Abstract
We examined the prevalence of major opportunistic pathogens identified in the dental plaque of adults/children with severe motor and intellectual disabilities who were residents of a rehabilitation and nursery center. Subsequently, oral care practice was changed to reduce the incidence of opportunistic pathogens in dental plaque expecting higher effects of disinfection, and the effectiveness was evaluated by bacteriological examination; identification of targeted organisms; and approximate number of colonies evaluated as (+), (++), (+++). Of 56 residents, 11 and 45 were cared in each of the intensive-care and day-care rooms, respectively. One to three types of targeted organisms were identified in the dental plaque of 24 residents, and the major opportunistic pathogens MRSA, Pseudomonas aeruginosa and Serratia marcescens were detected in 14(25.0%), 14(25.0%) and 5(8.9%) residents, respectively. Oral care practice was changed to two new methods for the residents in the intensive-care and day-care rooms, and bacteriological examination was performed for 20 residents in whom any of these 3 types of organisms was detected. Before the change of oral care practice, MRSA was found in 1(+++), 2(++) and 11(+) residents, P. aeruginosa in 8(+++), 5(++) and 1(+) residents, and S. marcescens(+++) in 5 residents. After the change of oral care practice, these three organisms tended to persist in the same residents, but 5 months later, MRSA was found in 0(+++), 0(++) and 7(+) residents, P. aeruginosa in 0(+++), 10(++) and 2(+) residents, and S. marcescens 3(+++) and 1(+) residents. Although the changed oral care practice was effective in removing or reducing opportunistic pathogens in dental plaque, P. aeruginosa was hard to remove. The present study indicates that further development is needed for oral care practice based on the individual condition of the oral cavity, bacterial species detected, and viable counts in adults/children with severe motor and intellectual disabilities.
