Endotracheal tube biofilm and ventilator‐associated pneumonia with mechanical ventilation

Souza, Paulo Roberto de; Andrade, Denise de; Cabral, Danielle Bezerra; Watanabe, Evandro

doi:10.1002/jemt.22344

Cited by 30 publications

(26 citation statements)

References 36 publications

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“…1 Biofilms initially form when microorganisms attach to a synthetic surface, multiply, and develop an extracellular polymeric substance matrix that colonizes the growth of bacteria. 2 The presence of endotracheal tubes in intubated patients increases the chances of contracting VAP due to a functionally compromised mucociliary system that would otherwise hamper formation of bacteria biofilm in the airway.…”

Section: Introductionmentioning

confidence: 99%

Visualizing biofilm formation in endotracheal tubes using endoscopic three-dimensional optical coherence tomography

et al. 2015

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Abstract. Biofilm formation has been linked to ventilator-associated pneumonia, which is a prevalent infection in hospital intensive care units. Currently, there is no rapid diagnostic tool to assess the degree of biofilm formation or cellular biofilm composition. Optical coherence tomography (OCT) is a minimally invasive, nonionizing imaging modality that can be used to provide high-resolution cross-sectional images. Biofilm deposited in critical care patients' endotracheal tubes was analyzed in vitro. This study demonstrates that OCT could potentially be used as a diagnostic tool to analyze and assess the degree of biofilm formation and extent of airway obstruction caused by biofilm in endotracheal tubes.

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Section: Introductionmentioning

confidence: 99%

Visualizing biofilm formation in endotracheal tubes using endoscopic three-dimensional optical coherence tomography

et al. 2015

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“…82 In another study, the presence of contaminated biofilm in subjects intubated for at least 8 d resulted in a 7-fold increase in VAP risk. 81 In a small prospective study on subjects intubated for an average of 6 d, daily use of the Mucus Shaver device to clean the internal lumen of the ETT markedly reduced bacterial colonization compared with controls (8% vs 83% colonization, P Ͻ .001). 83 Although not significant, the VAP rate was also lower (8% vs 25%).…”

Section: Pathophysiology Of Ventilator-associated Pneumoniamentioning

confidence: 97%

“…79 Within days of endotracheal intubation, the internal lumen of the tube is coated with biological material (eg, mucoproteins, fibrin, blood cells) that pathogenic bacteria and molds adhere to and that provides an excellent medium for growth, as well as the potential for enhanced virulence from comingling with other patho-gens. 80,81 Moreover, in mechanically ventilated patients receiving antibiotic therapy for pulmonary infections, bacteria growing within the biofilm are protected from antibiotics. In consequence, there is the potential for repeated re-inoculation of the lower respiratory tract as bacterial aggregates break off with routine suctioning or from sheer forces during inspiratory gas flow.…”

Section: Pathophysiology Of Ventilator-associated Pneumoniamentioning

confidence: 99%

The Vexing Problem of Ventilator-Associated Pneumonia: Observations on Pathophysiology, Public Policy, and Clinical Science

Kallet

2015

Respir Care

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SummaryVentilator-associated pneumonia (VAP) is an acquired infection related primarily to the consequences of prolonged endotracheal intubation. It is considered the most important infectious challenge in the critical care setting. Preventable complications of hospital care are considered an important source of wasted health-care costs believed to consume up to 47% of annual expenditures in the United States. Whether VAP is preventable has become a highly contentious debate since public reporting commenced a decade ago. This selective review focuses on specific aspects of this debate, including the inherent vagaries in the diagnosis of VAP and the marked disparities between VAP rates based on clinical diagnosis versus surveillance data. Also discussed is how this debate has impacted public policy, leading to the new paradigm of ventilator-associated events. The limited ability of artificial airways to prevent microaspiration and biofilm build-up, as well as non-modifiable conditions increasing the risk of VAP, is described in detail. In addition, the origins of the mistaken but widely embraced notion that zero VAP is a realistic achievement are examined.

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“…(1) The EPS matrix is produced by the microorganisms themselves and is organized into complex structures, similar to the honeycombs of a hive, (1) that confer mechanical and antimicrobial resistance. Biofilm acts as a continuous source of contamination and infection, and its properties (the presence of the EPS matrix, the reduced metabolism of microbial cells, transfer resistance genes between the present microbiota, and hindering recognition and attack by host's immune system) represent barriers to its control.…”

Section: Introductionmentioning

confidence: 99%

Prevenção da formação de biofilmes em marcapassos artificiais: é viável?

et al. 2017

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Objective: To identify the antimicrobial agents used in the prevention of biofilm formation on artificial pacemakers. Methods: Literature review, in order to answer the following question: "What antimicrobial agents are applied to prevent biofilm formation on artificial pacemakers?" The databases PubMed, Web of Science, Scopus, Science Direct, Cochrane, CINAHL, Embase, and LILACS were used in all languages and without time restriction. Results: The final sample consisted of five primary studies, mostly experimental laboratory ones. The investigations identified agents with promising potential for reduction or inhibition of biofilm formation on pacemakers. An association between physical-chemical agents and pharmacological antimicrobials was highlighted. Conclusion: Prevention of biofilm formation on pacemakers is feasible. Among the agents that stood out were rifampicin, AIGIS ® , aqueous neobactrim formulation, and a plasma coating using a combination of trimethylsilane and oxygen for coating deposition. ResumoObjetivo: Identificar os agentes antimicrobianos utilizados na prevenção da formação de biofilme em marcapassos artificiais. Métodos: Revisão da literatura para responder a seguinte questão: "Quais agentes antimicrobianos são usados para prevenir a formação de biofilmes em marcapassos artificiais?" As bases de dados PubMed, Web of Science, Scopus, Science Direct, Cochrane, CINAHL, Embas e e LILACS foram consultadas em todos os idiomas sem restrição de tempo. Resultados: A amostra final apresentou cinco estudos primários, sendo a maioria experimental. As investigações identificaram agentes com potencial para a redução ou inibição da formação de biofilmes em marcapassos. Destacou-se a associação de agentes físico-químicos e farmacológicos aos agentes antimicrobianos. Conclusão: A prevenção da formação de biofilmes em marcapassos é viável. Os agentes mais promissores para obter este efeito foram a rifampicina, AIGIS ® , a formulação aquosa neobactrim e a cobertura com trimetilsilano e oxigênio em superfícies tratadas com plasma.

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Endotracheal tube biofilm and ventilator‐associated pneumonia with mechanical ventilation

Abstract: The presence of the endotracheal tube permits microbial colonization, overall contributing to the development of biofilm and the occurrence of pneumonia.

Cited by 30 publications

References 36 publications

Visualizing biofilm formation in endotracheal tubes using endoscopic three-dimensional optical coherence tomography

Visualizing biofilm formation in endotracheal tubes using endoscopic three-dimensional optical coherence tomography

The Vexing Problem of Ventilator-Associated Pneumonia: Observations on Pathophysiology, Public Policy, and Clinical Science

Prevenção da formação de biofilmes em marcapassos artificiais: é viável?

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