 3rd-generation cephalosporin-resistant gram-negative bacteria (GNARB) were isolated from 18 participants (17.8%). An analysis of the relationship between oral ARBs and clinical status revealed that S. aureus/MRSA isolation was correlated with denture condition, while GNARB isolation was correlated with tube feeding. This study is the first comprehensive analysis of ARB carriage in the oral cavities of elderly people in HHCs. These results demonstrate the potential risk of oral ARB carriage and the importance of infection control in HHCs.

Keywords: Antimicrobial-resistant bacteria; Elderly; Home healthcare; Oral cavity..

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Isolation of antibiotic-resistant bacteria from oral cavity of home health care facilities. (a) Staphylococcus aureus (MSSA and MRSA), (b) Gram-negative ARBs.
Fig. 2
Fig. 2
Phylogenetic analysis and relationships with antimicrobial resistance genes, susceptibility to antibiotics and virulence genes.
Fig. 3
Fig. 3
Proportion of antibiotic-resistant bacteria by species or lineage in home health care facilities. (a) S.aureus/ Home health care (b) S.aureus/Long-term-care Facilities (c) Gram-negative ARBs / Home health care (d) Gram-negative ARBs/Long-term-care Facilities.
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