Oral and tracheal microbiota of pediatric and adolescent patients in an intensive care unit.

Abstract

To characterize the oral and tracheal microbiota of patients admitted to a pediatric intensive care unit (PICU). This is an exploratory study conducted on patients aged 5months to 13years admitted to the PICU of a referral hospital. Two microbiological samples were collected with a swab in the posterior region of the tongue from patients receiving spontaneous and mechanical ventilation within the first 24 and 48h after admission to the PICU. Among patients receiving mechanical ventilation, tracheal secretion was also collected in a second sampling. The caries experience was evaluated using the DMFT/dmf index, and the quality of oral hygiene was assessed based on the visual plaque index (VPI). A questionnaire was applied to obtain data on hospital routine and sample characteristics. The DMFT/dmf index was 1.66 (SD=2.18) and the mean VPI was 43.03 (SD=36.93). The most prevalent microorganisms were Klebsiella pneumoniae (15%). Oral colonization by opportunistic pathogens was significantly higher in patients receiving mechanical ventilation compared to those on spontaneous ventilation (p<.05). There was no relationship of VPI or DMFT/dmf with oral microbiological changes. The results indicate that PICU patients are susceptible to colonization by respiratory and opportunistic pathogens since the first hours of hospitalization.