Abstract
Ventilator-associated pneumonia (VAP) is one ofthe most prevalent healthcare-associated infections (HAI) andcauses of death in intensive care units (ICUs), and studies haveshown its relation to oral health. Aim: To report the impact ofthe incorporation of dental professionals into multidisciplinaryICU staff on the incidence of VAP. Methods: A retrospectiveobservational study was carried out to collect and analyzehealth indicators of patients in the ICUs from 2011 to 2018 andto differentiate these indicators between the periods beforeand after the participation of dental staff in the ICU. This studywas approved by the Research Ethics Committee. Results:The average number of monthly ICU admissions was 105.89 ±169.72, and the discharge was 105.21 ± 168.96, with a monthlyaverage number of deaths within 24 h of 38.61 ± 62.27. Theaverage number of monthly HAI-related deaths decreasedfrom 2011 to 2018, followed by a reduction in cases of HAIper month. The average monthly number of HAIs relatedto mechanical ventilation (MV) decreased, and the samewas observed for the infection density of HAIs related to MV(p < 0.001). In multivariate analysis, there was a significantdecrease in the number of HAIs related to MV (p = 0.005).Conclusion: Although a reduction in the number of admissionsor complexity of cases was not observed in the study period,multidisciplinary staff practices were essential for controllingHAIs and the presence of dental professionals can assist in thecontrol of HAIs related to MV.
Highlights
In Brazil, intensive care was implemented in the 1970s
The average monthly number of healthcare-associated infections (HAI) related to mechanical ventilation (MV) decreased, and the same was observed for the infection density of HAIs related to MV (p < 0.001)
Conclusion: a reduction in the number of admissions or complexity of cases was not observed in the study period, multidisciplinary staff practices were essential for controlling HAIs and the presence of dental professionals can assist in the control of HAIs related to MV
Summary
In Brazil, intensive care was implemented in the 1970s. This measure brought about a substantial decrease in the number of deaths in intensive care units (ICUs)[1] and reduced the number of healthcare-associated infections (HAIs), which are among the main causes of increased length of stay in ICUs and the incidence of death during hospitalization[2].Lack of attention to oral hygiene and reduced salivary flow in ICU patients increases the complexity and amount of biofilm, which can favor the interaction between indigenous plaque bacteria and respiratory pathogens such as P. aeruginosa and enteric gram-negative bacilli. In Brazil, intensive care was implemented in the 1970s This measure brought about a substantial decrease in the number of deaths in intensive care units (ICUs)[1] and reduced the number of healthcare-associated infections (HAIs), which are among the main causes of increased length of stay in ICUs and the incidence of death during hospitalization[2]. VAP remains a major cause of morbidity and mortality, and it increases the cost of care for critically ill patients[2,4,5,6]. The incidence of VAP ranges from 6% to 52%; in ICUs, it represents 25% of all infections. Intubation is associated with an increased risk; approximately 90% of VAP episodes in ICUs occur in patients on mechanical ventilation (MV)[7]. Despite a study that showed mortality rates of 50% in patients who develop VAP8; on average, death occurs in 10% of cases[4]
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