Oral Microbiological Evidence among Palliative Patients: An Integrated Systematic Review

Life-limiting diseases such as cancers and its related treatments often compromise normal oral microbial flora and predispose a palliative patient to diverse oral infections. Knowledge on microbial flora in the oral cavity of patients with life-limiting diseases is essential to develop treatment options for clinical practitioners. This review aimed to systematically synthesize the published evidence on the oral microbiology of palliative patients. An integrative review was undertaken with defined search strategy from five databases with manual search through key journals and reference list. Studies included were published during the year 2000-2017 focusing on microbiological evidence associated with oral conditions among palliative patients. Candida presence was reported in the oral cavity of terminally ill patients in seven of nine articles, with Candida albicans being the predominant species. The majority of the included studies used oral swabs as a technique for isolation of the organism. This review is first to systematically synthesize the published evidence on the oral microbial flora of palliative patients, taking into account the techniques for identification of the microbiota. Larger multicenter studies may help in developing standardized clinical guidelines for the oral care of these patients.