Cited by 180Nosocomial Infections in ICUBacterial biofilms and quorum sensingAntibiotic Resistance in Bacteria

Loss of Bacterial Diversity during Antibiotic Treatment of Intubated Patients Colonized with Pseudomonas aeruginosa

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Flanagan, J. L., Brodie, E. L., Weng, L., Lynch, S. V., Garcia, O., Brown, R., Hugenholtz, P., DeSantis, T. Z. +3 more·2007·Journal of Clinical Microbiology

Abstract

Management of airway infections caused by Pseudomonas aeruginosa is a serious clinical challenge, but little is known about the microbial ecology of airway infections in intubated patients. We analyzed bacterial diversity in endotracheal aspirates obtained from intubated patients colonized by P. aeruginosa by using 16S rRNA clone libraries and microarrays (PhyloChip) to determine changes in bacterial community compositions during antibiotic treatment. Bacterial 16S rRNA genes were absent from aspirates obtained from patients briefly intubated for elective surgery but were detected by PCR in samples from all patients intubated for longer periods. Sequencing of 16S rRNA clone libraries demonstrated the presence of many orally, nasally, and gastrointestinally associated bacteria, including known pathogens, in the lungs of patients colonized with P. aeruginosa. PhyloChip analysis detected the same organisms and many additional bacterial groups present at low abundance that were not detected in clone libraries. For each patient, both culture-independent methods showed that bacterial diversity decreased following the administration of antibiotics, and communities became dominated by a pulmonary pathogen. P. aeruginosa became the dominant species in six of seven patients studied, despite treatment of five of these six with antibiotics to which it was sensitive in vitro. Our data demonstrate that the loss of bacterial diversity under antibiotic selection is highly associated with the development of pneumonia in ventilated patients colonized with P. aeruginosa. Interestingly, PhyloChip analysis demonstrated reciprocal changes in abundance between P. aeruginosa and the class Bacilli, suggesting that these groups may compete for a similar ecological niche and suggesting possible mechanisms through which the loss of microbial diversity may directly contribute to pathogen selection and persistence.

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  • Bacterial pneumonia is characterised by increased bacterial burden and low community diversity, generally one dominant pathogen.

    “Bacterial pneumonia, a true lung infection, exemplifies these features: it is characterised by increased bacterial burden and low community diversity (generally one dominant pathogen).”

    From The microbiome and critical illness (2016) · cites this paper as [62]

  • At the current pace of development, point-of-care community sequencing and identification of pathogens will be available and affordable within years rather than decades.

    “At the current pace of development, point-of-care community sequencing and identification of pathogens will be available and affordable within years rather than decades.”

    From The microbiome and critical illness (2016) · cites this paper as [62]

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Authors
Flanagan, J. L., Brodie, E. L., Weng, L., Lynch, S. V., Garcia, O., Brown, R., Hugenholtz, P., DeSantis, T. Z., Andersen, G. L., Wiener-Kronish, J. P., & Bristow, J.
Affiliations
  • University of California, San Francisco (US)
  • Lawrence Berkeley National Laboratory (US)
  • Joint Genome Institute (US)
  • Department of Anesthesia and Perioperative Care, University of California, San Francisco, California 94143
Venue
Journal of Clinical Microbiology
Published
2007-06
Volume
45
Issue
6
Pages
1954-1962
ISSN
  • 0095-1137 (ISSN-L)
  • 1098-660X
OpenAlex
W2164628641
Cited by
180
References
55
Citations by year
2026: 4 · 2025: 2 · 2024: 6 · 2023: 10 · 2022: 2 · 2021: 9 · 2020: 6 · 2019: 5 · 2018: 6 · 2017: 6 · 2016: 6 · 2015: 8 · 2014: 12 · 2013: 14 · 2012: 15
FWCI
13.80
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Microbiology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
National Heart, Lung, and Blood Institute (HL-024075, P01HL024075, R01HL069809, HL69809, P50HL074005, PH 50HL74005)
Topics
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bacterial biofilms and quorum sensing
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
Keywords
Pseudomonas aeruginosa, bacterial diversity, antibiotic therapy, intubated patients, ventilator-associated pneumonia, tracheal aspirate, airway colonization, PhyloChip, bacterial community composition, antibiotic selection, bacilli, pathogen persistence, microbial ecology
MeSH terms
Aged, Aged, 80 and over, Anti-Bacterial Agents, Bacteria, Cloning, Molecular, DNA, Bacterial, Female, Humans, Infant, Intubation, Intratracheal, Lung, Male, Middle Aged, Molecular Sequence Data, Pseudomonas aeruginosa, Pseudomonas Infections, RNA, Ribosomal, 16S, Genetic Variation, Gene Library, Sequence Analysis, DNA, Ecosystem, Oligonucleotide Array Sequence Analysis

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