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Increased constituent ratios of Klebsiella sp., Acinetobacter sp., and Streptococcus sp. and a decrease in microflora

Wei Lu1, Jialin Yu1, Qing Ai2

  • 1Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, China ; Pediatrics Research Institution, Children's Hospital of Chongqing Medical University, Chongqing, China ; Ministry of Education Key Laboratory of Child Development and Disorder, Children's Hospital of Chongqing Medical University, Chongqing, China.

Plos One
|March 4, 2014
PubMed

Insights

Ventilator-associated pneumonia (VAP) in neonates reduces lower respiratory tract microflora diversity within three days. Increased Klebsiella, Acinetobacter, and Streptococcus may indicate VAP development in infants on mechanical ventilation.

Area of Science:

  • Neonatal critical care
  • Microbiology
  • Genomics

Background:

  • Ventilator-associated pneumonia (VAP) is a significant cause of mortality in neonates requiring mechanical ventilation.
  • Defining the specific causes of VAP in this vulnerable population remains challenging.
  • Understanding the microbial shifts associated with VAP is crucial for diagnosis and treatment.

Purpose of the Study:

  • To investigate the dynamic changes in lower respiratory tract microflora diversity in neonates with and without VAP.
  • To identify potential microbial indicators for early VAP detection in infants with respiratory distress syndrome (RDS).

Main Methods:

  • Prospective study comparing neonates with RDS and VAP (experimental group) to those with RDS alone (control group).
  • Sputum samples collected at 1, 3, and 5 days post-intubation.
  • 16S rDNA gene sequencing (PCR amplification, DGGE, cloning, sequencing) to analyze microbial composition and diversity.
  • Bioinformatic analysis (BLAST) and statistical evaluation of microbial richness and diversity indices (Shannon-Wiener).

Main Results:

  • No significant differences in microbial genus ratios between VAP and non-VAP groups within the first day of ventilation.
  • Between days 1-3, VAP group showed increased ratios of Klebsiella spp., Acinetobacter spp., and Streptococcus spp., with decreased Serratia spp. and Achromobacter spp. compared to controls.
  • Microbial richness and Shannon-Wiener diversity index were lower in the VAP group from days 1-3.
  • After 3-5 days, microbial ratios shifted, with decreased Klebsiella spp., Acinetobacter spp., Serratia spp., and Achromobacter spp. in the VAP group.

Conclusions:

  • VAP is associated with reduced lower respiratory tract microflora diversity in neonates during the initial three days of mechanical ventilation.
  • Elevated levels of Klebsiella spp., Acinetobacter spp., and Streptococcus spp. in sputum may serve as early indicators of VAP in neonates.
  • Further research into these microbial shifts can inform diagnostic strategies and targeted interventions for VAP.

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