Impact of Oral Hygiene Protocols for Critically Ill Patients on Pseudomonas aeruginosa, a Major Pathogen of Ventilator-Associated Pneumonia: A Randomized Controlled Trial



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Abstract


BACKGROUND: The oral hygiene of intensive care unit (ICU) patients influences the occurrence of nosocomial ventilator-associated pneumonia (VAP). Ventilator-associated pneumonia (VAP) is a common and serious clinical problem among critically ill patients with cardiovascular disease in the ICU. However, there is currently no definitive agreement on the most effective oral hygiene protocol.

AIM: To study the effects of different oral hygiene protocols in critically ill patients on the pathogens causing nosocomial pneumonia in the oral cavity.

METHODS: This study examined the microbiology of oral biotopes in patients treated in the intensive care unit (ICU) during a traditional oral hygiene protocol and a new oral hygiene protocol using an antiseptic based on an aqueous solution of electrochemically activated oxidants.

RESULTS: Based on the results of statistical analysis of comparison of two groups by microbial markers of nosocomial pneumonia before the study, it can be concluded that in the period "After treatment, day 1" there were significant differences in the decrease of the causative agent of nosocomial pneumonia "Pseudomonas aeruginosa" in group 2 (new protocol) to 0.00 (0.00; 3.00) compared to group 1 (traditional protocol) - 3.00 (0.50; 16.50), (P = 0.0022). In the period "Before treatment, day 2" there were significant differences in the decrease of "Pseudomonas aeruginosa" in group 2 (new protocol) to 1.50 (0.00; 17.00) compared to group 1 (traditional protocol) 11.00 (3.00; 44.50), (P = 0.0081). In the period “Before treatment, day 5”, reliable differences were revealed in the reduction of the causative agent of nosocomial pneumonia “Pseudomonas aeruginosa” in group 2 (new protocol) 2.50 (0.00; 26.25) in relation to group 1 (traditional protocol) 16.00 (5.00; 86.50), (P = 0.0016).

CONCLUSION: Pseudomonas aeruginosa, the causative agent of nosocomial pneumonia, is a hospital-acquired infection that most often affects patients in intensive care units. A significant increase in Pseudomonas aeruginosa was observed in Group 1 (traditional protocol) and no increase in Group 2 (new protocol), confirming the effectiveness of the proposed hygiene protocol for critically ill patients (P = 0.0016).

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About the authors

Malina D. Baykulova

Peoples’ Friendship University of Russia named after Patrice Lumumba

Author for correspondence.
Email: baykulova@pfur.ru
ORCID iD: 0000-0002-2195-4423
SPIN-code: 6942-8308
Russian Federation, Moscow

Svetlana N. Razumova

Peoples' Friendship University of Russia

Email: razumova-sn@rudn.ru
ORCID iD: 0000-0002-9533-9204
SPIN-code: 6771-8507

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

Anzhela S. Brago

Peoples’ Friendship University of Russia named after Patrice Lumumba

Email: anzhela_bogdan@mail.ru
ORCID iD: 0000-0001-8947-4357
SPIN-code: 2437-8867

MD, Cand. Sci. (Medicine), Associate Professor

Russian Federation, Moscow

Nikolay V. Utz

City Clinical Hospital named after F.I. Inozemtsev, Department of Health of the City of Moscow

Email: nvutz@rambler.ru
ORCID iD: 0009-0001-5930-3167
SPIN-code: 6348-4265

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

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