Kimberly Rathbun, BSN, RN,
Pre-Doctoral Fellow; PhD Student; Graduate Student Research Assistant
University of Central Florida
Orlando, Florida
Disclosure information not submitted.
Shibu Yooseph, PhD
Professor, Department of Computer Science; Lead for the Genomics and Bioinformatics Cluster
University of Central Florida, United States
Disclosure information not submitted.
Anna Forsman, PhD
Assistant Research Scientist
University of Central Florida
Orlando, Florida, United States
Disclosure information not submitted.
Mary Lou Sole, PhD, RN, CCNS, FAAN, FCCM
Dean and Professor, Orlando Health Endowed Chair in Nursing
University of Central Florida, College of Nursing
Orlando, Florida, United States
Disclosure information not submitted.
Annette Bourgault, PhD, RN, CNL, FAAN
Associate Professor
University of Central Florida, College of Nursing, Orlando, United States
Orlando, Florida
Disclosure information not submitted.
Steven Talbert, PhD, RN
Interim Director of Nursing PhD Program; Clinical Assistant Professor
University of Central Florida, United States
Disclosure information not submitted.
Title: Changes in the Oral Microbiome in Non-Ventilated Hospitalized Patients Over Time
Introduction: Non-ventilator hospital acquired pneumonia (NV-HAP) is a prevalent healthcare-associated infection associated with high mortality rates and costs. Changes in the oral microbiome may play a role in NV-HAP. We hypothesized that oral bacterial taxonomy and diversity would change during hospitalization, and that baseline oral bacterial diversity would be lower in patients admitted to the hospital from a nursing home compared to home.
Methods: This exploratory study 1) assessed changes in the oral microbiome over time of non-ventilated hospitalized adults > 65 yrs enrolled within 72h of admission; 2) compared baseline oral microbial diversity between patients admitted from home and nursing home; and 3) explored the relationship between the oral microbiome and NV-HAP. Preliminary data were analyzed from 9 patients who consented to participate in a larger prospective, longitudinal study. Oral salivary specimens were collected at four time points: baseline, day 3, day 5, and day 7 of hospitalization (or prior to discharge). Genomic DNA was extracted from samples for microbiome profiling by 16S rRNA sequencing. Taxonomic composition, relative abundance, and alpha-diversity (Shannon index) of the bacterial communities were determined from the 16S data. Data were analyzed with descriptive and non-parametric repeated measures statistics.
Results: Most patients were female (78%), white (67%), with median age 78 yrs. The most frequently identified oral bacterial genera were Prevotella, Streptococcus, and Veillonella. Mean Shannon index was similar across time points: 5.01, 4.78, 4.86, and 5.03 (p >.05). Mean baseline oral bacterial diversity was lower in the one nursing home patient compared to eight patients admitted from home (2.71 vs. 5.01). Oral care was completed a mean of 0.7 times/day during hospitalization. One of the nine patients (11%) developed probable NV-HAP on day 5, during which oral colonization with Neisseria increased and became predominant.
Conclusions: Changes in the oral microbiome may contribute to NV-HAP development. Assessment of oral microbial changes over time and the role of oral care on the oral microbiome in non-ventilated patients needs further exploration using a larger sample size.