Incidence of anaerobes in ventilator-associated pneumonia with use of a protected specimen brush.

Doré, P.; Robert, R.; Grollier, G.; Lanquetot, H; Charrière, J M; Fauchère, Jean-Louis

doi:10.1164/ajrccm.153.4.8616556

Cited by 124 publications

(55 citation statements)

References 30 publications

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“…F. nucleatum may also cause ventilator-associated pneumonia or other severe infections. 2,27 The yeast C. albicans lives in a state of commensalism in the oral cavity but is also an important opportunistic pathogen that can cause infections varying from harmless newborn thrush to severe deep mucocutaneous candidiasis or even sepsis in patients with a local or systemic compromised immune response or in patients who take antibiotics. 28 " 30 Our investigation has revealed that the killing efficacy of chlorhexidine against S. sanguinis was weaker than that of mouth rinses containing octenidine or polyhexamethylene biguanide (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the cyorganisms found in the oral cavity are also associated with totoxicity of chlorhexidine on corneal and endothelial cells, 7 pneumonia. 2,3 A meta-analysis by Chan et al 4 provided inthe neurotoxicity of chlorhexidine was observed in animal direct evidence of the impact of oral microorganisms; they models, which prevents it from being used for very long. 8,9 showed that oral decontamination with an antiseptic adminAllergic reactions are common if chlorhexidine is applied in istered as prophylaxis reduces the incidence of ventilatorconcentrations of more than 4%, and serious anaphylactic associated pneumonia.…”

Section: Infect Control Hosp Epidemiol 2010; 31(7):733-739mentioning

confidence: 99%

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Antimicrobial Efficacy of 3 Oral Antiseptics Containing Octenidine, Polyhexamethylene Biguanide, or Citroxx: Can Chlorhexidine Be Replaced?

Rohrer

Widmer

Waltimo

et al. 2010

Infect. Control Hosp. Epidemiol.

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Background.Use of oral antiseptics decreases the bacterial load in the oral cavity.Objective.To compare the antimicrobial activity of 3 novel oral antiseptics with that of Chlorhexidine, which is considered the “gold standard” of oral hygiene.Design.Comparative in vitro study.Methods.Four common oral microorganisms (Streptococcus sanguinis, Streptococcus mutans, Candida albicans, andFusobacterium nucleatum) were tested under standard conditions and at different concentrations, by use of a broth dilution assay and an agar diffusion assay and by calculating the log10reduction factor (RF). The antimicrobial activity of each antiseptic was assessed by counting the difference in bacterial densities (ie, the log10number of colony-forming units of bacteria) before and after the disinfection process.Results.The oral antiseptics containing octenidine (with an RF in the range of 7.1–8.24 CFU/mL) and polyhexamethylene biguanide (with an RF in the range of 7.1–8.24 CFU/mL) demonstrated antimicrobial activity comparable to that of Chlorhexidine (with an RF in the range of 1.03–8.24 CFU/mL), whereas the mouth rinse containing Citroxx (Citroxx Biosciences; with an RF in the range of 0.22–1.36 CFU/mL) showed significantly weaker antimicrobial efficacy. Overall, octenidine and polyhexamethylene biguanide were more active at lower concentrations.Conclusion.Oral antiseptics containing the antimicrobial agent octenidine or polyhexamethylene biguanide may be considered as potent alternatives to chlorhexidine-based preparations.

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Section: Discussionmentioning

confidence: 99%

Section: Infect Control Hosp Epidemiol 2010; 31(7):733-739mentioning

confidence: 99%

Antimicrobial Efficacy of 3 Oral Antiseptics Containing Octenidine, Polyhexamethylene Biguanide, or Citroxx: Can Chlorhexidine Be Replaced?

Rohrer

Widmer

Waltimo

et al. 2010

Infect. Control Hosp. Epidemiol.

