The dynamics of the pulmonary microbiome during mechanical ventilation in the intensive care unit and the association with occurrence of pneumonia

Respiratory microbiota and lower respiratory tract disease

“…51 Intubation was consistently a risk factor for bacterial disturbance in the lower respiratory tract (low diversity and evenness) supporting the hypothesis of a lung microbiota resulting from the equilibrium between microaspirations from the upper respiratory tract and clearance mechanisms. 34,51,58,63 Antibiotic administration seemed to have less effect on bacterial diversity than intubation, 58 and this effect was transitory, with recovery of a similar oropharyngeal microbiota a few days after antibiotic treatment compared to the microbiota before antibiotic administration. 52 However, most of the studies did not assess this effect, probably due to difficulties in assuming bacterial viability from DNA based measures.…”

“…Dominance by Streptococcus pneumoniae, Burkholderia, Bacillales, and to a lesser extent, Pseudomonadales was particularly correlated with decreased diversity. 58,68 In studies with repeated sampling, the dominance of one taxon was maintained over time, and its relative abundance increased throughout the pneumonia episode, particularly if the patient was intubated. 51 Intubation was consistently a risk factor for bacterial disturbance in the lower respiratory tract (low diversity and evenness) supporting the hypothesis of a lung microbiota resulting from the equilibrium between microaspirations from the upper respiratory tract and clearance mechanisms.…”

“…We excluded HIV infected patients, as it was object of a recently published review. 3 A total of 25 articles were retained for this section, 13 in adults, [46][47][48][49][50][51][52][53][54][55][56][57][58] and 11 in children. 19,[59][60][61][62][63][64][65][66][67][68][69] An overview of the studies characteristics is summarized in tables 2 (adults) and 3 (children).…”

Focus on infection and sepsis 2017

“…A recent manuscript by Zakharkina et al found that duration of mechanical ventilation, but not antibiotic administration, was associated with changes in the respiratory microbiome [15]. Recent studies reported that despite previous evidence [16], highly heterogeneous patterns of intestinal microbiota existed in both septic and non-septic critically ill patients.…”

Combined Estimation of Serum Procalcitonin Levels and Clinical Pulmonary Infection Score Improves Predictability for Survival of Ventilation-associated Pneumonia Patients

“…However, ventilator-associated pneumonia (VAP) is the most common nosocomial infections in patients admitted to the ICU (2).…”