Oral health promotion interventions on oral reservoirs of staphylococcus aureus: a systematic review
ABSTRACT The oral cavity serves as a reservoir of Staphylococcus aureus for infection of the lower respiratory tract and cross-infection to other patients. This systematic review was designed to examine the effectiveness of oral health promotion interventions on this pathogen. The PubMed, ISI Web of Science, and Cochrane Library databases were searched for clinical trials assessing the effect of oral health promotion interventions on oral and oropharyngeal carriage of S. aureus. Oral health promotion interventions on oral reservoirs of S. aureus in both systemically healthy and medically compromised groups consisted of oral hygiene interventions only. There was a lack of evidence pertaining to the effectiveness of mechanical oral hygiene interventions against this pathogen. Chlorhexidine delivered in oral hygiene products such as mouthrinses, gels, and sprays appeared to have some utility against S. aureus, although some studies found equivocal effects. There was a dearth of studies investigating the efficacy of other chemical agents. Although many chemical agents contained in oral hygiene products have proven in vitro activity against S. aureus, their clinical effectiveness and potential role as adjuncts or alternative therapies to conventional treatment remain to be confirmed by further high-quality randomized controlled trials.
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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.American journal of infection control 07/2012; 41(2). DOI:10.1016/j.ajic.2012.02.020 · 2.33 Impact Factor
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ABSTRACT: OBJECTIVE: The aim of this study was to evaluate and compare the activity of oral mouthwashes against biofilm forms of MRSA isolated from the oral cavity and the bloodstream. STUDY DESIGN: The time-kill kinetics efficacy of 7 over-the-counter mouthwashes were tested against 28 clinical MRSA biofilm isolates for 0.5, 1 and 2 min. RESULTS: Treatments of MRSA biofilms formed by oral and bloodstream isolates were not significantly different, with mouthwashes displaying a rapid and modest anti-biofilm effect. None of the biofilm isolates were completely eradicated by the compounds tested, with a maximal killing of only approximately 70% shown by Corsodyl and Peroxyl. Maximum activity of all compounds tested was observed after 0.5 min. Fluorigard showed the poorest overall activity (57% reduction). CONCLUSIONS: MRSA colonize the oral cavity, and are more prevalent in institutionalized persons and the elderly. Over-the-counter mouthwashes are ineffective at killing MRSA biofilms, which has infection control implications.03/2013; DOI:10.1016/j.oooo.2012.12.014