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Article

The Dynamics of Respiratory Microbiota during Mechanical Ventilation in Patients with Pneumonia

1
Institute of New frontier Research, Hallym University College of Medicine, Chuncheon 24253, Korea
2
Department of Neurosurgery, Chuncheon Sacred Heart Hospital, Hallym University Medical Center, Chuncheon 24253, Korea
3
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chuncheon Sacred Heart Hospital, Hallym University Medical Center, Chuncheon 24253, Korea
4
Lung Research Institute of Hallym University College of Medicine, Chuncheon 24253, Korea
*
Author to whom correspondence should be addressed.
Seongji Woo and So-Yeong Park contributed equally to the article as first authors.
J. Clin. Med. 2020, 9(3), 638; https://doi.org/10.3390/jcm9030638
Received: 5 February 2020 / Revised: 21 February 2020 / Accepted: 21 February 2020 / Published: 27 February 2020
(This article belongs to the Special Issue Diagnosis and Treatment of Pneumonia)
Bacterial pneumonia is a major cause of mechanical ventilation in intensive care units. We hypothesized that the presence of particular microbiota in endotracheal tube aspirates during the course of intubation was associated with clinical outcomes such as extubation failure or 28-day mortality. Sixty mechanically ventilated ICU (intensive care unit) patients (41 patients with pneumonia and 19 patients without pneumonia) were included, and tracheal aspirates were obtained on days 1, 3, and 7. Gene sequencing of 16S rRNA was used to measure the composition of the respiratory microbiome. A total of 216 endotracheal aspirates were obtained from 60 patients. A total of 22 patients were successfully extubatedwithin3 weeks, and 12 patients died within 28days. Microbiota profiles differed significantly between the pneumonia group and the non-pneumonia group (Adonis, p < 0.01). While α diversity (Shannon index) significantly decreased between day 1 and day 7 in the successful extubation group, it did not decrease in the failed extubation group among intubated patients with pneumonia. There was a significant difference in the change of βdiversity between the successful extubation group and the failed extubation group for Bray-Curtis distances (p < 0.001). At the genus level, Rothia, Streptococcus, and Prevotella correlated with the change of β diversity. A low relative abundance of Streptococci at the time of intubation was strongly associated with 28-day mortality. The dynamics of respiratory microbiome were associated with clinical outcomes such as extubation failure and mortality. Further large prospective studies are needed to test the predictive value of endotracheal aspirates in intubated patients. View Full-Text
Keywords: mechanical ventilation; pneumonia; microbiome mechanical ventilation; pneumonia; microbiome
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MDPI and ACS Style

Woo, S.; Park, S.-Y.; Kim, Y.; Jeon, J.P.; Lee, J.J.; Hong, J.Y. The Dynamics of Respiratory Microbiota during Mechanical Ventilation in Patients with Pneumonia. J. Clin. Med. 2020, 9, 638. https://doi.org/10.3390/jcm9030638

AMA Style

Woo S, Park S-Y, Kim Y, Jeon JP, Lee JJ, Hong JY. The Dynamics of Respiratory Microbiota during Mechanical Ventilation in Patients with Pneumonia. Journal of Clinical Medicine. 2020; 9(3):638. https://doi.org/10.3390/jcm9030638

Chicago/Turabian Style

Woo, Seongji, So-Yeong Park, Youngmi Kim, Jin Pyeong Jeon, Jae Jun Lee, and Ji Young Hong. 2020. "The Dynamics of Respiratory Microbiota during Mechanical Ventilation in Patients with Pneumonia" Journal of Clinical Medicine 9, no. 3: 638. https://doi.org/10.3390/jcm9030638

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