Identification of respiratory microbiota markers in ventilator-associated pneumonia.

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  • Additional Information
    • Source:
      Publisher: Springer Verlag Country of Publication: United States NLM ID: 7704851 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1238 (Electronic) Linking ISSN: 03424642 NLM ISO Abbreviation: Intensive Care Med Subsets: MEDLINE
    • Publication Information:
      Publication: New York : Springer Verlag
      Original Publication: Berlin ; New York, Springer International.
    • Subject Terms:
      Microbiota*; Biomarkers/*analysis ; Pneumonia, Ventilator-Associated/*microbiology; APACHE ; Adult ; Aged ; Case-Control Studies ; Cohort Studies ; Culture Techniques/instrumentation ; Culture Techniques/methods ; Female ; Humans ; Intensive Care Units/organization & administration ; Male ; Middle Aged ; Oropharynx/microbiology ; Pneumonia, Ventilator-Associated/mortality ; Prospective Studies ; RNA, Ribosomal, 16S/analysis ; Respiration, Artificial/adverse effects ; Switzerland ; Trachea/microbiology
    • Abstract:
      Purpose: To compare bacteria recovered by standard cultures and metataxonomics, particularly with regard to ventilator-associated pneumonia (VAP) pathogens, and to determine if the presence of particular bacteria or microbiota in tracheal and oropharyngeal secretions during the course of intubation was associated with the development of VAP.
      Methods: In this case-control study, oropharyngeal secretions and endotracheal aspirate were collected daily in mechanically ventilated patients. Culture and metataxonomics (16S rRNA gene-based taxonomic profiling of bacterial communities) were performed on serial upper respiratory samples from patients with late-onset definite VAP and their respective controls.
      Results: Metataxonomic analyses showed that a low relative abundance of Bacilli at the time of intubation in the oropharyngeal secretions was strongly associated with the subsequent development of VAP. On the day of VAP, the quantity of human and bacterial DNA in both tracheal and oropharyngeal secretions was significantly higher in patients with VAP than in matched controls with similar ventilation times. Molecular techniques identified the pathogen(s) of VAP found by culture, but also many more bacteria, classically difficult to culture, such as Mycoplasma spp. and anaerobes.
      Conclusions: Molecular analyses of respiratory specimens identified markers associated with the development of VAP, as well as important differences in the taxa abundance between VAP and controls. Further prospective trials are needed to test the predictive value of these markers, as well as the relevance of uncultured bacteria in the pathogenesis of VAP.
    • Comments:
      Comment in: Intensive Care Med. 2019 Aug;45(8):1133-1135. (PMID: 31317208)
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    • Grant Information:
      1 United States CX CSRD VA
    • Contributed Indexing:
      Keywords: Etiology; Metataxonomics; Molecular; Pathogenesis; Pneumonia; Prevention; VAP
    • Accession Number:
      0 (Biomarkers)
      0 (RNA, Ribosomal, 16S)
    • Publication Date:
      Date Created: 20190619 Date Completed: 20200420 Latest Revision: 20200420
    • Publication Date:
      20231215
    • Accession Number:
      PMC6667422
    • Accession Number:
      10.1007/s00134-019-05660-8
    • Accession Number:
      31209523