Relationships of variations in the tongue microbiota and pneumonia mortality in nursing home residents.
Abstract
Background: Aspiration of oral debris, containing dense oral bacteria, is a major cause of pneumonia in elderly adults. This study investigated the relationship between tongue microbiota composition and incidence of pneumonia-related deaths, in nursing home residents. Methods: The subjects were assessed for health conditions, including their tongue microbiota, at baseline. We determined tongue microbiota profiles by 16S ribosomal RNA gene sequencing and clustering approach. All subjects (n = 173) were followed prospectively for a median of 19 months to assess the incidence of all-cause death, including pneumonia-related death. We evaluated risk estimates of microbiota effects on death using multivariate Cox proportional hazards regression analysis. Results: Tongue microbiota were classified into two community types: type I was dominated by Prevotella and Veillonella species, while type II was dominated by Neisseria and Fusobacterium species. The subjects with type I microbiota exhibited a significantly greater risk of all-cause death (adjusted hazard ratio [aHR] = 3.79, 95% confidence interval [CI] = 1.38-10.39) and pneumonia-related death (aHR = 13.88, 95% CI = 1.64-117.21), than those with type II microbiota. There was no significant association between microbiota type and other-cause death. Conclusions: The tongue microbiota type was significantly associated with an increased mortality risk from pneumonia in nursing home residents.
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The tongue dorsum is one habitat niche of oral microbes, where the dominant microflora are Prevotella and Veillonella, which are associated with an increased risk of death due to pneumonia in older, frail patients.
“The tongue dorsum is one habitat niche of oral microbes, there the dominant microflora are Prevotella and Veillonella, which are associated with an increased risk of death due to pneumonia in older, frail patients (Asakawa et al., 2018; Kageyama et al., 2018).”
From Oral Microbiome and SARS-CoV-2: Beware of Lung Co-infection (2020) · cites this paper as Kageyama et al., 2018
Cites
Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987) · Journal of Chronic Diseases · doi:10.1016/0021-9681(87)90171-8 · Cited by 49,742 · see citing works
UPARSE: highly accurate OTU sequences from microbial amplicon reads
Edgar, R. C. (2013) · Nature Methods · doi:10.1038/nmeth.2604 · Cited by 16,587 · see citing works
Metagenomic biomarker discovery and explanation
Segata, N., Izard, J., Waldron, L., Gevers, D., Miropolsky, L., Garrett, W. S., & Huttenhower, C. (2011) · Genome Biology · doi:10.1186/gb-2011-12-6-r60 · Cited by 16,192 · see citing works
The Clinical Dementia Rating (CDR): Current version and scoring rules
Morris, J. C. (1993) · Neurology · doi:10.1212/wnl.43.11.2412-a · Cited by 9,882 · see citing works
Enterotypes of the human gut microbiome
MetaHIT Consortium (additional members), Arumugam, M., Raes, J., Pelletier, E., Le Paslier, D., Yamada, T., Mende, D. R., Fernandes, G. R., Tap, J., Bruls, T., et al. (2011) · Nature · doi:10.1038/nature09944 · Cited by 7,548 · see citing works
Kaiser, M., Bauer, J. M., Rämsch, C., Uter, W. J. C., Guigoz, Y., Cederholm, T., Thomas, D. R., Anthony, P. S., Charlton, K. E., Maggio, M. G., et al. (2009) · The journal of nutrition health & aging · doi:10.1007/s12603-009-0214-7 · Cited by 2,083 · see citing works
Defining the healthy “core microbiome” of oral microbial communities
Zaura, E., Keijser, B. J., Huse, S. M., & Crielaard, W. (2009) · BMC Microbiology · doi:10.1186/1471-2180-9-259 · Cited by 1,323 · see citing works
Chen, T., Yu, W.-H., Izard, J., Baranova, O. V., Lakshmanan, A., & Dewhirst, F. E. (2010) · Database · doi:10.1093/database/baq013 · Cited by 1,162 · see citing works
