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Updated: Dec 27, 2025
Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
The Dynamics of Respiratory Microbiota during Mechanical Ventilation in Patients with Pneumonia
Seongji Woo1, So-Yeong Park1, Youngmi Kim1
1Institute of New frontier Research, Hallym University College of Medicine, Chuncheon 24253, Korea.
Abstract:
Bacterial pneumonia is a major cause of mechanical ventilation in intensive care units. We hypothesized that the presence of particular microbiota in endotracheal tube aspirates during the course of intubation was associated with clinical outcomes such as extubation failure or 28-day mortality. Sixty mechanically ventilated ICU (intensive care unit) patients (41 patients with pneumonia and 19 patients without pneumonia) were included, and tracheal aspirates were obtained on days 1, 3, and 7. Gene sequencing of 16S rRNA was used to measure the composition of the respiratory microbiome. A total of 216 endotracheal aspirates were obtained from 60 patients. A total of 22 patients were successfully extubatedwithin3 weeks, and 12 patients died within 28days. Microbiota profiles differed significantly between the pneumonia group and the non-pneumonia group (Adonis, p < 0.01). While α diversity (Shannon index) significantly decreased between day 1 and day 7 in the successful extubation group, it did not decrease in the failed extubation group among intubated patients with pneumonia. There was a significant difference in the change of βdiversity between the successful extubation group and the failed extubation group for Bray-Curtis distances (p < 0.001). At the genus level, Rothia, Streptococcus, and Prevotella correlated with the change of β diversity. A low relative abundance of Streptococci at the time of intubation was strongly associated with 28-day mortality. The dynamics of respiratory microbiome were associated with clinical outcomes such as extubation failure and mortality. Further large prospective studies are needed to test the predictive value of endotracheal aspirates in intubated patients.
Insights
The respiratory microbiome in endotracheal aspirates can predict outcomes for mechanically ventilated patients. Changes in microbial diversity are linked to extubation failure and mortality in intensive care units.
Area of Science:
- Microbiology
- Critical Care Medicine
- Genomics
Background:
- Bacterial pneumonia frequently necessitates mechanical ventilation in intensive care units (ICUs).
- The respiratory microbiome's role in predicting clinical outcomes for intubated patients remains under investigation.
Purpose of the Study:
- To investigate the association between endotracheal aspirate microbiota composition and clinical outcomes in mechanically ventilated patients.
- To determine if respiratory microbiome dynamics can predict extubation failure and 28-day mortality.
Main Methods:
- Analysis of 16S rRNA gene sequencing on 216 endotracheal aspirates from 60 mechanically ventilated patients (41 with pneumonia, 19 without).
- Assessment of respiratory microbiome composition, alpha diversity (Shannon index), and beta diversity (Bray-Curtis distances) on days 1, 3, and 7.
- Correlation of microbial profiles with clinical outcomes, including extubation success/failure and 28-day mortality.
Main Results:
- Microbiota profiles significantly differed between pneumonia and non-pneumonia groups (p < 0.01).
- Alpha diversity decreased significantly over time in patients with successful extubation, but not in those with failed extubation.
- Significant differences in beta diversity changes were observed between successful and failed extubation groups (p < 0.001).
- Genera Rothia, Streptococcus, and Prevotella correlated with beta diversity changes.
- Low relative abundance of Streptococcus at intubation was strongly associated with 28-day mortality.
Conclusions:
- Respiratory microbiome dynamics in endotracheal aspirates are associated with clinical outcomes in intubated patients.
- Microbiome analysis shows potential for predicting extubation failure and mortality.
- Further large prospective studies are warranted to validate the predictive value of endotracheal aspirates.
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