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Respiratory microbiome in mechanically ventilated patients: a narrative review
The respiratory microbiome has been less explored than the gut microbiome. Despite the speculated importance of dysbiosis of the microbiome in ventilator-associated pneumonia (VAP) and acute respiratory distress syndrome (ARDS), only few studies have been performed in invasively ventilated ICU patie...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871139/ https://www.ncbi.nlm.nih.gov/pubmed/33559707 http://dx.doi.org/10.1007/s00134-020-06338-2 |
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author | Fromentin, Mélanie Ricard, Jean-Damien Roux, Damien |
author_facet | Fromentin, Mélanie Ricard, Jean-Damien Roux, Damien |
author_sort | Fromentin, Mélanie |
collection | PubMed |
description | The respiratory microbiome has been less explored than the gut microbiome. Despite the speculated importance of dysbiosis of the microbiome in ventilator-associated pneumonia (VAP) and acute respiratory distress syndrome (ARDS), only few studies have been performed in invasively ventilated ICU patients. And only the results of small cohorts have been published. An overlap exists between bacterial populations observed in the lower respiratory tract and the oropharyngeal tract. The bacterial microbiota is characterized by relatively abundant bacteria difficult to cultivate by standard methods. Under mechanical ventilation, a dysbiosis occurs with a drop overtime in diversity. During VAP development, lung dysbiosis is characterized by a shift towards a dominant bacterial pathogen (mostly Proteobacteria) whereas enrichment of gut-associated bacteria mainly Enterobacteriaceae is the specific feature discriminating ARDS patients. However, the role of this dysbiosis in VAP and ARDS pathogenesis is not yet fully understood. A more in-depth analysis of the interplay between bacteria, virus and fungi and a better understanding of the host-microbiome interaction could provide a more comprehensive view of the role of the microbiome in VAP and ARDS pathogenesis. Priority should be given to validate a consensual and robust methodology for respiratory microbiome research and to conduct longitudinal studies. A deeper understanding of microbial interplay should be a valuable guide for care of ARDS and VAP preventive/therapeutic strategies. We present a review on the current knowledge and expose perspectives and potential clinical applications of respiratory microbiome research in mechanically ventilated patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00134-020-06338-2. |
format | Online Article Text |
id | pubmed-7871139 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-78711392021-02-09 Respiratory microbiome in mechanically ventilated patients: a narrative review Fromentin, Mélanie Ricard, Jean-Damien Roux, Damien Intensive Care Med Review The respiratory microbiome has been less explored than the gut microbiome. Despite the speculated importance of dysbiosis of the microbiome in ventilator-associated pneumonia (VAP) and acute respiratory distress syndrome (ARDS), only few studies have been performed in invasively ventilated ICU patients. And only the results of small cohorts have been published. An overlap exists between bacterial populations observed in the lower respiratory tract and the oropharyngeal tract. The bacterial microbiota is characterized by relatively abundant bacteria difficult to cultivate by standard methods. Under mechanical ventilation, a dysbiosis occurs with a drop overtime in diversity. During VAP development, lung dysbiosis is characterized by a shift towards a dominant bacterial pathogen (mostly Proteobacteria) whereas enrichment of gut-associated bacteria mainly Enterobacteriaceae is the specific feature discriminating ARDS patients. However, the role of this dysbiosis in VAP and ARDS pathogenesis is not yet fully understood. A more in-depth analysis of the interplay between bacteria, virus and fungi and a better understanding of the host-microbiome interaction could provide a more comprehensive view of the role of the microbiome in VAP and ARDS pathogenesis. Priority should be given to validate a consensual and robust methodology for respiratory microbiome research and to conduct longitudinal studies. A deeper understanding of microbial interplay should be a valuable guide for care of ARDS and VAP preventive/therapeutic strategies. We present a review on the current knowledge and expose perspectives and potential clinical applications of respiratory microbiome research in mechanically ventilated patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00134-020-06338-2. Springer Berlin Heidelberg 2021-02-09 2021 /pmc/articles/PMC7871139/ /pubmed/33559707 http://dx.doi.org/10.1007/s00134-020-06338-2 Text en © Springer-Verlag GmbH Germany, part of Springer Nature 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Review Fromentin, Mélanie Ricard, Jean-Damien Roux, Damien Respiratory microbiome in mechanically ventilated patients: a narrative review |
title | Respiratory microbiome in mechanically ventilated patients: a narrative review |
title_full | Respiratory microbiome in mechanically ventilated patients: a narrative review |
title_fullStr | Respiratory microbiome in mechanically ventilated patients: a narrative review |
title_full_unstemmed | Respiratory microbiome in mechanically ventilated patients: a narrative review |
title_short | Respiratory microbiome in mechanically ventilated patients: a narrative review |
title_sort | respiratory microbiome in mechanically ventilated patients: a narrative review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871139/ https://www.ncbi.nlm.nih.gov/pubmed/33559707 http://dx.doi.org/10.1007/s00134-020-06338-2 |
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