Was Schluckstörungen mit Hygiene zu tun haben

Unerkannte Dysphagien können zu Pneumonien führen. Logopäden sowie ärztlichem Fachpersonal mit dysphagiologischem Bezug kommt in diesem Kontext eine besondere Rolle in der Infektionsprävention zu. Dabei trägt diese Personengruppe selbst ein hohes Infektionsrisiko durch die notwendige Nähe zu Patienten. Dieser Übersichtsartikel stellt die verschiedenen Aspekte der „Schluckdiagnostik“ und ihre Interaktion mit der Infektionsprävention dar.

Abstract

Unrecognized dysphagia can lead to pneumonia. The significance of dysphagia in the context of infection surveillance is currently not mapped but can lead to bias in detecting nosocomial respiratory tract infections. The professional groups of speech therapists and medical dysphagiologists from the fields of ENT, gastroenterology, neurology, neurosurgery, neuropaediatrics, and anaesthesiology have a special role in infection prevention in this context. These professionals themselves are concerned about infection control due to their proximity to the respiratory tract, as they become susceptible to respiratory infections and can also represent superspreaders. This review article presents the different aspects of swallowing diagnostics and their interaction with infection prevention.

Kernaussagen

• Der Stellenwert der Dysphagiediagnostik und -therapie im Präventionsbundle der nosokomialen Atemwegsinfektionen sollte reevaluiert werden und einen Kernbestandteil der Prävention bilden.

• Unerkannte Dysphagien führen zu Infektionen, die dann ggf. auch Hygienemängel suggerieren können.

• Zur Diagnose eignet sich neben anderen Verfahren insbesondere die FEES-Untersuchung mit hoher Sensitivität und Spezifität.

• Dysphagie ist nicht gleich Dysphagie: sensible Dysphagie braucht im Gegensatz zu motorischen Schluckstörungen andere therapeutische Maßnahmen.

• Eine zusätzliche Schulung in der Händehygiene unter didaktisch günstigen Bedingungen ist zwar nicht verkehrt, jedoch in Bezug auf eine Häufung von dysphagieassoziierten Atemwegsinfektionen wenig hilfreich.

• Das logopädische Fachpersonal stellt aufgrund seiner Assoziation zum ungeschützten Atemweg von infektiösen Personen, der Notwendigkeit der körperlichen Nähe sowie ihrer Fluktuation auf den Stationen relevante und potenzielle Superspreader dar.

• Im Rahmen von kontaktassoziierten Erkrankungen (Gastroenteritiden) sollte das logopädische Fachpersonal in Ausbruchssitzungen integriert werden oder zumindest engmaschig informiert werden.

• Der obligatorische Einsatz von antiinfektiven Substanzen im Falle einer Aspiration muss sehr kritisch hinterfragt werden.

Schlüsselwörter

Schluckstörung - Hygiene - Dysphagiologie - Pneumonien - Logopädie

Publication History

Article published online:
27 November 2023

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