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“…Multiple organisms may be involved in over half of all pneumonias [10,11]. Anaerobes are often co-pathogens in early pneumonia, but do not adversely affect outcome [12]. MRSA has a higher mortality and is more common in patients who have received steroids, prior antibiotics, and who have been ventilated for more than 6 days [13,14].…”

Section: Microbiologymentioning

confidence: 99%

Statement of the 4th International Consensus Conference in Critical Care on ICU-Acquired Pneumonia – Chicago, Illinois, May 2002

Hubmayr

2002

Intensive Care Med

132

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“…In one study, oral anaerobic bacteria such as Prevotella, Veillonella, and Fusobacterium spp. were isolated from VAP patients (4).…”

mentioning

confidence: 99%

Molecular Analysis of Oral and Respiratory Bacterial Species Associated with Ventilator-Associated Pneumonia

Paster²,

et al. 2007

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Trauma intensive care unit (TICU) patients requiring mechanical respiratory support frequently develop ventilator-associated pneumonia (VAP). Oral and oropharyngeal bacteria are believed to be responsible for many cases of VAP, but definitive evidence of this relationship is lacking. Earlier studies used conventional culture-based methods for identification of bacterial pathogens, but these methods are insufficient, as some bacteria may be uncultivable or difficult to grow. The purpose of this study was to use a culture-independent molecular approach to analyze and compare the bacterial species colonizing the oral cavity and the lungs of TICU patients who developed VAP. Bacterial samples were acquired from the dorsal tongue and bronchoalveolar lavage fluid of 16 patients. Bacterial DNA was extracted, and the 16S rRNA genes were PCR amplified, cloned into Escherichia coli, and sequenced. The sequencing data revealed the following: (i) a wide diversity of bacterial species in both the oral and pulmonary sites, some of them novel; (ii) known and putative respiratory pathogens colonizing both the oral cavity and lungs of 14 patients; and (iii) a number of bacterial pathogens (e.g., Dialister pneumosintes, Haemophilus segnis, Gemella morbillorum, and Pseudomonas fluorescens) in lung samples that had not been reported previously at this site when culture-based methods were used. Our data indicate that the dorsal surface of the tongue serves as a potential reservoir for bacterial species involved in VAP. Furthermore, it is clear that the diversity of bacterial pathogens for VAP is far more complex than the current literature suggests.Ventilator-associated pneumonia (VAP) frequently occurs in patients requiring mechanical respiratory support, with incidence from 8% to 28% and mortality rates from 24% to 76%, depending on the population studied and the techniques used for the diagnosis of pneumonia (3). VAP is often associated with prolonged hospitalization of trauma patients, which can result in additional hospital charges of about $40,000 per patient (1).The etiology of VAP is variable, depending on the time of onset, duration of hospitalization, population studied, and hospital setting (3). For example, Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae usually predominate in early-onset VAP. Aerobic gram-negative bacteria, including members of the family Enterobacteriaceae, have been isolated in both early-and late-onset pneumonia. Pseudomonas aeruginosa and Acinetobacter and Enterobacter species are often isolated from late-onset pneumonia. Trauma intensive care unit (TICU) patients are at high risk of infection with S. aureus, among a variety of other microorganisms. In the postsurgical population, H. influenzae and S. pneumoniae dominate in trauma patients but not in patients with other diagnoses (3, 5). In one study, oral anaerobic bacteria such as Prevotella, Veillonella, and Fusobacterium spp. were isolated from VAP patients (4).Several different routes of infection by VAP pathogens hav...

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Incidence of anaerobes in ventilator-associated pneumonia with use of a protected specimen brush.

Cited by 124 publications

References 30 publications

Antimicrobial Efficacy of 3 Oral Antiseptics Containing Octenidine, Polyhexamethylene Biguanide, or Citroxx: Can Chlorhexidine Be Replaced?

Antimicrobial Efficacy of 3 Oral Antiseptics Containing Octenidine, Polyhexamethylene Biguanide, or Citroxx: Can Chlorhexidine Be Replaced?

Statement of the 4th International Consensus Conference in Critical Care on ICU-Acquired Pneumonia – Chicago, Illinois, May 2002

Molecular Analysis of Oral and Respiratory Bacterial Species Associated with Ventilator-Associated Pneumonia

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