Oral carriage of yeasts and coliforms in stroke sufferers: a prospective longitudinal study

Aim: To investigate prospectively the qualitative and quantitative changes in oral carriage of yeasts and coliforms in southern Chinese people suffering from stroke. Materials and methods: In 56 elderly people suffering from stroke in a rehabilitation unit of a general medical hospital in Hong Kong, oral microbiological sampling using a combined imprint culture, oral rinse approach and clinical assessment was made during the acute stroke phase, on hospital discharge and 6 months later. Results: The oral carriage of yeasts increased significantly during acute stroke ( P < 0.05), whereas coliform carriage did not. A reduction in oral carriage of yeasts was found on hospital discharge and 6 months later and in coliforms at the 6‐month assessment ( P < 0.05). Candida albicans and Klebsiella pneumoniae were the predominant yeast and coliform respectively. Stroke‐related difficulty in tooth brushing and denture wearing were associated with higher oral yeast carriage ( P < 0.05). We also report here for the first time that the use of aspirin was associated with lower oral yeast carriage in people suffering from stroke. Conclusion: Oral yeast carriage was closely linked to the level of stroke‐related functional disability that improved over time but had not totally resolved 6 months after hospital discharge. The oral reservoir of yeasts and coliforms in people suffering from stroke is noteworthy by care providers as K. pneumoniae may cause aspiration pneumonia.