Segata, N., Haake, S. K., Mannon, P., Lemon, K. P., Waldron, L., Gevers, D., Huttenhower, C., & Izard, J. (2012) · Genome Biology · doi:10.1186/gb-2012-13-6-r42 · Cited by 1,076 · see citing works
Care‐Needs Certification in the Long‐Term Care Insurance System of Japan
Tsutsui, T., & Muramatsu, N. (2005) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2005.53175.x · Cited by 724 · see citing works
Biogeography of the ecosystems of the healthy human body
Zhou, Y., Gao, H., Mihindukulasuriya, K. A., Rosa, P. S. L., Wylie, K. M., Vishnivetskaya, T. A., Podar, M., Warner, B., Tarr, P. I., Nelson, D. E., et al. (2013) · Genome biology · doi:10.1186/gb-2013-14-1-r1 · Cited by 684 · see citing works
Role of Oral Bacteria in Respiratory Infection
Scannapieco, F. A. (1999) · Journal of Periodontology · doi:10.1902/jop.1999.70.7.793 · Cited by 653 · see citing works
Kaplan, V., Angus, D. C., Griffin, M. F., Clermont, G., Watson, R. S., & Linde‐Zwirble, W. T. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.165.6.2103038 · Cited by 561 · see citing works
Teramoto, S., Fukuchi, Y., Sasaki, H., Sato, K., Sekizawa, K., Matsuse, T., & Japanese Study Group on Aspiration Pulmonary Disease (2008) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2008.01597.x · Cited by 514 · see citing works
Etiology of Severe Pneumonia in the Very Elderly
El-Solh, A., Sikka, P., Ramadan, F. H., et al. (2001) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.163.3.2005075 · Cited by 508 · see citing works
Distribution of selected bacterial species on intraoral surfaces
Mager, D. L., Ximenez‐Fyvie, L., Haffajee, A. D., & Socransky, S. S. (2003) · Journal Of Clinical Periodontology · doi:10.1034/j.1600-051x.2003.00376.x · Cited by 481 · see citing works
Janssens, J.-P., & Krause, K. (2004) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(04)00931-4 · Cited by 450 · see citing works
Aspiration Pneumonia: Dental and Oral Risk Factors in an Older Veteran Population
Terpenning, M. S., Taylor, G. W., Lopatin, D. E., et al. (2001) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2001.49113.x · Cited by 394 · see citing works
Sjögren, P., Nilsson, E., Forsell, M., Johansson, O., & Hoogstraate, J. A. (2008) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2008.01926.x · Cited by 372 · see citing works
Bacterial diversity in saliva and oral health-related conditions: the Hisayama Study
Takeshita, T., Kageyama, S., Furuta, M., Tsuboi, H., Takeuchi, K., Shibata, Y., Shimazaki, Y., Akifusa, S., Ninomiya, T., Kiyohara, Y., et al. (2016) · Scientific Reports · doi:10.1038/srep22164 · Cited by 312 · see citing works
Self-citationTorres, A., Blasi, F., Peetermans, W. E., et al. (2014) · European Journal of Clinical Microbiology & Infectious Diseases · doi:10.1007/s10096-014-2067-1 · Cited by 185 · see citing works
Using cervical auscultation in the clinical dysphagia examination in long-term care
Zenner, P. M., Losinski, D. S., & Mills, R. H. (1995) · Dysphagia · doi:10.1007/bf00261276 · Cited by 170 · see citing works
On the ecosystemic network of saliva in healthy young adults
Zaura, E., Brandt, B. W., Prodan, A., de Mattos, M. J. T., Imangaliyev, S., Kool, J., Buijs, M. J., Jagers, F. L. P. W., Hennequin‐Hoenderdos, N. L., Slot, D. E., et al. (2017) · The ISME Journal · doi:10.1038/ismej.2016.199 · Cited by 168 · see citing works
Oho, T., Yoshida, Y., Shimazaki, Y., Yamashita, Y., & Koga, T. (2001) · Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology · doi:10.1067/moe.2001.112543 · Cited by 156 · see citing works
Self-citationModification of the Risk of Mortality from Pneumonia with Oral Hygiene Care
Bassim, C. W., Gibson, G., Ward, T., et al. (2008) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2008.01825.x · Cited by 145 · see citing works
Respiratory disease and the role of oral bacteria
Gomes‐Filho, I. S., Passos‐Soares, J. D. S., & da Cruz, S. S. (2010) · Journal of Oral Microbiology · doi:10.3402/jom.v2i0.5811 · Cited by 142 · see citing works
Parkinson disease and risk of mortality
