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2021 Vol.51, Issue 4 Preview Page

Original Article

Oral Microbiota Change in Intubated Patients under Mechanical Ventilation
Yoon Hee Choi1
Soo Hyun Kim2
Yeuni Yu3
Seo-Young Lee3
Yu Jung Jung4
Do Young Kim4
Myoung Soo Kim5
Hee Sam Na6*
1Department of Internal Medicine, Dongnam Institute of Radiological and Medical Sciences, Busan 46033, Republic of Korea
2Artificial Kidney Room, Busan Medical Center, Busan 47527, Republic of Korea
3Interdisplinary Program of Genomic Science, Pusan National University, Busan 46241, Republic of Korea
4School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea
5Department of Nursing, College of Natural Science, Pukyong National University, Busan 48513, Republic of Korea
6Department of Oral Microbiology, BK21 PLUS Project, School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea
*heesamy@pusan.ac.kr
31 December 2021. pp. 163-171
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Abstract

One of the complications that may develop in intubated patients under mechanical ventilator is ventilator‐associated pneumonia (VAP). In most cases, VAP appears to result from aspiration of the oropharyngeal microflora or colonizing pathogens. For efficient prevention and management, understanding oral microbiome dynamics during mechanical ventilator is required. In this study, we analyzed longitudinal oral microbiome in intubated patients under mechanical ventilation support. Intubated patients and healthy subjects were recruited for this study. Buccal samples were collected for microbiome study. For longitudinal comparison, intubated samples were grouped as initial 2 days, first week, second week, third week, and over 3 week group. 16S ribosomal RNA next generation sequencing was applied for microbiome analysis. Alpha diversity and beta diversity was applied to characterize the oral microbiome. Linear discriminant analysis effect size (LefSe) was applied to determine difference in the composition among tested group. In intubated patients, the richness and evenness of the microbiota was significantly reduced compared to the healthy control. The most abundant species in intubated patients were Corynebacterium, Acinetobacter, Streptococcus, Staphylococcus, and Enterococcus, which represented more than 70% of the total sequences at the genus level. The most abundant species were Acinetobacter baumannii, Proteus mirabilis, Enterococcus faecalis Pseudomonas aeruginosa, and Gardnerella vaginalis were among the significant taxa within intubated patients. Pathogenic bacteria including Acinetobacter, Enterococcus, Klebsiella, Pseudomonas, and Staphylococcus were also frequently observed during the observation period. In intubated patients, the composition of oral microbiome was heavily distorted compared to healthy subjects and high abundance of pathogenic bacteria was observed. A better understanding of the longitudinal microbiome change in oral cavity of intubated patients should provide better understanding for effective prophylactic and therapeutic interventions for VAP.

Keywords
Oral microbiota
Intubation
Mechanical ventilator
Ventilator associated pneumonia
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Information
  • Publisher :The Korean Society for Microbiology
  • Publisher(Ko) :대한미생물학회
  • Journal Title :JOURNAL OF BACTERIOLOGY AND VIROLOGY
  • Volume : 51
  • No :4
  • Pages :163-171
  • Received Date :2021. 09. 03
  • Revised Date :2021. 09. 27
  • Accepted Date : 2021. 09. 27
  • DOI :https://doi.org/10.4167/jbv.2021.51.4.163
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