Margaret S. Terpenning's research while affiliated with University of Michigan and other places

Publications (35)

Article
The oral cavity is a complex microenvironment consisting of multiple bacterial and fungal species, their associated biofilms, and a cytokine milieu influenced by constant inflammatory stimulation. Multiple infectious consequences of poor oral health have been extensively described and primarily affect older adults. Probably the most common sequelae...
Article
This paper's goal is to review the relationship between infections and chronic respiratory disease, with particular reference to periodontal disease. The link between oral diseases in general, periodontal disease, and respiratory disease remains somewhat controversial. However, with cooperation between dentistry and medicine, the nature of the conn...
Article
To investigate the importance of medical and dental factors in aspiration pneumonia in an older veteran population. Prospective enrollment of subjects with retrospective analysis of data. Department of Veterans Affairs outpatient clinic, inpatient ward, and nursing home. 358 veterans age 55 and older; 50 subjects with aspiration pneumonia. Demograp...
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Evidence is increasing that oral health has important impacts on systemic health. This paper presents data from the third National Health and Nutrition Examination Survey (NHANES III) describing the prevalence of dental caries and periodontal diseases in the older adult population. It then evaluates published reports and presents data from clinical...
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To assess colonization and serious infection with yeasts and the risk factors that are associated with colonization by these organisms. Monthly surveillance for colonization and infection over a period of 2 years. A long-term-care facility (LTCF) attached to an acute-care Veterans Affairs Medical Center. The 543 men and 10 women in the facility. Co...
Article
We report here information obtained from a cross-sectional study of 401 veterans, who were at least 60 years of age, which showed that several dental/oral conditions can be significantly associated with the diagnosis of a cerebral vascular accident (CVA), when included in a multivariate logistic regression model with and without many of the known r...
Article
Several recent studies have shown a link between dental disease and coronary heart disease. The authors studied 320 U.S. veterans in a convenience sample to assess the relationship between oral health and systemic diseases among older people. They present cross-sectional data confirming that a statistically significant association exists between a...
Article
Full-text available
Aspiration pneumonia is a major cause of morbidity and mortality among the elderly who are hospitalized or in nursing homes. Multiple risk factors for pneumonia have been identified, but no study has effectively compared the relative risk of factors in several different categories, including dysphagia. In this prospective outcomes study, 189 elderl...
Article
Influenza and pneumococcal vaccines have been available for decades and have repeatedly been shown to be efficacious in healthy adults. However, for both vaccines, efficacy in high risk populations and older individuals does not seem to be as great, leading to reluctance to use them as recommended. Recent observational studies in older individuals...
Article
Margaret S. Terpenning is currently an associate professor of internal medicine in the Division of Geriatric Medicine at the University of Michigan. Her base is the Ann Arbor Veterans Affairs Medical Center. Her training included both infectious diseases and geriatrics fellowships. The interactions between dental and medical diseases in the elderly...
Article
The most commonly measured bacterial parameters in saliva are the levels of the mutans group streptococci and lactobacilli, which have diagnostic implications for the incidence of dental decay. Diagnostic guidelines which are applicable to children and young adults in whom most, if not all, teeth are present and in whom the rate of stimulated saliv...
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Full-text available
To determine whether there is a difference in the oral/dental health in older persons with different life styles and medical status. Survey (cross-sectional study) included four groups: (1) subjects (n = 123) living in a residential retirement home or community dwelling; (2) subjects (n = 218) seeking dental treatment at a Veterans Affairs Dental O...
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Full-text available
To study the relationship between complaints of xerostomia and salivary performance and food avoidances in four geriatric groups chosen to reflect a broad spectrum of individuals along the health-disease continuum. To determine whether xerogenic medications taken by these individuals could be associated with either complaints of xerostomia or with...
Article
To assess the prevalence of high-level gentamicin-resistant enterococcus (HGRE) colonization, transmission patterns, and spectrum of illness among residents of a long-term care facility. Monthly surveillance for HGRE colonization of wounds, rectum, and perineum over a 1-year period. A Veterans Affairs long-term care facility attached to an acute-ca...
