Patterns in the longitudinal oropharyngeal microbiome evolution related to ventilator-associated pneumonia.
Adolescent
Adult
Aged
Case-Control Studies
Enterobacteriaceae
/ classification
Enterobacteriaceae Infections
/ microbiology
Female
Haemophilus influenzae
/ classification
High-Throughput Nucleotide Sequencing
Humans
Intensive Care Units
Longitudinal Studies
Male
Microbiota
Middle Aged
Oropharynx
/ microbiology
Pneumonia, Ventilator-Associated
/ microbiology
Prospective Studies
RNA, Ribosomal, 16S
/ genetics
Respiration, Artificial
/ adverse effects
Trachea
/ microbiology
Young Adult
Infection prevention
Intensive care
Nosocomial pneumonia
Oropharyngeal and tracheal microbiome
Ventilator-associated pneumonia
Journal
Antimicrobial resistance and infection control
ISSN: 2047-2994
Titre abrégé: Antimicrob Resist Infect Control
Pays: England
ID NLM: 101585411
Informations de publication
Date de publication:
2019
2019
Historique:
received:
15
01
2019
accepted:
28
04
2019
entrez:
30
5
2019
pubmed:
30
5
2019
medline:
28
5
2020
Statut:
epublish
Résumé
The aim of the study was to evaluate the composition and the temporal evolution of the oropharyngeal microbiome in antibiotic-naïve patients requiring mechanical ventilation and to gain new insights into the pathogenesis of ventilator-associated pneumonia (VAP). Prospective, observational single-center nested case-control study. Patients with acute critical illness and anticipated duration of mechanical ventilation > 4 days were eligible. We took oropharyngeal swabs (and if available, tracheal secretions) daily, starting at the day of intubation. The microbiota was characterized by 16S rRNA high-throughput sequencing and compared between patients developing VAP versus controls. Five patients developed VAP. In three patient the causative pathogens were Enterobacteriaceae and in two In acutely-ill patients who developed enterobacterial VAP the causative pathogen gained access to the oropharynx early after starting mechanical ventilation and outgrew the commensal members of the microbiome. Whether a specific pattern of the oropharyngeal microbiome between days three to five of mechanical ventilation may predict VAP enterobacterial VAP has to be evaluated in further studies.
Sections du résumé
Background
The aim of the study was to evaluate the composition and the temporal evolution of the oropharyngeal microbiome in antibiotic-naïve patients requiring mechanical ventilation and to gain new insights into the pathogenesis of ventilator-associated pneumonia (VAP).
Methods
Prospective, observational single-center nested case-control study. Patients with acute critical illness and anticipated duration of mechanical ventilation > 4 days were eligible. We took oropharyngeal swabs (and if available, tracheal secretions) daily, starting at the day of intubation. The microbiota was characterized by 16S rRNA high-throughput sequencing and compared between patients developing VAP versus controls.
Results
Five patients developed VAP. In three patient the causative pathogens were Enterobacteriaceae and in two
Conclusions
In acutely-ill patients who developed enterobacterial VAP the causative pathogen gained access to the oropharynx early after starting mechanical ventilation and outgrew the commensal members of the microbiome. Whether a specific pattern of the oropharyngeal microbiome between days three to five of mechanical ventilation may predict VAP enterobacterial VAP has to be evaluated in further studies.
Identifiants
pubmed: 31139364
doi: 10.1186/s13756-019-0530-6
pii: 530
pmc: PMC6530040
doi:
Substances chimiques
RNA, Ribosomal, 16S
0
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
81Déclaration de conflit d'intérêts
Competing interestsThe authors declare that they have no competing interests.
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