2018 Section 6 - Laryngology, Voice Disorders, and Bronchoesophalogy

Volume 27, Number 12, December 2015

Oral microbiota in older dysphagic patients

locations on the first visit. Around 245 410 good quality sequencing reads were obtained, with a median of 1569 reads per sample. As seen on rarefaction plots, this sequencing depth permitted making robust con- clusions regarding the diversity measures, even though the plateau in terms of detection of all bacterial taxa was not reached (Fig. S1). Microbiota composition showed high inter-individual variability; however, nasopharynx microbiota was markedly different from oral (from oral rinse and saliva) in all groups (Fig. 3). Microbiota of nasopharynx was dominated by Moraxella , Corynebacterium , Staphylococcus , Strep- tococcus , and Alloiococcus , whereas saliva and oral rinse were quite similar to each other and contained predominantly Veionella , Neisseria , Prevotella , Por- phyromonas , Haemophilus , and streptococci. The dif- ferences among nasopharynx and oral samples were highly significant (permanova performed on unifrac distances, unweighted Pseudo-F = 10.9, p < 0.001; weighted, Pseudo-F = 13.8, p < 0.001). As many as 87 of the 113 identified operational taxonomic units (OTUs) differed significantly between the anatomical locations (data not shown). Nasopharyngeal microbiota was much less diverse than that in oral rinse and saliva (Figs. S2 and S3). The differences among patient groups were less pronounced (Fig. 3). Control group showed higher microbiota diversity, significant for saliva ( p = 0.03, Table S1). Microbiota composition showed no significant differences among patient groups (per-

338.7 108.9 ms, patients with OD, 317.33 63.19 ms and patients with OD-APN, even longer with 409.2 115.6 ms; p < 0.05 vs both groups.

Oral health and hygiene

Oral health and hygiene status were found to be similar and very poor in all groups, with high prevalence of periodontal diseases and caries and high accumulation of plaque and/or calculus (Table 2). We found a slightly healthier status in the control group, but without significant differences (Table 2). The following results are based on dentate patients. OHI-S data showed high prevalence of patients with poor oral hygiene and very few with good oral hygiene status (OHI-S value between 0 and 1). More than 50% of this poor OHI-S in all groups was caused by accumulation of soft dental plaque that can be easily removed by tooth brushing (Table 2). Prevalence of periodontitis ( > 87%) and caries ( > 72%) was very high in all groups of patients with OD. Only 40% of OD- PNP, nearly 25% of OD and OD-APN, and 55.6% healthy patients had visited the dentist during the previous year.

Oral microbiota

Microbiota composition Microbiota composition was evaluated in samples taken from four anatomical

Table 2 Oral hygiene and health of the study groups

G1 OD-PNP

G2 OD

G3 OD-APN

G4 H

p -value

Subjects

14

13

11

13

Edentulism (%) Number of teeth

35.7 (5)

15.4 (2)

27.3 (3)

7.7 (1)

ns ns ns ns

16.22 8.6 3.13 1.5

18.6 10.1

18.11 6.8 3.26 1.5

21.17 6.2 2.54 1.3

OHI-S

3.4 1.1

0 – 1 (good) (%) 1.1 – 3 (fair) (%) 3.1 – 6 (poor) (%)

11.1 (1) 33.3 (3) 55.6 (5)

0

14.3 (1) 14.3 (1) 71.4 (5)

16.7 (2) 58.3 (7)

45.5 (5) 54.5 (6)

25 (3) 68.68 31.32

Plaque (%)

60.25 39.75

58.49 41.51

55.86 44.14

ns ns

Calculus (%)

Oral diseases Healthy (%)

11.11 (1)

9.09 (1)

0 0

8.33 (1)

ns ns ns ns

Gingivitis (%)

0

0

0

Periodontitis (%)

88.9 (8) 77.8 (7)

90.9 (10) 72.7 (8)

87.5 (7) 85.71 (6)

91.7 (11)

Caries (%)

50 (6)

Oral habits (persons) Tooth brushing ( ≥ 1/day) (%) Denture cleaning ( ≥ 1/day) (%) Last visit dentist ( ≤ 1 year) (%)

5

11

10

9

60 (3)

63.63 (7)

60 (6)

88.9 (8)

ns

40 (2)

45.5 (5)

30 (3)

33.3 (3)

ns

40 (2)

27.27 (3)

20 (2)

55.6 (5)

ns

OD-PNP, patients with oropharyngeal dysphagia and prior pneumonia; OD, patients with oropharyngeal dysphagia; OD-APN, patients with acute pneumonia and oropharyngeal dysphagia; H, healthy older persons.

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