Comparative evaluation of oral microbial profile in periodontitis and ventilator associated pneumonia patients

Aim: Dental plaque of patients in the Intensive Care Unit (ICU) can provide an environment for colonization of potential respiratory pathogens (PRP) making it a major risk factor for developing Ventilator associated pneumonia(VAP). This study was aimed to assess and compare the role of dental plaque as a reservoir for respiratory pathogens in causing Ventilator Associated Pneumonia.
Materials and Methods: A total of 30 patients belonging to the age group of 40-75 years were enrolled in the study. The subjects were assigned into 3 groups: Group 1 – Healthy, Group 2 – Chronic generalized periodontitis (CGP) and Group 3 – Ventilator associated pneumonia (VAP). Dental examination included recording Simplified Oral Hygiene Index (OHI-S), Gingival Index (GI) and Plaque Index (PI) to assess the oral hygiene status and gingival condition. Supragingival plaque samples were collected from all the 3 groups and subgingival plaque samples were collected only from group 2. The samples were subjected for aerobic and anerobic microbial analysis. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) software.
Results: Aerobic culture of supragingival plaque showed the presence of Klebsiellapneumoniae, Pseudomonas aeruginosa and Escherichia coli in group 3 patients, which was statistically significant (P < 0.001) when compared to group-2 and group-1 patients. It also showed a statistically significant difference in the mean scores of OHI-S, GI and PI scores (p< 0.001) in group 3 when compared to group 1 suggesting that VAP patients had poor oral hygiene and attributed to lack or abstinence of oral hygiene practices during mechanical ventilation.
Conclusion: There was a definitive, qualitative difference of oral microflora seen between above 3 groups and Dental plaque acts as a reservoir for potential respiratory pathogens (Klebsiellapneumoniae, Pseudomonas aeruginosa and Escherichia coli) in causation of ventilator associated pneumonia.