Yudong Yin1, Peter Hountras, Richard G Wunderink. 1. aDepartment of Infectious Disease and Clinical Microbiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China bPulmonary and Critical Care, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Abstract
PURPOSE OF REVIEW: Discovery of a normal lung microbiome requires reassessment of our concepts of HAP/VAP pathogenesis and has important implications for clinical diagnosis and management. RECENT FINDINGS: Changes in the microbiome of dental plaque are associated with increased risk of HAP/VAP. A transition to a lung microbiome enriched with gut flora is found in ARDS with an increased inflammatory response in patients with this change in microbial flora. A characteristic microbiome pattern of higher amounts of bacterial DNA, lower community diversity, and greater relative abundance of a single species characterize pneumonia and occasionally identify bacteria not found in culture. The influence of the microbiome makes probiotics a logical strategy to prevent or ameliorate HAP/VAP but so far clinical support is unclear. SUMMARY: The presence of a normal lung microbiome and the interaction of that microbiome with other microbiota have an important but previously overlooked impact on the pathogenesis of HAP/VAP. Deep sequencing suggests that the repertoire of microorganisms and the pattern of bacterial communities associated with HAP/VAP remains incompletely understood but recent studies are adding greater clarity.
PURPOSE OF REVIEW: Discovery of a normal lung microbiome requires reassessment of our concepts of HAP/VAP pathogenesis and has important implications for clinical diagnosis and management. RECENT FINDINGS: Changes in the microbiome of dental plaque are associated with increased risk of HAP/VAP. A transition to a lung microbiome enriched with gut flora is found in ARDS with an increased inflammatory response in patients with this change in microbial flora. A characteristic microbiome pattern of higher amounts of bacterial DNA, lower community diversity, and greater relative abundance of a single species characterize pneumonia and occasionally identify bacteria not found in culture. The influence of the microbiome makes probiotics a logical strategy to prevent or ameliorate HAP/VAP but so far clinical support is unclear. SUMMARY: The presence of a normal lung microbiome and the interaction of that microbiome with other microbiota have an important but previously overlooked impact on the pathogenesis of HAP/VAP. Deep sequencing suggests that the repertoire of microorganisms and the pattern of bacterial communities associated with HAP/VAP remains incompletely understood but recent studies are adding greater clarity.
Authors: Frits van Charante; Anneleen Wieme; Petra Rigole; Evelien De Canck; Lisa Ostyn; Lucia Grassi; Dieter Deforce; Aurélie Crabbé; Peter Vandamme; Marie Joossens; Filip Van Nieuwerburgh; Pieter Depuydt; Tom Coenye Journal: Biofilm Date: 2022-06-14
Authors: Rami Sommerstein; Tobias M Merz; Sabine Berger; Julia G Kraemer; Jonas Marschall; Markus Hilty Journal: Antimicrob Resist Infect Control Date: 2019-05-22 Impact factor: 4.887
Authors: Peter M Mourani; Marci K Sontag; Kayla M Williamson; J Kirk Harris; Ron Reeder; Chris Locandro; Todd C Carpenter; Aline B Maddux; Katherine Ziegler; Eric A F Simões; Christina M Osborne; Lilliam Ambroggio; Matthew K Leroue; Charles E Robertson; Charles Langelier; Joseph L DeRisi; Jack Kamm; Mark W Hall; Athena F Zuppa; Joseph Carcillo; Kathleen Meert; Anil Sapru; Murray M Pollack; Patrick McQuillen; Daniel A Notterman; J Michael Dean; Brandie D Wagner Journal: Eur Respir J Date: 2021-03-18 Impact factor: 16.671