Heterogeneous antimicrobial activity in broncho-alveolar aspirates from mechanically ventilated intensive care unit patients
Heterogeneous antimicrobial activity in broncho-alveolar aspirates from mechanically ventilated intensive care unit patients
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重症监护病房机械通气患者支气管肺泡抽吸物的异质抗菌活性
DOI：
10.1080/21505594.2019.1682797
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发表时间：
2019
期刊：
影响因子：
5.2
通讯作者：
van Dijl JM
中科院分区：
文献类型：
--
作者：
Seinen J;Dieperink W;Mekonnen SA;Lisotto P;Harmsen HJM;Hiemstra B;Schultz D;Lalk M;Oswald S;Hammerschmidt S;de Smet AMGA;van Dijl JM
肺炎是一种肺部感染，感染部位的肺泡充满了脓和液体。虽然接受通气的患者有风险，但并非所有接受通气的患者都会患上肺炎。这表明痰液环境可能具有抗菌活性。尽管普遍承认抗菌活性在保护人类肺部免受感染方面的重要性，但迄今为止尚未对其进行系统评估。因此，本研究的目的是测量重症监护病房（ICU）患者支气管肺泡吸出液（“痰”）样本中的抗菌活性，并将检测到的抗菌活性与抗生素水平、痰微生物组和各自患者的特征联系起来。为此，收集53例机械通气ICU患者的临床资料和痰液。测定痰液对肺炎链球菌、金黄色葡萄球菌和血管性链球菌的抑菌活性。在这里，我们表明从不同患者收集的痰液在抗菌活性方面存在高度差异，这可以部分归因于抗生素治疗。痰菌群虽然有可能产生抗菌剂，但似乎对痰的抗菌活性贡献不大，如果有的话。值得注意的是，尽管其具有潜在的保护作用，但在所调查的痰液中抗菌活性水平与患者预后呈负相关，很可能是因为疾病严重程度超过了有益的抗菌活性。
Pneumonia is an infection of the lungs, where the alveoli in the affected area are filled with pus and fluid. Although ventilated patients are at risk, not all ventilated patients develop pneumonia. This suggests that the sputum environment may possess antimicrobial activities. Despite the generally acknowledged importance of antimicrobial activity in protecting the human lung against infections, this has not been systematically assessed to date. Therefore, the objective of the present study was to measure antimicrobial activity in broncho-alveolar aspirate (‘sputum”) samples from patients in an intensive care unit (ICU) and to correlate the detected antimicrobial activity with antibiotic levels, the sputum microbiome, and the respective patients’ characteristics. To this end, clinical metadata and sputum were collected from 53 mechanically ventilated ICU patients. The antimicrobial activity of sputum samples was tested againstStreptococcus pneumoniae, Staphylococcus aureusandStreptococcus anginosus. Here we show that sputa collected from different patients presented a high degree of variation in antimicrobial activity, which can be partially attributed to antibiotic therapy. The sputum microbiome, although potentially capable of producing antimicrobial agents, seemed to contribute in a minor way, if any, to the antimicrobial activity of sputum. Remarkably, despite its potentially protective effect, the level of antimicrobial activity in the investigated sputa correlated inversely with patient outcome, most likely because disease severity outweighed the beneficial antimicrobial activities.
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影响因子：
14.2
作者：
Veloo, A. C. M.;Elgersma, P. E.;van Winkelhoff, A. J.
通讯作者：
van Winkelhoff, A. J.
DOI：
10.1016/j.jinf.2013.03.003
发表时间：
2013-07
期刊：
The Journal of infection
影响因子：
--
作者：
Musher DM;Roig IL;Cazares G;Stager CE;Logan N;Safar H
通讯作者：
Safar H
头孢噻肟 (HR756) 去乙酰代谢物的活性与头孢噻肟和其他头孢菌素的活性相比
影响因子：
4.9
作者：
R. Wise;P. J. Wills;J. Andrews;K. Bedford
通讯作者：
K. Bedford
影响因子：
158.5
作者：
de Smet, A. M. G. A.;Kluytmans, J. A. J. W.;Bonten, M. J. M.
通讯作者：
Bonten, M. J. M.
DOI：
10.1056/nejmoa1500245
发表时间：
2015-07-30
期刊：
The New England journal of medicine
影响因子：
--
作者：
Jain S;Self WH;Wunderink RG;Fakhran S;Balk R;Bramley AM;Reed C;Grijalva CG;Anderson EJ;Courtney DM;Chappell JD;Qi C;Hart EM;Carroll F;Trabue C;Donnelly HK;Williams DJ;Zhu Y;Arnold SR;Ampofo K;Waterer GW;Levine M;Lindstrom S;Winchell JM;Katz JM;Erdman D;Schneider E;Hicks LA;McCullers JA;Pavia AT;Edwards KM;Finelli L;CDC EPIC Study Team
通讯作者：
CDC EPIC Study Team