Bacteriological Assessment of Healthcare-Associated Pneumonia Using a Clone Library Analysis

Noguchi, Shingo; Mukae, Hiroshi; Kawanami, Toshinori; Yamasaki, Kei; Fukuda, Kazumasa; Akata, Kentaro; Ishimoto, Hiroshi; Taniguchi, Hatsumi; Yatera, Kazuhiro

doi:10.1371/journal.pone.0124697

Cited by 41 publications

(79 citation statements)

References 40 publications

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“…These bacteria may play important roles in the development of aspiration pneumonia in the elderly. However, their prevalence is not so high, and bacterial pathogens are unclear in a large portion of aspiration pneumonia cases, suggesting the limited role of bacteria in aspiration pneumonia affecting the elderly (14,15).…”

Section: Pathogens Of Aspiration Pneumoniamentioning

confidence: 99%

Dysphagia, dystussia, and aspiration pneumonia in elderly people

Ebihara¹,

Sekiya²,

Miyagi³

et al. 2016

J. Thorac. Dis.

136

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Despite the development and wide distribution of guidelines for pneumonia, death from pneumonia is increasing due to population aging. Conventionally, aspiration pneumonia was mainly thought to be one of the infectious diseases. However, we have proven that chronic repeated aspiration of a small amount of sterile material can cause the usual type of aspiration pneumonia in mouse lung. Moreover, chronic repeated aspiration of small amounts induced chronic inflammation in both frail elderly people and mouse lung. These observations suggest the need for a paradigm shift of the treatment for pneumonia in the elderly. Since aspiration pneumonia is fundamentally based on dysphagia, we should shift the therapy for aspiration pneumonia from pathogen-oriented therapy to function-oriented therapy. Function-oriented therapy in aspiration pneumonia means therapy focusing on slowing or reversing the functional decline that occurs as part of the aging process, such as "dementia → dysphagia → dystussia → atussia → silent aspiration". Atussia is ultimate dysfunction of cough physiology, and aspiration with atussia is called silent aspiration, which leads to the development of life-threatening aspiration pneumonia. Research pursuing effective strategies to restore function in the elderly is warranted in order to decrease pneumonia deaths in elderly people.

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Section: Pathogens Of Aspiration Pneumoniamentioning

confidence: 99%

Dysphagia, dystussia, and aspiration pneumonia in elderly people

Ebihara¹,

Sekiya²,

Miyagi³

et al. 2016

J. Thorac. Dis.

136

View full text Add to dashboard Cite

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“…Anaerobe is not detected by usual sputum culture, so sputum culture cannot detect actual causal microorganisms of pneumonia but sometimes simply detects bacterial colonization in the airway in HCAP patients 13) .…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of Prognostic Factors of Nursing and Healthcare-Associated Pneumonia

Hara

Iwakami

Sasaki

et al. 2017

Juntendo Medical Journal

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Objective: Nursing and healthcare-associated pneumonia (NHCAP) is similar to healthcare-associated pneumonia (HCAP) -a category of pneumonia proposed by the Japanese Respiratory Society (JRS). This study aims to determine the thus far unclear prognostic factors of NHCAP patients, and to clarify the relevance and effectiveness of the selection of antimicrobial agents in accordance with the NHCAP guidelines proposed by the JRS. Materials:A retrospective observational study of NHCAP patients hospitalized at Juntendo University Shizuoka Hospital between January, 2010 and December, 2012 was undertaken.Methods: Clinical data were obtained from clinical records, and subjects were assigned to a group which included survived patients at 30 days after admission, and a group which included patients who died within 30 days. The groups were compared regarding baseline characteristics, vital signs, laboratory data, performance status, determination of the severity of the pneumonia (such as with the A-DROP scoring system proposed by the JRS in cases of community-acquired pneumonia), microbiological examinations, and the antimicrobial agents used initially.Results: 151 NHCAP patients in total were evaluated. A score of 3 or more in the A-DROP scoring system is a factor that has an independent influence on NHCAP patientsʼ prognoses. There were no statistically significant differences in the use of broad-spectrum antimicrobials between the two groups, even those where the use of broad-spectrum antimicrobials was recommended. Conclusion:The results suggest that the severity of the pneumonia is an independent prognostic factor of NHCAP patients, for whom using broad-spectrum antimicrobials does not contribute to improving their prognoses.

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“…BALF specimens were obtained from radiologically-identified pneumonia lesions using 40 ml saline via bronchofiberscopy, as previously described (Yamasaki et al 2013;Noguchi et al 2015). Sputum specimens were evaluated in patients with sputum production.…”

Section: Specimen Collectionmentioning

confidence: 99%

“…Bacterial cultivation of BALF and sputum specimens was performed using the Vitek 2 apparatus (bioMérieux) with or without the associated API identification strip (bioMérieux) by a semiquantitative method (Yamasaki et al 2013;Mukae et al 2015;Noguchi et al 2015).…”

Section: Microbiological Evaluation Using Conventional Cultivation Mementioning

confidence: 99%

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Determining the Possible Etiology of Hospital-Acquired Pneumonia Using a Clone Library Analysis in Japan

Yatera

Noguchi

Yamasaki

et al. 2017

Tohoku J. Exp. Med.

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Obtaining precise etiological information regarding causative bacteria is important for the proper use of antimicrobials in hospital-acquired pneumonia (HAP), which is associated with a high rate of mortality. The aim of this study was to comparatively investigate the bacterial diversity in bronchoalveolar lavage fluid (BALF) in Japanese patients with HAP by the clone library method using the 16S rRNA gene. This study included Japanese patients with HAP who were treated at our hospital and referring hospitals. BALF specimens were obtained from pneumonia lesions identified on chest radiographs and/or computed tomography. Sputum specimens were also evaluated in patients with sputum production. Sixty-eight patients were ultimately enrolled. BALF cultivation revealed bacterial positivity in 53 of 68 (77.9%) patients, and Staphylococcus aureus (30.9%) was the most frequently isolated, followed by Pseudomonas aeruginosa (16.2%), and Escherichia coli (10.3%). In contrast, the clone library analysis identified the presence of some bacterial phenotype in 65 of 68 (95.6%) patients, and streptococci (16.2%), Corynebacterium species (11.8%), anaerobes (10.3%) were frequently detected as the predominant phylotypes. Both methods tended to detect S. aureus, Klebsiella pneumoniae, and E. coli in patients with late-onset pneumonia. In addition, the cases that phylotypes of S. aureus and P. aeruginosa were found to account for > 5% of the bacterial flora of each case were 42.9% and 72.7%, respectively. These results indicate that attention should be paid to the roles of gram-positive bacilli such as streptococci, Corynebacterium species and anaerobes, in addition to Gram-negative bacilli, in the pathogenesis of HAP.

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Bacteriological Assessment of Healthcare-Associated Pneumonia Using a Clone Library Analysis

Cited by 41 publications

References 40 publications

Dysphagia, dystussia, and aspiration pneumonia in elderly people

Dysphagia, dystussia, and aspiration pneumonia in elderly people

A Retrospective Analysis of Prognostic Factors of Nursing and Healthcare-Associated Pneumonia

Determining the Possible Etiology of Hospital-Acquired Pneumonia Using a Clone Library Analysis in Japan

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