# Bacterial counts in saliva of patients with percutaneous endoscopic gastrostomy: Cross-sectional research

## TL;DR

This study found that patients using percutaneous endoscopic gastrostomy (PEG) have much higher bacterial counts in their saliva compared to those who eat orally.

## Contribution

The novel finding is that PEG users have significantly higher salivary bacterial counts, independent of oral hygiene indicators.

## Key findings

- PEG users had over 10 times higher salivary bacterial counts than oral feeders.
- Higher bacterial counts in PEG users were observed even after adjusting for oral hygiene indicators like OHI-DI and WTCI.

## Abstract

Dysphagia in older adults requiring long-term care often necessitates nutritional management via percutaneous endoscopic gastrostomy (PEG). Although PEG effectively prevents food aspiration, it does not mitigate the risk of silent saliva aspiration, leaving patients vulnerable to aspiration pneumonia. The purpose of this study was to evaluate the bacterial count in the saliva of PEG users.

This study included 13 PEG users and 13 oral feeders residing in a facility for individuals with disabilities. We investigated the participants’ age, sex, Eastern Cooperative Oncology Group performance status, oral wetness, Oral Hygiene Index Debris Index (OHI-DI), Winkel Tongue Coating Index (WTCI), number of teeth, and denture use. We also measured the number of bacteria in the saliva using the real-time polymerase chain reaction.

The study population comprised 12 men and 14 women. The oral feeding group had an average age of 61.9 years, whereas the PEG group had a lower average age of 50.6 years. The PEG group exhibited lower OHI-DI scores compared to the oral feeding group. However, the salivary bacterial count in the PEG group was over 10 times higher than that in oral feeders. Multivariate analysis revealed a higher salivary bacterial load in PEG users than in oral feeders, independent of oral hygiene indicators such as OHI-DI, oral wetness, and WTCI.

PEG users demonstrated significantly higher salivary bacterial counts than oral feeders.