Effect of chlorhexidine vs. saline for oral care on oral microbiota and prognosis of elderly mechanically ventilated patients in the intensive care unit: a single-center, single-blind, randomized controlled trial

作者：Changcui Qiu, Lulu Tang, Zhuo Hang, Ke Wei, Sheng Wang, Xiaoping Zhu, Qixing Wang · 发表于：BMC Oral Health · 年份：2025 · DOI：10.1186/s12903-025-07579-7 · 被引用次数：2 · 研究领域：Nosocomial Infections in ICU、Oral microbiology and periodontitis research、Dental Research and COVID-19

BACKGROUND: The role of chlorhexidine in oral care for mechanically ventilated elderly patients remains debated, particularly regarding its impact on oral microbiota and clinical outcomes. OBJECTIVE: To compare oral microbiota composition and prognosis among elderly mechanically ventilated patients receiving oral care with either chlorhexidine solution or normal saline. METHODS: Sixty intubated patients (≥ 65 years) were randomized to receive oral care with 0.12% chlorhexidine (intervention group) or 0.9% saline (control group) three times daily during mechanical ventilation. All patients underwent standardized oral hygiene during mechanical ventilation. Oral samples were analyzed by 16 S rRNA sequencing, with outcomes compared to oral health and clinical data. Secondary outcomes included dental plaque index, ventilator-associated pneumonia (VAP), 28-day mortality, patient outcomes, and oral complications. RESULTS: One week after intervention, the chlorhexidine group exhibited a significant decrease in oral bacterial diversity (Simpson index, P = 0.037). Despite this, no significant differences were observed in clinical infection symptoms-defined as fever, purulent airway secretions, elevated white blood cell count, or increased C-reactive protein levels requiring evaluation by the attending physician. All participants received standard ICU antimicrobial prophylaxis or therapy according to institutional protocols; no additional systemic antibiotics were initiated solely for o...