Association between pathogens from tracheal aspirate and oral biofilm of patients on mechanical ventilation

Area of Science:

• Medical Microbiology
• Intensive Care Medicine
• Infectious Diseases

Background:

• Intubated patients in intensive care units (ICUs) are at high risk for respiratory infections, including ventilator-associated pneumonia (VAP).
• The oral cavity can serve as a reservoir for respiratory pathogens, potentially contributing to VAP development.

Purpose of the Study:

• To investigate the association between respiratory pathogens in tracheal aspirates and oral biofilm samples from intubated ICU patients.
• To identify common respiratory pathogens in oral biofilms, particularly in patients who developed VAP.

Main Methods:

• Oral biofilm samples were collected from the tongue of intubated patients at admission and 48 hours later.
• Samples were analyzed using culture and Antibiotic Sensitivity Testing.
• Results were compared with tracheal secretion samples.

Main Results:

• 59.37% of patients showed identical pathogens in both tracheal aspirates and oral biofilms.
• Significant associations (p < 0.05) were found for Klebsiella pneumoniae, Candida albicans, Pseudomonas aeruginosa, Enterobacter gergoviae, Streptococcus spp, and Serratia marcescens.
• Pathogen presence in oral cavities was higher in patients who developed VAP or aspiration pneumonia.

Conclusions:

• Respiratory pathogens in intubated patients' tracheal aspirates can be detected in their oral cavity.
• A strong correlation exists between oral and tracheal pathogens, especially in VAP patients.
• Enhanced oral care protocols in ICUs may be crucial for reducing VAP rates.