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Alterations in oropharyngeal flora in patients with a nasogastric tube: a cohort study.

The authors undertook this prospective study to determine whether the presence of a nasogastric tube results in a change in the bacterial flora in the oropharynx. Patients scheduled to undergo an elective surgical procedure under general endotracheal anesthesia were studied. Sixteen patients had a nasogastric tube placed and 14 patients did not. The two patient groups were comparable in terms of age, gender, severity of underlying illness, and use of perioperative antibiotics. A commercially available, presterilized, clear plastic nasogastric tube was used in all patients. The tube was placed either for gastric decompression or feeding. All patients had a high oropharyngeal swab taken just before surgery. A similar swab was obtained 48 and 72 hours later. Patients were examined for evidence of otitis, sinusitis, and pharyngitis at the beginning of the study and 48 hours later. The authors found a significant increase in the frequency of oropharyngeal colonization by pathogenic Gram-negative bacteria after...