Oropharyngeal Microbiota in Frail Older Patients Unaffected by Time in Hospital

Area of Science:

• Microbiology
• Geriatrics
• Infectious Diseases

Background:

• Nosocomial infections, particularly respiratory tract infections (RTIs), are common in elderly patients with comorbidities.
• The oropharyngeal microbiota serves as a primary reservoir for these infections.
• Understanding factors influencing oropharyngeal microbial community structure is crucial for infection prevention in vulnerable patient groups.

Purpose of the Study:

• To investigate the influence of hospitalization duration and patient demographics on the oropharyngeal microbiota community structure in older adults with lower limb fractures.
• To determine whether patient characteristics at admission or time in hospital are more significant drivers of microbial community composition.

Main Methods:

• 16S rRNA gene sequencing of 167 throat swabs from 53 patients (mean age 83) over 14 days post-hospitalization.
• Assessment of frailty/comorbidity indices, dental status, and RTI incidence.
• Analysis of microbial community structure using correspondence analysis (CA) and canonical correspondence analysis.

Main Results:

• Microbial community structure was significantly associated with frailty, number of teeth, and comorbidity at admission, with comorbidity having the most substantial impact.
• Hospitalization duration did not significantly alter alpha or beta diversity of the oropharyngeal microbiota.
• The incidence of respiratory pathogens was not linked to time in hospital or oral microbiota alpha diversity.

Conclusions:

• Patient characteristics present at admission, particularly comorbidities, are the primary determinants of oropharyngeal microbiota structure in older adults with fractures.
• Hospitalization duration is not a significant factor in shaping the oropharyngeal microbial landscape in this population.
• These findings highlight the importance of baseline patient factors in understanding infection risk and oropharyngeal microbiota dynamics.