Physiologic Factors Contributing to a Transition in Oral Immunity among Mechanically Ventilated Adults

Pamela V. O’neal, Nicole Brown, Cindy Munro

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Ventilator-associated pneumonia (VAP), a specific type of nosocomial pneumonia, occurs in approximately 21% of patients in intensive care, and the mortality can be as high as 71%. VAP causes considerable mortality and morbidity, and it exponentially increases health care costs. The incidence of VAP is associated with oropharyngeal colonization of gram-negative bacteria. Within 48 h of hospital admission, the composition of the oropharyngeal flora of critically ill patients undergoes a change fromthe usual gram-positive streptococci and dental pathogens to a predominant gram-negative flora that includes more virulent organisms, which predispose patients to VAP. Identification and understanding of this oral transition from gram-positive to predominantly gram-negative flora may assist health care professionals in differentiating among oral immune markers that suggest compromised immunity. The purpose of this article is to provide a review of the literature that promotes an understanding of current knowledge about the transition of oral immunity in mechanically ventilated patients.

Original languageEnglish (US)
Pages (from-to)132-139
Number of pages8
JournalBiological Research For Nursing
Issue number3
StatePublished - Jan 2002
Externally publishedYes


  • Ventilator-associated pneumonia
  • immune system
  • mechanical ventilation
  • nosocomial pneumonia
  • oral immunity
  • oral secretions

ASJC Scopus subject areas

  • Research and Theory


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