Incidence of anaerobes in ventilator-associated pneumonia with use of a protected specimen brush.
Abstract
The role of anaerobic bacteria in ventilator-associated pneumonia (VAP) has been little investigated. In this study we analyzed the incidence of anaerobes in patients with a first episode of bacteriologically documented VAP (> 10(3)CFU/ml), using protected specimen brushes (PSB). We particularly took care to preserve anaerobic conditions during transport and the microbiological procedure. Two groups were considered: group A with anaerobic bacteria recovered from PSB, with or without anaerobes, and group B with aerobic bacteria only. One hundred and thirty patients were included, 30 (23%) in group A, and 100 (77%) in group B. The main anaerobic strains isolated were Prevotella melaninogenica (36%), Fusobacterium nucleatum (17%), and Veillonella parvula (12%). Univariate analysis demonstrated that patients in group A were younger than those in group B (p < 0.05) and their simplified acute physiologic score was higher (p < 0.02). The percentage of patients receiving antibiotics before PSB did not differ significantly between group A (57%) and group B (35%). VAP with anaerobes occurred more often in patients orotracheally intubated than nasotracheally intubated (p < 0.02). Episodes of VAP involving anaerobic bacteria occurred more often in the first five days (early VAP) than after the fifth day (late VAP) (p < 0.05). The 3-mo mortality rate was similar in the two groups, but death occurred earlier in group B (p < 0.01). Multivariate analysis demonstrated that presence of altered level of consciousness (p = 0.0002), higher simplified acute physiologic score (p = 0.003), and admission to the medical ICU (p = 0.02) were the factors independently predisposing to the development of VAP with anaerobes.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The main pathophysiologic mechanism for VAP development is oropharyngeal colonization.
“Many studies have reported that the main pathophysiologic mechanism for VAP development is oropharyngeal colonization (Doré et al., 1996; Bahrani-Mougeot et al., 2007).”
From Oral Microbiome and SARS-CoV-2: Beware of Lung Co-infection (2020) · cites this paper as Doré et al., 1996
Cites
Principles and Practice of Infectious Diseases.
(1991) · Annals of Internal Medicine · doi:10.7326/0003-4819-114-9-818_5 · Cited by 12,045 · see citing works
Cox, D. R. (2008) · Springer eBooks · doi:10.1007/978-0-387-32833-1_5 · Cited by 2,678 · see citing works
A simplified acute physiology score for ICU patients
Gall, J. L., Loirat, P., Alpérovitch, A., GLASER, P., Granthil, C., Mathieu, D., MERCIER, P., THOMAS, R., & Villers, D. (1984) · Critical Care Medicine · doi:10.1097/00003246-198411000-00012 · Cited by 1,247 · see citing works
Fagon, J.-Y., Chastre, J. E., Hance, A. J., Montravers, P., Novara, A., & Gibert, C. (1993) · The American Journal of Medicine · doi:10.1016/0002-9343(93)90060-3 · Cited by 1,175 · see citing works
Nosocomial Respiratory Infections with Gram-Negative Bacilli
JOHANSON, W. G., PIERCE, A. K., SANFORD, J. P., & THOMAS, G. D. (1972) · Annals of Internal Medicine · doi:10.7326/0003-4819-77-5-701 · Cited by 1,091 · see citing works
Changing Pharyngeal Bacterial Flora of Hospitalized Patients: Emergence of Gram-Negative Bacilli
Johanson, W. G., Pierce, A. K., & Sanford, J. P. (1969) · New England Journal of Medicine · doi:10.1056/nejm196911202812101 · Cited by 910 · see citing works
Fagon, J.-Y., Chastre, J. E., Domart, Y., Trouillet, J., Pierre, J., Darne, C., & Gibert, C. (1989) · American Review of Respiratory Disease · doi:10.1164/ajrccm/139.4.877 · Cited by 819 · see citing works
Risk factors for pneumonia and fatality in patients receiving continuous mechanical ventilation.
