高齢在宅療養者の口腔内微生物―経口摂取群と非経口摂取群における検討

Oral Microorganisms in the Homebound Elderly: A Comparison between Oral Feeding and Tube Feeding

要旨

　目的：高齢の在宅療養者を対象に，経口摂取群者と非経口摂取群者の口腔内衛生状態について検討した．

　方法：在宅療養中の65歳以上の高齢者56名を対象として，滅菌綿棒による口腔内擦掻により口腔内微生物を採取し，Staphylococcus aureus，Pseudomonas aeruginosaおよびCandida albicansを定量的に測定した．

　結果：P. aeruginosaは経口摂取者からは全く検出されなかったが，非経口摂取者において検出率（64.7％），総菌数（中央値2.0×10CFUs/ml，範囲0～1.5×104CFUs/ml）ともに有意に多かった（p＜.001）．S. aureus，C. albicansは検出率，総菌数ともにいずれも有意差はみられなかった．

　結論：高齢の在宅療養者においては，経口摂取者に比較して非経口摂取者の口腔内の衛生状態はより不良で，肺炎のハイリスク群であることが示唆された．

Abstract

　Purpose：To compare oral hygiene of the homebound elderly receiving oral feeding with those receiving tube feeding.

　Methods：In 56 homebound elderly over 65 years, the oral mucous membrane was rubbed with a disinfected cotton swab and oral microbes were obtained. Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans were measured quantitatively.

　Results：P. aeruginosa was not detected in the oral feeding group. The rate of detection（64.7%） and colony forming units（median；2.0×10 CFUs/ml，range；0～1.5×104 CFUs/ml） of P. aeruginosa were significantly higher in the tube feeding group（p＜.001）. No significant differences were found in the rate of detection and colony forming units of S. aureus and C. albicans between the two groups.

　Conclusions：In the homebound elderly, the oral hygiene of those receiving tube feeding was inferior to those receiving oral feeding, which indicates a higher risk of aspiration pneumonia in tube feeding than in oral feeding.