Article
To assess colonization and infection with methicillin-resistant Staphylococcus aureus (MRSA), high-level gentamicin-resistant enterococci (R-ENT) and gentamicin and/or ceftriaxone-resistant Gram-negative bacilli (R-GNB) and the factors that are associated with colonization and infection with these organisms. Monthly surveillance for colonization an...
Article
To assess the impact of the use of mupirocin ointment on colonization, transmission, and infection with methicillin-resistant Staphylococcus aureus (MRSA) in a long-term-care facility. All 321 residents of a Veterans Affairs long-term-care facility from June 1990 through June 1991 were studied for MRSA colonization and infection. MRSA-colonized pat...
Article
Infective endocarditis is an infection of the heart valves or the endothelium of the heart with any of a variety of bacteria, fungi, rickettsiae, or other agents. Infective endocarditis has a worldwide distribution with 10,000–20,000 new cases per year in the United States (1). This disease has been known virtually since the beginning of the histor...
Article
Methicillin-resistant Staphylococcus aureus (MRSA) infections emerged as a problem in acute-care hospitals in this country in the 1970s. However, as is true of most nosocomial infections, long-term care facilities have not been exempt from those issues that plague acute-care hospitals, and, indeed, bring their own peculiar circumstances to bear on...
Article
Recent reports have emphasized an increase in both infection and colonization with methicillin-resistant Staphylococcus aureus (MRSA) in institutionalized older patients. We studied whether or not local treatment with mupirocin ointment could eliminate nasal colonization with S aureus. A total of 102 patients in a Veterans Administration nursing ho...
Article
Protein malnutrition is associated with a decreased febrile and acute phase response to infection and increased mortality. To elucidate a cause for this poor response, we assessed the effect of chronic protein malnutrition on monocyte production of the pyrogens interleukin-1 (IL-1) and tumor necrosis factor (TNF). Thirteen malnourished nursing home...
Article
Thirty-five elderly patients receiving intermittent urethral catheterization in a Veterans Administration Hospital and attached nursing home care unit were prospectively studied for development of bacteriuria and/or urinary tract infection. Thirty-one of the 35 patients (88.6%) developed urinary tract colonization. The mean time from initiation of...
Article
Anaerobic bacteremia occurred in 68 patients over the age of 60 in a university hospital. These elderly patients were more likely than younger patients to have an underlying malignancy. Anaerobes involved included Bacteroides fragilis group (64 isolates), Bacteroides melaninogenicus group (11) and Clostridium species (11). Polymicrobial bacteremia...
Article
We studied 157 episodes of infection or colonization with enterococci in 122 patients over a six-month period. One hundred twelve episodes (71.3%) occurred in patients over age 60 years. The most common sites for isolation of enterococci were the urinary tract, and bone and soft tissue. Nosocomial acquisition of enterococci occurred in 74.7% of all...
Article
Nosocomial endocarditis occurred in 22 patients who were discharged from a university hospital, a veterans' hospital, and a community hospital during the period of January 1976 to December 1985. Nosocomial episodes were 14.3% of the total endocarditis cases seen. Fourteen (63.6%) of 22 nosocomial endocarditis episodes occurred in patients over the...
Article
As the population ages but continues to be active and to travel extensively, it is likely that more elderly people will be exposed to and infected with deep fungi endemic in certain areas of the country. Travel to the rural Midwest may lead to contact with Histoplasma capsulatum, whereas exposure to southwestern desert country may result in infecti...

Citations

... The reason of dominate of Staphylococcus spp isolates over the other gram negative bacteria in wounds infection may be due to these isolates have the ability to invade and spread to skin and soft-tissue, such as surgical site, abscesses, carbuncles, and boils. Furthermore, its ability to produce many enzymes and toxins require to cause infections [20,37], also represent some of these isolates (S. aureus) a large part of the normal flora of the human body, as they are found in many areas such as throat, nose, gut, genital tract, and the skin, if they move from the body to the affected areas they will cause wound infections, also the possibility of transmission through carriers from healthy people [21]. The possible reason for the availability of negative gram bacteria in samples of wound infection might be these isolates are commonly found in the hospital environment, so whenever damage in skin and soft tissue, they can easily disseminate [22]. ...
