Pseudomonas aeruginosa and Candida Species Interaction, an Approach for the Prevention of Nosocomial Pneumonia

Abstract

Abstract: Mechanical ventilation is used in about one-third of patients in intensive cares units (ICU). Ventilator-associated pneumonia (VAP) is a frequent infectious complication, affecting approximately 8% to 28%. The pathogenesis of VAP is intimately related with the endotracheal tube (ET) biofilm. Although, most if not all VAP is due to bacteria, the role of Candida albicans is unclear in immunocompetent hosts. Recently, some clinical findings suggest a possible interaction between Pseudomonas aeruginosa and Candida albicans. Indeed, C. albicans and P. aeruginosa are frequently isolated from ET biofilm and tracheal secretions in patients with VAP. Despite these findings there is not a confirmed causal link. There are many strategies for prevention of VAP and despite considerable efforts to implement guidelines for prevention this complication remains common among critically ill patients. Demonstration of a causal link between previous Candida species colonization and subsequent infection with P. aeruginosa would open to a new approach in the prevention of VAP.