Driver, J. A., Kurth, T., Buring, J. E., Gaziano, J. M., & Logroscino, G. (2008) · Neurology · doi:10.1212/01.wnl.0000310414.85144.ee · Cited by 140 · see citing works
Tongue-coating as risk indicator for aspiration pneumonia in edentate elderly
Abe, S., Ishihara, K., Adachi, M., & Okuda, K. (2007) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2007.08.005 · Cited by 124 · see citing works
Oral hygiene evaluation for effective oral care in preventing pneumonia in dentate elderly
Abe, S., Ishihara, K., Adachi, M., et al. (2005) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2005.09.002 · Cited by 112 · see citing works
Sjögren, P., Wårdh, I., Zimmerman, M., Almståhl, A., & Wikström, M. B. (2016) · Journal of the American Geriatrics Society · doi:10.1111/jgs.14260 · Cited by 99 · see citing works
Hämäläinen, P., Meurman, J. H., Keskinen, M., & Heikkinen, E. M. (2003) · European Journal Of Oral Sciences · doi:10.1034/j.1600-0722.2003.00055.x · Cited by 98 · see citing works
Kageyama, S., Takeshita, T., Asakawa, M., Shibata, Y., Takeuchi, K., Yamanaka, W., & Yamashita, Y. (2017) · PLoS ONE · doi:10.1371/journal.pone.0174782 · Cited by 92 · see citing works
Self-citationYamanaka, W., Takeshita, T., Shibata, Y., Matsuo, K., Eshima, N., Yokoyama, T., & Yamashita, Y. (2012) · PLoS ONE · doi:10.1371/journal.pone.0042806 · Cited by 90 · see citing works
Self-citationTakeshita, T., Suzuki, N., Nakano, Y., Shimazaki, Y., Yoneda, M., Hirofuji, T., & Yamashita, Y. (2010) · Applied and Environmental Microbiology · doi:10.1128/aem.02304-09 · Cited by 66 · see citing works
Self-citationDental Health Behaviors, Dentition, and Mortality in the Elderly: The Leisure World Cohort Study
Paganini‐Hill, A., White, S. C., & Atchison, K. A. (2011) · Journal of Aging Research · doi:10.4061/2011/156061 · Cited by 61 · see citing works
Usefulness of new wetness tester for diagnosis of dry mouth in disabled patients
Kakinoki, Y., Nishihara, T., Arita, M., et al. (2004) · Gerodontology · doi:10.1111/j.1741-2358.2004.00037.x · Cited by 57 · see citing works
Sumi, Y., Miura, H., Nagaya, M., Michiwaki, Y., & Uematsu, H. (2006) · Gerodontology · doi:10.1111/j.1741-2358.2006.00093.x · Cited by 38 · see citing works
Takeshita, T., Tomioka, M., Shimazaki, Y., Matsuyama, M., Koyano, K., Matsuda, K., & Yamashita, Y. (2010) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2010.02867.x · Cited by 37 · see citing works
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- Authors
- Kageyama, S., Takeshita, T., Furuta, M., Tomioka, M., Asakawa, M., Suma, S., Takeuchi, K., Shibata, Y., Iwasa, Y., & Yamashita, Y.
- Affiliations
- Kyushu University (JP)
- Haradoi Hospital (JP)
- Corresponding author
- Yamashita, Yoshihisa
- ORCID
- Venue
- The Journals of Gerontology Series A
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-10-19
- Volume
- 73
- Issue
- 8
- Pages
- 1097-1102
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- OpenAlex
- W2765983973
- Cited by
- 73
- References
- 38
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 11 · 2023: 4 · 2022: 9 · 2021: 14 · 2020: 12 · 2019: 11 · 2018: 4
- FWCI
- 10.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- PubMed (publishedVersion)
- Kyushu University Institutional Repository (QIR) (Kyushu University) (submittedVersion)
- Funders
- Ministry of Education, Culture, Sports, Science and Technology (16H02692, 16H05850, 16H05557, 16K15856)
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Keywords
- tongue microbiota, pneumonia mortality, nursing home residents, older adults, oral bacteria, bacterial community composition, Prevotella, Veillonella, Neisseria, Fusobacterium, aspiration pneumonia, all-cause mortality
- MeSH terms
- Aged, Aged, 80 and over, Cause of Death, Female, Humans, Male, Middle Aged, Nursing Homes, Risk Factors, RNA, Ribosomal, 16S, Tongue, Proportional Hazards Models, Sequence Analysis, RNA, Pneumonia, Bacterial, Microbiota
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