Oral carriage of yeasts and coliforms in stroke sufferers: a prospective longitudinal study

Abstract

To investigate prospectively the qualitative and quantitative changes in oral carriage of yeasts and coliforms in southern Chinese people suffering from stroke. In 56 elderly people suffering from stroke in a rehabilitation unit of a general medical hospital in Hong Kong, oral microbiological sampling using a combined imprint culture, oral rinse approach and clinical assessment was made during the acute stroke phase, on hospital discharge and 6 months later. The oral carriage of yeasts increased significantly during acute stroke (P<0.05), whereas coliform carriage did not. A reduction in oral carriage of yeasts was found on hospital discharge and 6 months later and in coliforms at the 6-month assessment (P<0.05). Candida albicans and Klebsiella pneumoniae were the predominant yeast and coliform respectively. Stroke-related difficulty in tooth brushing and denture wearing were associated with higher oral yeast carriage (P<0.05). We also report here for the first time that the use of aspirin was associated with lower oral yeast carriage in people suffering from stroke. Oral yeast carriage was closely linked to the level of stroke-related functional disability that improved over time but had not totally resolved 6 months after hospital discharge. The oral reservoir of yeasts and coliforms in people suffering from stroke is noteworthy by care providers as K. pneumoniae may cause aspiration pneumonia.