Genetic relationships between respiratory pathogens isolated from dental plaque and bronchoalveolar lavage fluid from patients in the intensive care unit undergoing mechanical ventilation.
Genetic relationships between respiratory pathogens isolated from dental plaque and bronchoalveolar lavage fluid from patients in the intensive care unit undergoing mechanical ventilation.
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DOI：
10.1086/593193
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发表时间：
2008-12-15
期刊：
影响因子：
--
通讯作者：
Scannapieco FA
中科院分区：
文献类型：
--
作者：
Heo SM;Haase EM;Lesse AJ;Gill SR;Scannapieco FA
呼吸机相关性肺炎（VAP）是重症监护病房住院患者发病和死亡的主要原因。最近的研究表明，牙菌斑生物膜是呼吸道病原体的储存库。本研究的目的是确定首先从口腔分离到支气管肺泡灌洗液分离的呼吸道病原体菌株之间的遗传关系，这些菌株来自同一名接受机械通气的疑似VAP患者。在100例机械通气患者入院当天及此后每隔一天采集一次斑块和气管分泌物样本，直至从重症监护病房出院。对30例疑似VAP患者行支气管肺泡灌洗。采用脉冲场凝胶电泳和多位点序列分型来确定从口腔、气管和支气管肺泡灌洗液样本中获得的菌株的遗传相关性。从大多数患者的斑块中分离出的金黄色葡萄球菌、铜绿假单胞菌、不动杆菌和肠道菌种与从支气管肺泡灌洗液中分离出的菌种难以区分（即脉冲场凝胶电泳图谱相似度为95%）。近一半的假单胞菌菌株在患者之间显示出相同的基因图谱，这表明存在共同的环境感染源。从肺部分离的呼吸道病原体与从社区入院接受机械通气的患者口腔分离的同一物种的菌株通常在遗传上难以区分。因此，牙菌斑是机械通气患者呼吸道病原体的重要储存库。ClinicalTrials.gov识别码：NCT00123123
Ventilator-associated pneumonia (VAP) is a leading cause of morbidity and mortality in patients hospitalized in intensive care units. Recent studies suggest that dental plaque biofilms serve as a reservoir for respiratory pathogens. The goal of this study was to determine the genetic relationship between strains of respiratory pathogens first isolated from the oral cavity and later isolated from bronchoalveolar lavage fluid from the same patient undergoing mechanical ventilation with suspected VAP. Plaque and tracheal secretion samples were obtained on the day of hospital admission and every other day thereafter until discharge from the intensive care unit from 100 patients who underwent mechanical ventilation. Bronchoalveolar lavage was performed for 30 patients with suspected VAP. Pulse-field gel electrophoresis and multilocus sequence typing were used to determine the genetic relatedness of strains obtained from oral, tracheal, and bronchoalveolar lavage samples. Isolates of Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter species, and enteric species recovered from plaque from most patients were indistinguishable from isolates recovered from bronchoalveolar lavage fluid (i.e., had >95% similarity of pulse-field gel electrophoresis patterns). Nearly one-half of the Pseudomonas strains showed identical genetic profiles between patients, which suggested a common environmental source of infection. Respiratory pathogens isolated from the lung are often genetically indistinguishable from strains of the same species isolated from the oral cavity in patients who receive mechanical ventilation who are admitted to the hospital from the community. Thus, dental plaque serves as an important reservoir for respiratory pathogens in patients who undergo mechanical ventilation. ClinicalTrials.gov identifier: NCT00123123
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影响因子：
9.4
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