Document Detail


Colonization of lower respiratory tract with anaerobic bacteria in mechanically ventilated patients.
MedLine Citation:
PMID:  12698243     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To study lower respiratory tract colonization by anaerobic bacteria in ICU patients on prolonged mechanical ventilation using two types of protected tracheal sampling methods. DESIGN AND SETTING: Prospective clinical investigation in the intensive care unit of a university hospital. PATIENTS: Twenty-six consecutive patients mechanically ventilated within 24 h after their admission in ICU and with expected duration of mechanical ventilation longer than 7 days. MEASUREMENTS AND RESULTS: Two types of protected tracheal sampling methods were obtained without the use of bronchoscopic guidance on the day following intubation and twice a week until extubation: protected tracheal aspiration and protected tracheal specimen brush. Specific methods for anaerobic isolation were used. Early colonization was defined if colonization occurred within the first 5 days after intubation. Of the 26 patients studied 22 were colonized by at least one bacterial strain. Twenty-one patients were colonized by aerobic and 15 by anaerobic bacteria. Twenty-eight anaerobic strains were identified, with bacterial counts higher than 10(3) cfu/ml in 11 cases. Of the 15 patients colonized by anaerobes 14 were also colonized by aerobic bacteria. The use of protected specimens ruled out oropharyngeal contamination. Early onset colonization occurred in 16 of 22 patients colonized by aerobes and in 8 of 15 patients colonized by anaerobes. Five patients developed ventilatory-acquired pneumonia following colonization (by anaerobic bacteria in two cases). In eight patients colonization by anaerobic bacteria occurred despite antimicrobial therapy. CONCLUSIONS: These results show that anaerobic bacteria frequently colonize the lower respiratory tract of mechanically ventilated patients and underline the potential importance of the anaerobic bacteria in ventilatory acquired pneumonia.
Authors:
René Robert; Ghislaine Grollier; Jean-Pierre Frat; Cendrine Godet; Michèle Adoun; Jean-Louis Fauchère; Pierre Doré
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2003-04-16
Journal Detail:
Title:  Intensive care medicine     Volume:  29     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-09     Completed Date:  2003-12-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1062-8     Citation Subset:  IM    
Affiliation:
Service de Réanimation Médicale, Hôpital Jean Bernard CHU, 86021, Poitiers cedex, France. r.robert@chu-poitiers.fr
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / pharmacology
Bacteria, Anaerobic / classification,  drug effects,  isolation & purification*
France
Humans
Microbial Sensitivity Tests
Prospective Studies
Respiration, Artificial*
Respiratory System / microbiology*
Species Specificity
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents
Comments/Corrections
Erratum In:
Intensive Care Med. 2003 Nov;29(11):2107

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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