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Published on: October 20, 2011
Oral flora in acute stroke patients: A prospective exploratory observational study
Elizabeth Boaden1, Mary Lyons1, Sim K Singhrao2
1Faculty of Health and Wellbeing, School of Nursing, University of Central Lancashire, Preston, UK.
Objective:
To describe the bacterial profile of the oral flora during the first 2 weeks following a stroke, examining changes in the condition of the oral cavity and infections.
Background:
Dysphagia is common after a stroke and can lead to aspiration pneumonia. Oral flora changes associated with stroke have been implicated as a possible source of bacteria that can cause systemic infections.
Materials And Methods:
Seventy-seven participants were recruited over a period of 9 months. Fifty participants had a complete set of swabs from four different oral sites and a saliva sample taken at three time points over a 14-day period. Molecular identification of bacteria was performed on the pooled DNA extracted.
Results:
A total of 103 bacterial phylotypes were identified, 29 of which were not in the Human Oral Microbiome Database (HOMD). Fourteen of the twenty most common bacterial phylotypes found in the oral cavity were Streptococcal species with Streptococcus salivarius being the most common. The condition of the oral cavity worsened during the study period. Fifteen (30%) patients had at least one infection.
Conclusions:
There appears to be huge diversity of bacterial organisms in the oral cavity of stroke patients, and as most phylotypes identified were only found in one or two participants, no particular patterns linked to infection or the condition of the oral cavity could be discerned.
Insights
Stroke patients show diverse oral bacteria, with Streptococcus species being common. Oral health declined, and infections occurred, but specific bacterial patterns linked to these outcomes were not identified in the first two weeks post-stroke.
Area of Science:
- Microbiology
- Neurology
- Oral Health
Background:
- Stroke often causes dysphagia, increasing aspiration pneumonia risk.
- Altered oral flora post-stroke may contribute to systemic infections.
Purpose of the Study:
- To characterize oral bacterial profiles in stroke patients within 2 weeks of stroke.
- To assess oral cavity condition and infection development.
Main Methods:
- Recruited 77 participants over 9 months.
- Collected oral swabs and saliva from 50 participants at 3 time points over 14 days.
- Used molecular identification for bacterial phylotypes from pooled DNA.
Main Results:
- Identified 103 bacterial phylotypes; 29 were novel to the Human Oral Microbiome Database.
- Streptococcal species, particularly Streptococcus salivarius, were most common.
- Oral cavity condition worsened, and 30% of patients developed infections.
Conclusions:
- Stroke patients exhibit high oral bacterial diversity.
- No clear patterns linked specific bacteria to oral condition or infections were identified.
- Further research is needed to understand oral microbiome changes post-stroke.
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