Effects of oral antiseptics on bacterial colonisation in mechanically ventilated patients

Background: Oral care interventions with active disinfectants have great potential to effect the oropharyngeal, subglottic and endotracheal bacterial colonization in invasive mechanically ventilated patients and nosocomial pneumonia should be reduced by oral care with topical antiseptic agents containing chlorhexidine and povidone iodine. Objective: To evaluate the effects of oral care with chlorhexidine and povidone iodine on oropharyngeal, subglottic and endotracheal bacterial colonization in endotracheal intubated patients in intensive care unit. Materials: Endotracheal intubated and mechanically ventilated 30 patients were equally randomized to receive oral decontamination with normal saline (control group), %0.12 chlorhexidine gluconat + %0.15 benzidamine hydrochloride (KG) and %7.5 povidone iodine (PI), 4 times per day. Bacterial sampling and cultures of oropharyngeal, subglottic and endotracheal aspirates were done at intensive care admission and on days 3 and 5. Colonization with gram negative and positive bacilli was assessed and compared between the groups. Results: The characteristics of all groups were not significantly different. Oral care with active disinfectants reduced bacterial colonization when compared with normal saline in intensive care process. Bacterial colonization in subglottic aspirates were detected in %80 of control group?s patients and %10 of PI group?s patients; however, colonization was not detected in subglottic specimens in chlorhexidine group. Conclusion: Oral care with chlorhexidine and povidone iodine either reduced or prevented oral, subglottic and endotracheal bacterial colonization in invasive mechanically ventilated patients.