Aspiration

Aspiration of the oropharyngeal or gastric contents may lead to aspiration pneumonia or chemical (acid) pneumonitis. Risk factors for aspiration include:

• Change in oropharyngeal colonization

• Gastroesophageal reflux (GER)

• Decreased host defenses

Dysphagia can be caused by stroke or other neurologic disorders, seizures, alcoholism, and aging.15 Oropharyngeal colonization may be altered by oral/dental disease, poor oral hygiene, tube feedings, or medications. This could result in a higher number of anaerobic organisms in the oral cavity or colonization with enteric gram-negative bacilli.15 GER occurs in all individuals to a degree; however, those with GER disease (GERD) have it more frequently. Acid suppression is an important factor in the treatment of GERD, which may allow enteric gram-negative bacilli to colonize the gastric contents. Finally, impaired mucous production or cilia function, decreased immuno-globulin in secretions, and altered cough reflex may increase the likelihood of infection following an aspiration. The infection can result in a necrotizing pneumonia or lung abscess.

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