Could daily changes in respiratory microbiota help predicting early Staphylococcus aureus ventilator-associated pneumonia? - Université de Limoges Accéder directement au contenu
Article Dans Une Revue Intensive Care Medicine Experimental Année : 2023

Could daily changes in respiratory microbiota help predicting early Staphylococcus aureus ventilator-associated pneumonia?

Les changements quotidiens du microbiote respiratoire peuvent-ils aider à prédire la pneumonie précoce associée à la ventilation assistée à Staphylococcus aureus ?

Résumé

Ventilator-associated pneumonia (VAP) remains the most frequent healthcare-associated infection in Intensive Care Units (ICUs) with a prevalence of 9–27% [1]. Factors driving the progression from colonization to infection during VAP development are not fully elucidated. Metataxonomics [16S rRNA gene next-generation sequencing (NGS)] has emerged as an efficient tool to investigate pulmonary microbiota. When compared to conventional aerobic culture, metataxonomics provides additional information which allows assessing exhaustively the local bacterial community, including anaerobes, that are fastidious and yet-unculturable organisms. This culture-free approach provides new insights into respiratory microbiota dynamics and potential mechanisms of VAP development [2–5]. No study has yet sequentially explored respiratory microbiota dysbiosis on a daily basis and its potential relationship with the development of early VAP. We hypothesized post hoc that patients who develop Staphylococcus aureus VAP might exhibit modified respiratory microbiota during mechanical ventilation (MV) when compared to patients without VAP. In this pilot study (IRB #464-2021-120), we analyzed the daily changes of respiratory microbiota in a homogeneous population of patients under MV without prior exposure to antibiotics or antibiotic treatment during the study period until potential VAP diagnosis. Eligible patients were adults admitted to the ICU for an acute brain injury requiring at least 48 h of MV, with no chronic or acute respiratory disease, and who did not receive antibiotics in the previous 15 days. If antibiotics were administered during the study period, patients were secondarily excluded. Endotracheal aspirates (ETA) were collected every morning from the day of tracheal intubation (day 1) to either the day of VAP suspicion, the day of extubation or until day 7 whichever occurred first. All VAP events were blindly adjudicated by two independent ICU physicians

Dates et versions

hal-04179334 , version 1 (09-08-2023)

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Sylvain Meyer, Nadia Gaïa, Vladimir Lazarevic, Jacques Schrenzel, Bruno François, et al.. Could daily changes in respiratory microbiota help predicting early Staphylococcus aureus ventilator-associated pneumonia?. Intensive Care Medicine Experimental, 2023, 11 (1), pp.34. ⟨10.1186/s40635-023-00521-7⟩. ⟨hal-04179334⟩
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