Molecular Analysis of Oral and Respiratory Bacterial Species Associated with Ventilator-Associated Pneumonia

Trauma intensive care unit (TICU) patients requiring mechanical respiratory support frequently develop ventilator-associated pneumonia (VAP). Oral and oropharyngeal bacteria are believed to be responsible for many cases of VAP, but definitive evidence of this relationship is lacking. Earlier studies...

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Bibliographic Details
Published in:Journal of Clinical Microbiology 2007-05, Vol.45 (5), p.1588-1593
Main Authors: Bahrani-Mougeot, Farah K, Paster, Bruce J, Coleman, Shirley, Barbuto, Sara, Brennan, Michael T, Noll, Jenene, Kennedy, Thomas, Fox, Philip C, Lockhart, Peter B
Format: Article
Language:English
Subjects:
Adult
Bacteria - classification
Bacteria - genetics
Bacteriology
Biological and medical sciences
Escherichia coli
Female
Fundamental and applied biological sciences. Psychology
Gemella morbillorum
Haemophilus
Humans
Infectious diseases
Male
Medical sciences
Microbiology
Middle Aged
Miscellaneous
Mouth - microbiology
Phylogeny
Pneumonia, Bacterial - microbiology
Pneumonia, Ventilator-Associated - diagnosis
Pneumonia, Ventilator-Associated - microbiology
Pseudomonas fluorescens
Respiratory System - microbiology
Species Specificity
Wounds and Injuries
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Summary:Trauma intensive care unit (TICU) patients requiring mechanical respiratory support frequently develop ventilator-associated pneumonia (VAP). Oral and oropharyngeal bacteria are believed to be responsible for many cases of VAP, but definitive evidence of this relationship is lacking. Earlier studies used conventional culture-based methods for identification of bacterial pathogens, but these methods are insufficient, as some bacteria may be uncultivable or difficult to grow. The purpose of this study was to use a culture-independent molecular approach to analyze and compare the bacterial species colonizing the oral cavity and the lungs of TICU patients who developed VAP. Bacterial samples were acquired from the dorsal tongue and bronchoalveolar lavage fluid of 16 patients. Bacterial DNA was extracted, and the 16S rRNA genes were PCR amplified, cloned into Escherichia coli, and sequenced. The sequencing data revealed the following: (i) a wide diversity of bacterial species in both the oral and pulmonary sites, some of them novel; (ii) known and putative respiratory pathogens colonizing both the oral cavity and lungs of 14 patients; and (iii) a number of bacterial pathogens (e.g., Dialister pneumosintes, Haemophilus segnis, Gemella morbillorum, and Pseudomonas fluorescens) in lung samples that had not been reported previously at this site when culture-based methods were used. Our data indicate that the dorsal surface of the tongue serves as a potential reservoir for bacterial species involved in VAP. Furthermore, it is clear that the diversity of bacterial pathogens for VAP is far more complex than the current literature suggests.
ISSN:0095-1137
1098-660X
1098-5530
DOI:10.1128/JCM.01963-06