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Ventilator-associated pneumonia (VAP) is the most commonly reported nosocomial infection among intensive care unit (ICU) patients. This study aimed to evaluate the influence of an oral hygiene protocol on VAP incidence among mechanically-ventilated (MV) ICU patients. The dentate patients admitted without VAP to the hospital’s adult ICU requiring mechanical ventilation for ≥48 hours during a 4-month period in two consecutive years (2015 – Control group and 2016 – Experimental group) were included in this investigation. The oral hygiene protocol was implemented daily, once a day, in the morning hours, using a disposable brush with suction and ultrasoft bristles and 3 g of 0.12% chlorhexidine gel. Hospital-related respiratory infection data, including VAP diagnoses and microbiological analyses, were collected from the monthly health epidemiological notification bulletins issued by the hospital. T tests were applied to compare variables before versus after implementation of the oral hygiene protocol with a significance criterion of P < .05. 43.94% reduction in VAP rate after the protocol implementation was observed. Implementation of the protocol was associated with a significant reduction of Enterobacter spp infections and no cases of VAP related to the main etiological agents of the disease (i.e., S. aureus and C. albicans) were identified. It can be concluded that an oral hygiene protocol performed with a suction brush and 0.12% chlorhexidine gel can serve as an effective prophylaxis against VAP in patients under mechanical ventilation.Keywords: Intensive Care Units. Disease Prevention. Oral Hygiene.ResumoA pneumonia associada a ventilacao (PAV) e a infeccao nosocomial mais comumente relatada em pacientes de Unidade de Terapia Intensiva (UTI). Este estudo teve como objetivo avaliar a influencia de um protocolo de higiene bucal na incidencia de PAV entre pacientes sob ventilacao mecânica (VM). Os pacientes dentados internados na UTI adulta do hospital sem PAV e que necessitaram de ventilacao mecânica por ≥ 48 horas durante um periodo de 4 meses em dois anos consecutivos (2015 - grupo Controle e 2016 - grupo Experimental) foram incluidos nesta investigacao. O protocolo de higiene bucal foi implementado diariamente, uma vez ao dia, nas primeiras horas da manha, utilizando-se escova descartavel com cerdas de succao e ultramacia e 3 g de gel de clorexidina a 0,12%. Dados de infeccao respiratoria relacionada ao hospital, incluindo diagnosticos de PAV e analises microbiologicas, foram coletados dos boletins mensais de notificacao epidemiologica de saude emitidos pelo hospital. Testes t foram aplicados para comparar as variaveis antes e apos a implementacao do protocolo de higiene bucal com um criterio de significância de P <0,05. Observamos uma reducao de 43,94% na taxa de PAV apos a implementacao do protocolo. A implementacao do protocolo foi associada a uma reducao significativa das infeccoes por Enterobacter spp e nao foram identificados casos de PAV relacionados aos principais agentes etiologicos da doenca (isto e, S. aureus e C. albicans). Pode-se concluir que u protocolo de higiene bucal realizado com escova de succao e gel de clorexidina a 0,12% pode servir como uma profilaxia efetiva contra a PAV em pacientes sob ventilacao mecânica.Palavras-chave: Unidade de Terapia Intensiva. Prevencao de Doencas. Higiene Bucal.

Analysis of the Preventative Influence of an Oral Hygiene Protocol on Ventilator-Associated Pneumonia