... Pneumonia generally occurs following aspiration of microorganisms from the oral cavity or nasopharynx. Aspiration pneumonia is common in the nursing home population and is often associated with oropharyngeal dysphagia and regurgitation of gastric contents [1]. Dental plaque has been particularly studied as a source of bacteria that may cause respiratory infections. ...
... Devastating consequences of poor oral health can include a variety of local and systemic illnesses, including local abscess formation, rapid spread of infection through fascial planes, and infective endocarditis [3,[6][7][8][9][10]. Older adults are disproportionately affected by these illnesses, and several excellent recent reviews have been authored on these topics (see [3], among others). ...
... The oropharyngeal region has a special role in inferior respiratory tract infections related to severe anaerobic pulmonary infections, due to aspiration of saliva, especially in patients with periodontal disease (SCANNAPIECO, 1999). This occurs because both conditions share a common etiologic factor, the gram-negative anaerobic bacteria, leading to an immunological and inflammatory response from the host (TERPENNING, 1996). The oropharynx microbial colonization is considered the greatest source of bacteria involved in the etiology of VAP (RAGHAVENDRAN et al., 2000). ...
... This contention is indirectly supported by additional evidence, suggesting that aspiration pneumonia can result from the colonization of aspirated material by pathogens in the oral cavity and the pharynx [12] [16] [17]. Related to this, there is also evidence to show that a dedicated oral hygiene routine decreases the risk of developing aspiration pneumonia [16]- [18]. ...
... In addition, tooth loss may lead to changes in dietary patterns, which can be related to hypertension [11]. A high number of lost teeth was associated with an increased risk of heart failure and the development of cardiovascular diseases [12][13][14]. However, few studies have reported associations between oral hygiene and the development of hypertension in a longitudinal setting. ...
... Factors affecting microbiota composition between different patient groups include age, physical function, general health, systemic disease, cognitive function, and indwelling devices such as urinary catheters and nasogastric tubes [38][39][40][41][42]. Langmore et al. (1998) found that factors associated with aspiration pneumonia included dependency on feeding methods, oral care, and number of decayed teeth [43]. Due to limited physical function, home-care patients suffered from severe and profound disability and were often bedridden. ...
... The increased use of prosthetic devices, oral radiation, and immunosuppressive agents renders the elderly vulnerable to more-serious complications of oral infection or bacteremias of oral origin [3]. The presence of antibiotic-resistant flora may complicate the prophylaxis needed to prevent seeding of prosthetic devices or cardiac valves during dental or oral procedures [4]. ...
... (3,l1-13) DOP-like symptoms can also be seen in cerebrovascular disease and central nervous system disorders such as dementia, multiple sclerosis, head injury and multiple system atrophy. (3,11,(14)(15)(16)(17) Central nervous system infections such as neurosyphilis, meningitis and encephalitis are some other illnesses which need to be excluded. (3) Paresthesia due to metabolic disorders especially type 2 DM can also lead to a picture of DOP. ...
... Another finding of this study is that an aqueous cream with ingredients of 500 μg/ml of allicin has an identical activity to 256 μg/ml of allicin liquid, and more interestingly, the cream formulation containing 500 µg/mL of allicin exert noteworthy antimicrobial properties versus all pathogenic organisms studied, while to create such an antimicrobial property, we should use 20,000 µg/mL of mupirocin. [80] Consequently, the cream formulation containing allicin with a therapeutic concentration (500 µg/mL) can act as a potential alternative agent to conventional (mupirocin) topical agents. [57] Prosthetic mesh infection is considered one of the main difficulties after hernia repair. ...