2009 Volume 24 Issue 1 Pages 27-35
This study investigated infection control procedures for preventing pneumonia in long-term home-care patients who require endotracheal suctioning. We interviewed 20 patients and caregivers regarding the maintenance condition of endotracheal suction catheters and oral care of patients. At the same time, cleaning solution used before and after catheter suctioning, soaking solution used for catheter maintenance, and supragingival plaque sample were collected from each patient, and bacteriological examinations were performed. Of 20 patients, 20 had undergone tracheotomy, 18 were bedridden, and 15 had episodes of pneumonia. Of 20 caregivers who used catheters repeatedly for more than 24 hours, 16 were used soaking solutions and 4 used dry containers for catheter maintenance, and 8 used only one solution for cleaning and soaking. Serratia marcescens and Pseudomonas aeruginosa were isolated at high frequencies from the cleaning and/or soaking solutions of 14 and 6 patients, respectively. The solutions from 6 patients were highly contaminated by bacteria at levels exceeding 105 cfu/mL. Oral care was provided to most patients once or twice a day. However, P. aeruginosa, S. marcescens, and Klebsiella pneumoniae were isolated from the supragingival plaque samples of 16, 8, and 3 patients, respectively. Levels of these bacteria exceeding 105 cfu/mL were detected from supragingival plaque samples of 18 patients. P. aeruginosa and/or S. marcescens isolated from supragingival plaque samples of 17 patients were also isolated from the cleaning and/or soaking solutions of 11 patients. Infection control procedures are very important to practice for home-care patients at high risk for pneumonia, focusing on the use of clean catheters, and the necessity for improving the daily oral care strategy.
