Bacterial Colonization Profile With Tracheal Intubation and Mechanical Ventilation

Bryant, Lester R.; Trinkle, J. Kent; Mobin-Uddin, Kazi; Baker, Jeanne; Griffen, Ward O.

doi:10.1001/archsurg.1972.04180050023006

Cited by 105 publications

(7 citation statements)

References 9 publications

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“…The development of an ex vivo model of repair performed on human bronchial tissue [9], allowed us to demonstrate that the increased P. aeruginosa binding, which occurred in repairing human bronchial epithelium, was not an in vitro artefact. These results may also explain why non‐CF patients develop pneumonia with non‐mucoid P. aeruginosa strains with tracheal intubation and mechanical ventilation [1]. These P. aeruginosa ‐targeted FD nasal or bronchial cells have epithelial characteristics and all express cytokeratin 13 as previously reported [22].…”

Section: Discussionmentioning

confidence: 58%

“…Pseudomonas aeruginosa is an opportunistic pathogen responsible for severe respiratory infections in patients with bronchial inflammatory diseases, particularly with cystic fibrosis (CF) and in patients with compromised host defences [1, 2]. The airway initial infection by P. aeruginosa may occur through a variety of bacterial strategies, including binding to mucins and epithelial receptors present at the surface of the respiratory epithelium [3–5].…”

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confidence: 99%

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Fibronectin and α5β1 integrin mediate binding of Pseudomonas aeruginosa to repairing airway epithelium

Roger¹,

Puchelle²,

Bajolet-Laudinat³

et al. 1999

Eur Respir J

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Fibronectin and a5b1 integrin mediate binding of Pseudomonas aeruginosa to repairing airway epithelium. P. Roger, E. Puchelle, O. Bajolet-Laudinat, J-M. Tournier, C. Debordeaux, M-C. Plotkowski, J.H.M. Cohen, D. Sheppard, and S. de Bentzmann. #ERS Journals Ltd 1999. ABSTRACT: Initial infection of the airway by Pseudomonas aeruginosa may occur through a variety of bacterial strategies including binding to epithelial receptors present at the surface of the respiratory epithelium.In order to characterize the adherence sites for P. aeruginosa in damaged and repairing bronchial tissue, an ex vivo model of airway epithelial injury and repair was developed using primary cell cultures of nasal cells from 14 subjects with polyposis.P. aeruginosa strongly adhered to flattened dedifferentiated (FD) bronchial and nasal cytokeratin 13-positive epithelial cells in the process of migration for repair. In in vitro experiments, competitive binding inhibition assays demonstrated that a5b1 integrins and cellular fibronectin, in particular the RGD sequence, are receptors involved in P. aeruginosa adherence to FD nasal epithelial cells. Fluorescent cell sorting analysis and immunofluorescence techniques revealed that the a5b1 integrins are overexpressed and apically exposed in FD nasal epithelial cells. One 50 kDa outer membrane protein was identified in piliated and nonpiliated strains of P. aeruginosa that was involved in binding to cellular fibronectin and a5b1 epithelial integrins.These results demonstrate that Pseudomonas aeruginosa adherence is related to the dedifferentiation of airway epithelium during the repair process which unmasks and upregulates the a5b1 integrin expression and induces active synthesis of cellular fibronectin. These epithelial receptors are then used by a Pseudomonas aeruginosa 50 kDa outer membrane protein as sites of bacterial adherence. Eur Respir J 1999; 13: 1301±1309.

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Section: Discussionmentioning

confidence: 58%

mentioning

confidence: 99%

Fibronectin and α5β1 integrin mediate binding of Pseudomonas aeruginosa to repairing airway epithelium

Roger¹,

Puchelle²,

Bajolet-Laudinat³

et al. 1999

Eur Respir J

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“…The decision to eventually withdraw life Support can only be made on the basis of numerous factors. (5,12,26,36), ebenso zunehmende Intubationsdauer und fortgeschrittenes Alter (2,9,33). Generell wird die Prognose postoperativer Pneumonien trotz moderner Chemotherapie als schlecht angesehen (2,33,36).…”

