Document Detail

Description and Microbiology of Endotracheal Tube Biofilm in Mechanically Ventilated Patients.
MedLine Citation:
PMID:  25371399     Owner:  NLM     Status:  Publisher    
BACKGROUND: A biofilm is found on the inner side of endotracheal tubes (ETT) in mechanically ventilated patients, but its features and role in pneumonia remain unclear.
METHODS: This prospective, observational, monocentric study included critically ill ventilated subjects. Measurement of the ETT inner volume was first performed before extubation using the acoustic reflection method. After extubation, the biofilm was studied by means of optical and atomic force microscopy. Bacteriological analysis was then performed and compared with clinical documentation RESULTS: Twenty-four subjects were included. Duration of intubation lasted from 2 to 79 d (mean ± SD: 11 ± 15 d). The mean percentage of ETT volume loss evaluated in situ (n = 21) was 7.1% and was not linked with the duration of intubation. Analyses with atomic force microscopy (n = 6) showed a full coverage of the inner part of the tube with biofilm, even after saline rinse. Its thickness ranged from 0.8 to 5 μm. Bacteriological cultures of the biofilm (n = 22) often showed the same bacteria as in tracheal secretions, especially for pathogenic organisms. Pseudomonas aeruginosa and Candida albicans were among the most frequent microorganisms. In subjects who had experienced a successfully treated episode of ventilator-associated pneumonia (n = 5), the responsible bacteria were still present in the biofilm.
CONCLUSIONS: ETT biofilm is always present in intubated patients whatever the duration of intubation and appears quickly after intubation. Even after soft rinse, a small but measurable part of biofilm remains always present, and seems strongly adherent to the ETT lumen. It contains potentially pathogenic bacteria for the lung.
Pierre-Eric Danin; Emmanuelle Girou; Patrick Legrand; Bruno Louis; Redouane Fodil; Christo Christov; Jérôme Devaquet; Daniel Isabey; Laurent Brochard
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-4
Journal Detail:
Title:  Respiratory care     Volume:  -     ISSN:  1943-3654     ISO Abbreviation:  Respir Care     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-5     Completed Date:  -     Revised Date:  2014-11-6    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2015 by Daedalus Enterprises Inc.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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