Abstract
Ventilator-associated pneumonia (VAP) is a common complication and cause of death in neonates on mechanical ventilation. However, it is difficult to define the causes of VAP. To understand the causes of VAP, we undertook a prospective study based on the diversity of the microflora in VAP. The experimental group consisted of newborns who suffered from respiratory distress syndrome (RDS) and VAP, while the control group suffered from RDS without VAP. Sputa were collected within 1, 3, and 5 days of ventilation and were divided into six groups. DNA was extracted from the samples, and the 16S rDNA was PCR amplified, separated using denaturing gradient gel electrophoresis (DGGE), cloned and sequenced. The resulting sequences were compared using BLAST. The DGGE pictures were measured, and the richness, Shannon-Wiener index, and cluster maps were analyzed. No differences were found regarding the constituent ratio of any genus between the Non-VAP and VAP group within 1 day after intubation. After 1 to 3 days, the constituent ratios of Klebsiella sp., Acinetobacter sp., and Streptococcus sp. in the VAP group were higher than those in the Non-VAP group, and the ratios of Serratia sp. and Achromobacter sp. were lower. After 3 to 5 days, the ratios of Klebsiella sp., Acinetobacter sp., Serratia sp., and Achromobacter sp. were lower than those in the Non-VAP group. The richness and Shannon-Wiener index of the Non-VAP group were higher than those of the VAP group from 1 to 3 days after intubation, while no differences were found within 1 day and from 3 to 5 days. We conclude that during the first three days of intubation, the microflora diversity in the lower respiratory tract was reduced due to VAP, and the greater constituent ratios of Klebsiella sp., Acinetobacter sp., and Streptococcus sp. in the sputum may be indicators of VAP.
Highlights
There is mounting evidence that shows that a variety of microorganisms exist in the human respiratory tract, gastrointestinal tract, skin, vagina, and other parts of the body
We found that the following six genera were present in the sputum within one day of intubation: Klebsiella sp., Serratia sp., Achromobacter sp., Acinetobacter sp., Staphylococcus sp., and Streptococcus sp
Klebsiella subspecies and Acinetobacter baumannii were cultured in this study, and the constituent ratios of Klebsiella sp. and Acinetobacter sp. were larger in the Ventilator-associated pneumonia (VAP) group than in the Non-VAP group
Summary
There is mounting evidence that shows that a variety of microorganisms exist in the human respiratory tract, gastrointestinal tract, skin, vagina, and other parts of the body. 95% of our symbiotic microorganisms are poorly understood, and we do not fully know the effects that these microorganisms have on our health, even though the Human Genome Project was completed in 2003 [1]. To this end, SCIENCE published a special issue entitled ‘‘Gut Microflora’’ in August 2012 that discussed the importance of studying the microflora. Current research has focused primarily on the intestines, teeth, and vagina, while somewhat ignoring the microflora of the respiratory tract
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