Association between the point‑rating system used for oral health and the prevalence of pneumonia‑causing bacteria in malnourished patients

Despite the importance of oral care in the prevention of aspiration pneumonia, the association between oral hygiene and the prevalence of pneumonia‑causing bacteria has not yet been determined. The present study is a cross‑sectional study aimed at determining the association between the original point‑rating system used during oral examinations (the prompt non‑invasive oral assessment) and the prevalence of pneumonia‑causing bacteria in a population of hospitalized patients with malnutrition. The nutrition support team cared for 61 patients; 6 were excluded as they were not eligible. Bedside analyses were conducted using the point‑rating system. The findings were analyzed to determine the association between the prompt non‑invasive oral assessment and the detection of pneumonia‑causing bacteria. Patients who tested positive for pneumonia‑causing bacteria (n=13) received significantly higher total and hygiene item scores than those who tested negative (n=42) [median (25th, 75th percentile), total score, 6 (4, 7) vs. 3 (1, 5), P=0.02; hygiene score, 2 (1, 3) vs. 1 (0, 2), P=0.02]. In the receiver operating characteristic analysis, a total oral assessment cut‑off score of 4 was identified as optimal for detecting pneumonia‑causing bacteria. Additionally, a multivariable analysis revealed a high odds ratio for the presence of pneumonia‑causing bacteria in patients with poor oral hygiene (odds ratio, 2.09; 95% CI, 1.04 to 4.22). Thus, the present study demonstrates that the prompt non‑invasive oral assessment is a simple and effective tool for detecting pneumonia‑causing bacteria in hospitalized patients.