Section: Discussionunclassified

Zum prognostischen Wert einiger intensivmedizinischer Parameter bei langzeitintubierten neurochirurgischen Patienten

Hausmann¹,

Esch²

1982

Anästhesiol Intensivmed Notfallmed Schmerzther

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“…Frequently, the criteria for diagnosis have been fever, cough, and development of purulent sputum, in conjunction with radiologic evidence of a new or progressive pulmonary infiltrate, a suggestive Gram stain, and positive cultures of sputum, tracheal aspirate, pleural fluid, or blood (3,4,23,25,(33)(34)(35)(36). Although clinical findings in conjunction with cultures of sputum or tracheal specimens may be sensitive for bacterial pathogens, they are highly nonspecific, especially in patients receiving mechanically assisted ventilation (8,9,(12)(13)(14)(15)18,(24)(25)(26)29,31,(37)(38)(39)(40)(41)(42); conversely, cultures of blood or pleural fluid have very low sensitivity (8,18,19,43).…”

Section: Diagnosismentioning

confidence: 99%

Guidelines for Prevention of Nosocomial Pneumonia

1997

PsycEXTRA Dataset

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This revised guideline is designed to reduce the incidence of nosocomial pneumonia and is intended for use by personnel who are responsible for surveillance and control of infections in acute-care hospitals; the information may not be applicable in long-term-care facilities because of the unique characteristics of such settings. This revised guideline addresses common problems encountered by infection-control practitioners regarding the prevention and control of nosocomial pneumonia in U.S. hospitals. Sections on the prevention of bacterial pneumonia in mechanically ventilated and/or critically ill patients, care of respiratory-therapy devices, prevention of cross-contamination, and prevention of viral lower respiratory tract infections (e.g., respiratory syncytial virus {RSV} and influenza infections) have been expanded and updated. New sections on Legionnaires disease and pneumonia caused by Aspergillus sp. have been included. Lower respiratory tract infection caused by Mycobacterium tuberculosis is not addressed in this document. Part I, "An Overview of the Prevention of Nosocomial Pneumonia, 1994," provides the background information for the consensus recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC) in Part II, "Recommendations for Prevention of Nosocomial Pneumonia." Pneumonia is the second most common nosocomial infection in the United States and is associated with substantial morbidity and mortality. Most patients who have nosocomial pneumonia are infants, young children, and persons greater than 65 years of age; persons who have severe underlying disease, immunosuppression, depressed sensorium, and/or cardiopulmonary disease; and persons who have had thoracoabdominal surgery. Although patients receiving mechanically assisted ventilation do not represent a major proportion of patients who have nosocomial pneumonia, they are at highest risk for acquiring the infection. Most bacterial nosocomial pneumonias occur by aspiration of bacteria colonizing the oropharynx or upper gastrointestinal tract of the patient. Because intubation and mechanical ventilation alter first-line patient defenses, they greatly increase the risk for nosocomial bacterial pneumonia. Pneumonias caused by Legionella sp., Aspergillus sp., and influenza virus are often caused by inhalation of contaminated aerosols. RSV infection usually occurs after viral inoculation of the conjunctivae or nasal mucosa by contaminated hands. Traditional preventive measures for nosocomial pneumonia include decreasing aspiration by the patient, preventing cross-contamination or colonization via hands of personnel, appropriate disinfection or sterilization of respiratory-therapy devices, use of available vaccines to protect against particular infections, and education of hospital staff and patients. New measures being investigated involve reducing oropharyngeal and gastric colonization by pathogenic microorganisms.

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Bacterial Colonization Profile With Tracheal Intubation and Mechanical Ventilation

Cited by 105 publications

References 9 publications

Fibronectin and α5β1 integrin mediate binding of Pseudomonas aeruginosa to repairing airway epithelium

Fibronectin and α5β1 integrin mediate binding of Pseudomonas aeruginosa to repairing airway epithelium

Zum prognostischen Wert einiger intensivmedizinischer Parameter bei langzeitintubierten neurochirurgischen Patienten

Guidelines for Prevention of Nosocomial Pneumonia

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