Airway Bacterial Colonization, Biofilms and Blooms, and Acute Respiratory Infection.
Airway Bacterial Colonization, Biofilms and Blooms, and Acute Respiratory Infection.
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DOI：
10.1097/pcc.0000000000003017
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发表时间：
2022-10-01
期刊：
影响因子：
--
通讯作者：
中科院分区：
文献类型：
--
作者：
气管切开术儿童患者的急性呼吸道感染通常很严重，导致住院时间延长，未安排的ICU住院，年死亡率为5%（1-6）。尽管有大量的发病率、死亡率和高成本（即估计每年10亿至10亿美元[3,5]），但没有标准化的治疗指南(7)。事实上，文献中关于急性呼吸道感染（ARIs）的潜在病理生理存在很多争论(8)，更不用说气管切开术人群中的ARIs了。最近对气道微生物组的研究表明，定植细菌有可能增加对急性呼吸道感染的易感性和严重程度，特别是由病毒引起的急性呼吸道感染（8-12）。特别是气管造口气道为下呼吸道微生物群的动态提供了一个独特的窗口，这使得收集必要的纵向样本来了解ARIs既可行又合乎道德。从气管切开术患者收集的一些信息与PICU人群中使用的其他形式的人工气道有关，但需要更多的研究。在本文中，我们讨论：1)气道细菌定植，2)病毒感染期间定植细菌的大量繁殖，3)定植细菌对ARI易感性和严重程度的影响，以及4)临床意义，包括诊断方法和未来的研究。
Acute respiratory infections in pediatric patients with tracheostomy are often severe, resulting in prolonged hospitalizations, unscheduled ICU admissions, and an annual mortality rate of 5%(1–6). Despite this substantive morbidity, mortality, and high cost (ie, estimated at> $1 billion annually [3, 5]), no standardized treatment guidelines exist (7). Indeed, there is much debate in the literature regarding the underlying pathophysiology of acute respiratory tract infections (ARIs) in general (8), let alone ARIs in the population of people with tracheostomy. Recent research into the airway microbiome has shown the potential for colonizing bacteria to enhance susceptibility to and severity of ARIs, particularly those caused by viruses (8–12). The tracheostomized airway in particular offers a unique window into the dynamics of the lower respiratory microbiota that makes it both feasible and ethical to gather the necessary longitudinal samples to understand ARIs. Some of the information gathered from patients with tracheostomy relates to other forms of artificial airway used in the PICU population, but more research is required. In this article, we discuss: 1) bacterial colonization of the airway, 2) blooms of colonizing bacteria during viral infection, 3) colonizing bacteria effect on susceptibility and severity of ARI, and 4) clinical implications including diagnostic approach and future studies.
影响因子：
12.4
作者：
Hasegawa K;Mansbach JM;Ajami NJ;Petrosino JF;Freishtat RJ;Teach SJ;Piedra PA;Camargo CA Jr
通讯作者：
Camargo CA Jr
影响因子：
3.7
作者：
Brugger SD;Frei L;Frey PM;Aebi S;Mühlemann K;Hilty M
通讯作者：
Hilty M