Craven, D. E., Kunches, L. M., Kilinsky, V., et al. (1986) · PubMed · Cited by 688 · see citing works
Fagon, J.-Y., Chastre, J. E., Hance, A. J., et al. (1988) · American Review of Respiratory Disease · doi:10.1164/ajrccm/138.1.110 · Cited by 430 · see citing works
Chastre, J. E., Viau, F., Brun, P., Pierre, J., Dauge, M., Bouchama, A., Akesbi, A., & Gibert, C. (1984) · PubMed · doi:10.1164/arrd.1984.130.5.924 · Cited by 354 · see citing works
Chastre, J. E., Fagon, J.-Y., Soler, P., et al. (1988) · The American Journal of Medicine · doi:10.1016/s0002-9343(88)80085-8 · Cited by 330 · see citing works
The Standardization of Bronchoscopic Techniques for Ventilator-Associated Pneumonia
Meduri, G. U., & Chastre, J. E. (1992) · CHEST Journal · doi:10.1378/chest.102.5_supplement_1.557s · Cited by 295 · see citing works
Bacteriology of Hospital-Acquired Pneumonia
Bartlett, J. G. (1986) · Archives of Internal Medicine · doi:10.1001/archinte.1986.00360170064009 · Cited by 259 · see citing works
Spray, S. B., Zuidema, G. D., & Cameron, J. L. (1976) · The American Journal of Surgery · doi:10.1016/0002-9610(76)90181-1 · Cited by 193 · see citing works
A Prospective Study of Protected Bronchoalveolar Lavage in the Diagnosis of Nosocomial Pneumonia
Rouby, J., Rossignon, M. D., Nicolas, M.-H., et al. (1989) · Anesthesiology · doi:10.1097/00000542-198911000-00010 · Cited by 190 · see citing works
Meduri, G. U., Beals, D. H., Maijub, A. G., et al. (1991) · American Review of Respiratory Disease · doi:10.1164/ajrccm/143.4_pt_1.855 · Cited by 184 · see citing works
Sundqvist, G., Carlsson, J., HERRMANN, B. F., & Tärnvik, A. (1985) · Journal of Medical Microbiology · doi:10.1099/00222615-19-1-85 · Cited by 177 · see citing works
Stamm, W. E., Martin, S. M., & Bennett, J. V. (1977) · The Journal of Infectious Diseases · doi:10.1093/infdis/136.supplement.s151 · Cited by 174 · see citing works
Pollock, H. M., Hawkins, E. L., Bonner, J. R., et al. (1983) · Journal of Clinical Microbiology · doi:10.1128/jcm.17.2.255-259.1983 · Cited by 155 · see citing works
Ventilator-Associated Pneumonia in Patients with Respiratory Failure
Meduri, G. U. (1990) · CHEST Journal · doi:10.1378/chest.97.5.1208 · Cited by 152 · see citing works
Baselski, V. S., Eltorky, M., Coalson, J. J., & Griffin, J. P. (1992) · CHEST Journal · doi:10.1378/chest.102.5_supplement_1.571s · Cited by 146 · see citing works
Anaerobic Bacterial Infections of the Lung
Bartlett, J. G. (1987) · CHEST Journal · doi:10.1378/chest.91.6.901 · Cited by 131 · see citing works
Transtracheal Aspiration in Pulmonary Infection
Ries, K. (1974) · Archives of Internal Medicine · doi:10.1001/archinte.1974.00320150127017 · Cited by 104 · see citing works
Reliability of the Bronchoscopic Protected Catheter Brush in Intubated and Ventilated Patients
Villers, D., DERRIENNIC, M., Raffi, F., et al. (1985) · CHEST Journal · doi:10.1378/chest.88.4.527 · Cited by 90 · see citing works
de Castro, F. R., Violán, J. S., Capuz, B., et al. (1991) · Critical Care Medicine · doi:10.1097/00003246-199102000-00010 · Cited by 84 · see citing works
Nosocomial pneumonia in the critically ill
Fiddian-Green, R. G., & Baker, S. P. (1991) · Critical Care Medicine · doi:10.1097/00003246-199106000-00006 · Cited by 82 · see citing works
Moser, K. M., Maurer, J., Jassy, L. N., et al. (1982) · PubMed · doi:10.1164/arrd.1982.125.4.436 · Cited by 80 · see citing works
The Telescoping Plugged Catheter in Suspected Anaerobic Infections
Bordelon, J. Y., Legrand, P., Wc, G., et al. (1983) · American Review of Respiratory Disease · doi:10.1164/arrd.1983.128.3.465 · Cited by 44 · see citing works
Okahashi, N., Koga, T., Nishihara, T., et al. (1988) · Microbiology · doi:10.1099/00221287-134-6-1707 · Cited by 36 · see citing works
Musial, C. E., & Rosenblatt, J. E. (1989) · Mayo Clinic Proceedings · doi:10.1016/s0025-6196(12)65727-9 · Cited by 30 · see citing works
Mechanisms of resistance in anaerobes and new developments in testing
Finegold, S. M. (1989) · Diagnostic Microbiology and Infectious Disease · doi:10.1016/0732-8893(89)90123-5 · Cited by 20 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Oral Microbiome and SARS-CoV-2: Beware of Lung Co-infection
Bao, L., Zhang, C., Dong, J., Zhao, L., Li, Y., & Sun, J. (2020) · Frontiers in Microbiology · doi:10.3389/fmicb.2020.01840 · Cited by 207 · see citing works
Bahrani-Mougeot, F. K., Paster, B. J., Coleman, S., Barbuto, S., Brennan, M. T., Noll, J., Kennedy, T., Fox, P. C., & Lockhart, P. B. (2007) · Journal of Clinical Microbiology · doi:10.1128/jcm.01963-06 · Cited by 176 · see citing works
- Authors
- Doré, P., Robert, R., Grollier, G., Rouffineau, J., Lanquetot, H., Charrière, J. M., & Fauchère, J. L.
- Affiliations
- Centre Hospitalier Universitaire de Poitiers (FR)
- Service de Pneumologie, Centre Hospitalier Regional et Universitaire de Poitiers, France
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 1996-04-01
- Volume
- 153
- Issue
- 4
- Pages
- 1292-1298
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2120770115
- Cited by
- 129
- References
- 31
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 3 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 3 · 2015: 4 · 2013: 2 · 2012: 4
- FWCI
- 4.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Respiratory and Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
- Keywords
- ventilator-associated pneumonia, anaerobic bacteria, protected specimen brush, Prevotella melaninogenica, Fusobacterium nucleatum, Veillonella parvula, orotracheal intubation, altered level of consciousness, risk factors, mortality
- MeSH terms
- Adult, Aged, Bacteria, Anaerobic, Cross Infection, Female, Humans, Male, Middle Aged, Pneumonia, Respiration, Artificial, Specimen Handling
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
