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The Dynamics of the Pulmonary Microbiome During Mechanical Ventilation in the Intensive Care Unit and the Association with Occurrence of Pneumonia

2017-09Journal article Open access
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dc.contributor.authorZakharkina, T
dc.contributor.authorMartin-Loeches, I
dc.contributor.authorMatamoros, S
dc.contributor.authorPovoa, P
dc.contributor.authorTorres, A
dc.contributor.authorKastelijn, JB
dc.contributor.authorHofstra, JJ
dc.contributor.authorde Wever, B
dc.contributor.authorde Jong, M
dc.contributor.authorSchultz, MJ
dc.contributor.authorSterk, PJ
dc.contributor.authorArtigas, A
dc.contributor.authorBos, L
dc.date.accessioned2018-01-30T16:24:34Z
dc.date.available2018-01-30T16:24:34Z
dc.date.issued2017-09
dc.description.abstractRATIONALE: Ventilator-associated pneumonia (VAP) is the most common nosocomial infections in patients admitted to the ICU. The adapted island model predicts several changes in the respiratory microbiome during intubation and mechanical ventilation. OBJECTIVES: We hypothesised that mechanical ventilation and antibiotic administration decrease the diversity of the respiratory microbiome and that these changes are more profound in patients who develop VAP. METHODS: Intubated and mechanically ventilated ICU-patients were included. Tracheal aspirates were obtained three times a week. 16S rRNA gene sequencing with the Roche 454 platform was used to measure the composition of the respiratory microbiome. Associations were tested with linear mixed model analysis and principal coordinate analysis. MEASUREMENTS AND MAIN RESULTS: 111 tracheal aspirates were obtained from 35 patients; 11 had VAP, 18 did not have VAP. Six additional patients developed pneumonia within the first 48 hours after intubation. Duration of mechanical ventilation was associated with a decrease in α diversity (Shannon index; fixed-effect regression coefficient (β): -0.03 (95% CI -0.05 to -0.005)), but the administration of antibiotic therapy was not (fixed-effect β: 0.06; 95% CI -0.17 to 0.30). There was a significant difference in change of β diversity between patients who developed VAP and control patients for Bray-Curtis distances (p=0.03) and for Manhattan distances (p=0.04). Burkholderia, Bacillales and, to a lesser extent, Pseudomonadales positively correlated with the change in β diversity. CONCLUSION: Mechanical ventilation, but not antibiotic administration, was associated with changes in the respiratory microbiome. Dysbiosis of microbial communities in the respiratory tract was most profound in patients who developed VAP.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationThorax. 2017 Sep;72(9):803-810pt_PT
dc.identifier.doi10.1136/thoraxjnl-2016-209158pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2868
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherBMJ Publishing Grouppt_PT
dc.subjectAdultpt_PT
dc.subjectAgedpt_PT
dc.subjectAnti-Bacterial Agentspt_PT
dc.subjectDysbiosispt_PT
dc.subjectFemalept_PT
dc.subjectGenetic Variationpt_PT
dc.subjectHumanspt_PT
dc.subjectIntubation, Intratrachealpt_PT
dc.subjectMalept_PT
dc.subjectMicrobiotapt_PT
dc.subjectMiddle Agedpt_PT
dc.subjectPneumonia, Bacterialpt_PT
dc.subjectPneumonia, Ventilator-Associatedpt_PT
dc.subjectRNA, Ribosomal, 16Spt_PT
dc.subjectRespiration, Artificialpt_PT
dc.subjectRespiratory Systempt_PT
dc.subjectTracheapt_PT
dc.subjectIntensive Care Unitspt_PT
dc.subjectCHLC UCIpt_PT
dc.titleThe Dynamics of the Pulmonary Microbiome During Mechanical Ventilation in the Intensive Care Unit and the Association with Occurrence of Pneumoniapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage810pt_PT
oaire.citation.issue9pt_PT
oaire.citation.startPage803pt_PT
oaire.citation.titleThoraxpt_PT
oaire.citation.volume72pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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