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Oral carriage of yeasts and coliforms in stroke sufferers: a prospective longitudinal study
H W Zhu1, A S McMillan, C McGrath
1Oral Rehabilitation, Faculty of Dentistry, University of Hong Kong, and Department of Rehabilitation Medicine, Tung Wah Hospital, Sheung Wan, Hong Kong.
Aim:
To investigate prospectively the qualitative and quantitative changes in oral carriage of yeasts and coliforms in southern Chinese people suffering from stroke.
Materials And Methods:
In 56 elderly people suffering from stroke in a rehabilitation unit of a general medical hospital in Hong Kong, oral microbiological sampling using a combined imprint culture, oral rinse approach and clinical assessment was made during the acute stroke phase, on hospital discharge and 6 months later.
Results:
The oral carriage of yeasts increased significantly during acute stroke (P<0.05), whereas coliform carriage did not. A reduction in oral carriage of yeasts was found on hospital discharge and 6 months later and in coliforms at the 6-month assessment (P<0.05). Candida albicans and Klebsiella pneumoniae were the predominant yeast and coliform respectively. Stroke-related difficulty in tooth brushing and denture wearing were associated with higher oral yeast carriage (P<0.05). We also report here for the first time that the use of aspirin was associated with lower oral yeast carriage in people suffering from stroke.
Conclusion:
Oral yeast carriage was closely linked to the level of stroke-related functional disability that improved over time but had not totally resolved 6 months after hospital discharge. The oral reservoir of yeasts and coliforms in people suffering from stroke is noteworthy by care providers as K. pneumoniae may cause aspiration pneumonia.
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