Correlation between Oral Care and Fever in General Ward Patients

Abstract

Many studies have examined the preventive effects of oral care provided by dental professionals against aspiration pneumonia in elderly nursing home residents who require care. However, few reports have evaluated routine oral care provided by nurses to inpatients. Therefore, we investigated the correlation between oral care provided to general ward patients and the incidence of fever and the detection of the etiologic agents of hospital-acquired pneumonia in the oral cavity in 69 in-patients, aged 40 years or older, who were admitted to four hospitals in Niigata and required assistance in oral care. The number and details of oral care procedures were recorded. The presence of Staphylococcus aureus, MRSA, and Pseudomonas aeruginosa in the oral cavity were quantified, and fevers of 37.5°C or higher over the previous week were recorded. The subjects were divided into two groups based on oral intake (oral intake and non-oral intake groups), and Fisher's direct probability test was used to compare their results. For the oral intake group, the incidence of fever and the detection rate of S. Aureus were significantly lower for subjects who received oral care three times a day. On the other hand, for the non-oral intake group, the ratio of patients with fevers was significantly lower for those who received oral care using toothbrushes. These findings suggest that, for inpatients who ingest food orally, frequent oral care can prevent fever and opportunistic pathogen colonization in the oral cavity, and that for inpatients who do not ingest food orally, fever can be prevented by mechanical oral care using a toothbrush. © 2010, Japanese Society for Infection Prevention and Control. All rights reserved.