Altered Ecology of the Respiratory Tract Microbiome and Nosocomial Pneumonia

Frontiers in Microbiology

Fernando Baquero¹  Teresa M. Coque²  Ana Elena Pérez-Cobas³  Raúl de Pablo⁴  María Cruz Soriano⁴ 

[1] CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain;CIBER in Infectious Diseases (CIBERINFEC), Madrid, Spain;Department of Microbiology, Ramón y Cajal Institute for Health Research (IRYCIS), Ramón y Cajal University Hospital, Madrid, Spain;Intensive Care Department, Ramón y Cajal University Hospital, Madrid, Spain;

关键词: respiratory tract microbiome (RTM);    ecology;    nosocomial pneumonia;    intensive care unit (ICU);    dysbiosis;    antibiotic resistance genes (ARGs);   

DOI  :  10.3389/fmicb.2021.709421

来源: DOAJ

【 摘 要 】

Nosocomial pneumonia is one of the most frequent infections in critical patients. It is primarily associated with mechanical ventilation leading to severe illness, high mortality, and prolonged hospitalization. The risk of mortality has increased over time due to the rise in multidrug-resistant (MDR) bacterial infections, which represent a global public health threat. Respiratory tract microbiome (RTM) research is growing, and recent studies suggest that a healthy RTM positively stimulates the immune system and, like the gut microbiome, can protect against pathogen infection through colonization resistance (CR). Physiological conditions of critical patients and interventions as antibiotics administration and mechanical ventilation dramatically alter the RTM, leading to dysbiosis. The dysbiosis of the RTM of ICU patients favors the colonization by opportunistic and resistant pathogens that can be part of the microbiota or acquired from the hospital environments (biotic or built ones). Despite recent evidence demonstrating the significance of RTM in nosocomial infections, most of the host-RTM interactions remain unknown. In this context, we present our perspective regarding research in RTM altered ecology in the clinical environment, particularly as a risk for acquisition of nosocomial pneumonia. We also reflect on the gaps in the field and suggest future research directions. Moreover, expected microbiome-based interventions together with the tools to study the RTM highlighting the “omics” approaches are discussed.

【 授权许可】

Unknown