Marino Poala J, Wise Matt P, Smith Ann, Marchesi Julian R, Riggio Marcello P, Lewis Michael A O, Williams David W
School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff, United Kingdom.
University Hospital of Wales, Heath Park, Cardiff, United Kingdom.
J Crit Care. 2017 Jun;39:149-155. doi: 10.1016/j.jcrc.2017.02.020. Epub 2017 Feb 16.
Mechanically ventilated patients are at risk for developing ventilator-associated pneumonia, and it has been reported that dental plaque provides a reservoir of respiratory pathogens that may aspirate to the lungs and endotracheal tube (ETT) biofilms. For the first time, metataxonomics was used to simultaneously characterize the microbiome of dental plaque, ETTs, and non-directed bronchial lavages (NBLs) in mechanically ventilated patients to determine similarities in respective microbial communities and therefore likely associations.
Bacterial 16S rRNA gene sequences from 34 samples of dental plaque, NBLs, and ETTs from 12 adult mechanically ventilated patients were analyzed.
No significant differences in the microbial communities of these samples were evident. Detected bacteria were primarily oral species (e.g., Fusobacterium nucleatum, Streptococcus salivarius, Prevotella melaninogenica) with respiratory pathogens (Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcuspneumoniae, and Haemophilus influenzae) also in high abundance.
The high similarity between the microbiomes of dental plaque, NBLs, and ETTs suggests that the oral cavity is indeed an important site involved in microbial aspiration to the lower airway and ETT. As such, maintenance of good oral hygiene is likely to be highly important in limiting aspiration of bacteria in this vulnerable patient group.
机械通气患者有发生呼吸机相关性肺炎的风险,据报道,牙菌斑是呼吸道病原体的储存库,这些病原体可能会吸入肺部和气管内导管(ETT)生物膜。首次采用宏分类学方法同时对机械通气患者的牙菌斑、ETT和非定向支气管灌洗(NBL)的微生物群进行表征,以确定各自微生物群落的相似性以及可能存在的关联。
分析了12名成年机械通气患者的34份牙菌斑、NBL和ETT样本的细菌16S rRNA基因序列。
这些样本的微生物群落没有明显差异。检测到的细菌主要是口腔菌种(如具核梭杆菌、唾液链球菌、产黑色素普雷沃菌),呼吸道病原体(金黄色葡萄球菌、铜绿假单胞菌、肺炎链球菌和流感嗜血杆菌)的丰度也很高。
牙菌斑、NBL和ETT的微生物群之间的高度相似性表明,口腔确实是参与微生物吸入下呼吸道和ETT的重要部位。因此,保持良好的口腔卫生对于限制这一脆弱患者群体中的细菌吸入可能非常重要。