BACKGROUND: Previous studies by our group have identified a high prevalence of Gram-negative bacilli in the mouths of stroke patients. Eradication of such organisms by selective decontamination of the digestive tract (SDD) has not previously been studied. Enterobacter sakazakii is a rarely found organism that has previously been identified as a cause of neonatal meningitis and sepsis but that has rarely been reported as a pathogen in older people. The purpose of this study was to look specifically for E. sakazakii in the mouths of stroke patients and to correlate its isolation with response to SDD gel and the presence of clinical complications such as pneumonia. METHODS: Following an acute stroke, 203 patients were recruited for the study and received placebo or SDD in a 50:50 ratio. Oral swabs were obtained on nine separate occasions and E. sakazakii was cultured from them. Clinical data were prospectively collected and analysed. RESULTS: E. sakazakii was identified in 7 of 203 patients. The organism was almost exclusively removed by SDD gel, but in those patients in whom an abnormal swallow was present, pneumonia was found in two of the four cases. CONCLUSION: E. sakazakii may colonise the mouths of acute stroke patients. Since SDD gel is not routinely administered to such patients, this organism may be implicated in patients who subsequently develop aspiration pneumonia.
BACKGROUND: Previous studies by our group have identified a high prevalence of Gram-negative bacilli in the mouths of strokepatients. Eradication of such organisms by selective decontamination of the digestive tract (SDD) has not previously been studied. Enterobacter sakazakii is a rarely found organism that has previously been identified as a cause of neonatal meningitis and sepsis but that has rarely been reported as a pathogen in older people. The purpose of this study was to look specifically for E. sakazakii in the mouths of strokepatients and to correlate its isolation with response to SDD gel and the presence of clinical complications such as pneumonia. METHODS: Following an acute stroke, 203 patients were recruited for the study and received placebo or SDD in a 50:50 ratio. Oral swabs were obtained on nine separate occasions and E. sakazakii was cultured from them. Clinical data were prospectively collected and analysed. RESULTS:E. sakazakii was identified in 7 of 203 patients. The organism was almost exclusively removed by SDD gel, but in those patients in whom an abnormal swallow was present, pneumonia was found in two of the four cases. CONCLUSION:E. sakazakii may colonise the mouths of acute strokepatients. Since SDD gel is not routinely administered to such patients, this organism may be implicated in patients who subsequently develop aspiration pneumonia.
Authors: L Carter; L A Lindsey; C J Grim; V Sathyamoorthy; K G Jarvis; G Gopinath; C Lee; J A Sadowski; L Trach; M Pava-Ripoll; B A McCardell; B D Tall; L Hu Journal: Appl Environ Microbiol Date: 2012-11-09 Impact factor: 4.792
Authors: J Caubilla-Barron; E Hurrell; S Townsend; P Cheetham; C Loc-Carrillo; O Fayet; M-F Prère; S J Forsythe Journal: J Clin Microbiol Date: 2007-10-10 Impact factor: 5.948
Authors: Christopher J Grim; Michael L Kotewicz; Karen A Power; Gopal Gopinath; Augusto A Franco; Karen G Jarvis; Qiong Q Yan; Scott A Jackson; Venugopal Sathyamoorthy; Lan Hu; Franco Pagotto; Carol Iversen; Angelika Lehner; Roger Stephan; Séamus Fanning; Ben D Tall Journal: BMC Genomics Date: 2013-05-31 Impact factor: 3.969