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Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
04:32

Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia

Published on: June 28, 2018

Novel toxin assays implicate Mycoplasma pneumoniae in prolonged ventilator course and hypoxemia

Mark T Muir1, Stephen M Cohn1, Christopher Louden2

  • 1Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX.

Chest
|October 2, 2010
PubMed
Abstract

Insights

Mycoplasma pneumoniae, detected by novel assays, was found in 41% of mechanically ventilated patients. This pathogen is linked to longer ventilator use and poorer oxygenation, especially in ARDS patients.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Pulmonary Medicine

Background:

  • Community-acquired respiratory distress syndrome (CARDS) toxin is a key Mycoplasma pneumoniae virulence factor.
  • Novel molecular assays offer higher sensitivity for M. pneumoniae detection.
  • The role of M. pneumoniae as a nosocomial infection in critical illness requires further investigation.

Purpose of the Study:

  • To determine the incidence of M. pneumoniae in mechanically ventilated subjects using advanced molecular assays.
  • To investigate the impact of M. pneumoniae infection on pulmonary outcomes in critically ill patients.

Main Methods:

  • Prospective observational study in a surgical trauma ICU.
  • Enrollment of subjects with suspected ventilator-associated pneumonia (VAP) undergoing bronchoalveolar lavage (BAL).
  • Testing of lavage fluid and serum for M. pneumoniae via CARDS toxin gene, protein, or antitoxin antibodies.

Main Results:

  • 41% (15 of 37) of subjects tested positive for M. pneumoniae.
  • No significant differences in baseline demographics between positive and negative groups.
  • M. pneumoniae-positive subjects had fewer ventilator-free days (P=.04) and worse oxygenation (P=.02), particularly those with ARDS.

Conclusions:

  • M. pneumoniae is present in a significant proportion of mechanically ventilated patients with suspected VAP.
  • M. pneumoniae infection is associated with prolonged mechanical ventilation and impaired oxygenation.
  • Novel assays confirm M. pneumoniae as a relevant pathogen in critical care settings.

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