Commensal oropharyngeal flora may cause ventilator-associated pneumonia

Commensal oropharyngeal flora may cause ventilator-associated pneumonia

Commensal oropharyngeal flora appeared to be a possible cause of ventilator-associated pneumonia in a number of patients admitted to the ICU, according to study results.

“The current study demonstrated a probable association between merely significant growth of [commensal oropharyngeal flora (COF)] in [ventilator-associated pneumonia (VAP)] suspected patients and worse outcome,” Johannes B. J. Scholte, PhD, of the department of intensive care medicine at Luzerner Kantonspital in Switzerland, and colleagues wrote. “Similar to VAP caused by other microorganisms, it remains unknown whether this association is causal or that COF-VAP results from critical illness and that the outcome is therefore unfavorable.”

Scholte and colleagues conducted a retrospective clinical, microbiological and radiographic analysis of patients suspected to have VAP between 2005 and 2014.

The analysis included 23 patients diagnosed with VAP and 899 patients recently admitted to the ICU without VAP as a reference population.

Patients developed VAP after a median of 8 days of mechanical ventilation. The patients faced a prolonged stay in the ICU (35 days; P < .001), a prolonged stay in the hospital (45 days; P = .001) and a trend to higher mortality (39% vs. 26%; P = .158).

COF-VAP had been considered the most likely diagnosis in 15 patients with pneumonia, according to the researchers.

“As COF was identified as the most likely causative agent in 9.4% of all VAP episodes, COF is probably an over-looked cause of VAP,” the researchers wrote. “In the absence of other pulmonary and non-pulmonary explanations for a patient’s pulmonary deterioration, ICU physicians should perhaps acknowledge this entity and treat it accordingly.” – by Ryan McDonald

Disclosure: The researchers report no relevant financial disclosures.

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