{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Mourani PM"],"funding":["NICHD NIH HHS","NHLBI NIH HHS","National Institutes of Health"],"pagination":["2001829"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC7979474"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["57(3)"],"pubmed_abstract":["We sought to determine whether temporal changes in the lower airway microbiome are associated with ventilator-associated pneumonia (VAP) in children.Using a multicentre prospective study of children aged 31 days to 18 years requiring mechanical ventilation support for >72 h, daily tracheal aspirates were collected and analysed by sequencing of the 16S rRNA gene. VAP was assessed using 2008 Centers for Disease Control and Prevention paediatric criteria. The association between microbial factors and VAP was evaluated using joint longitudinal time-to-event modelling, matched case-control comparisons and unsupervised clustering.Out of 366 eligible subjects, 66 (15%) developed VAP at a median of 5 (interquartile range 3-5) days post intubation. At intubation, there was no difference in total bacterial load (TBL), but Shannon diversity and the relative abundance of <i>Streptococcus</i>, Lactobacillales and <i>Prevotella</i> were lower for VAP subjects <i>versus</i> non-VAP subjects. However, higher TBL on each sequential day was associated with a lower hazard (hazard ratio 0.39, 95% CI 0.23-0.64) for developing VAP, but sequential values of diversity were not associated with VAP. Similar findings were observed from the matched analysis and unsupervised clustering. The most common dominant VAP pathogens included <i>Prevotella</i> species (19%), <i>Pseudomonas aeruginosa</i> (14%) and <i>Streptococcus mitis</i>/<i>pneumoniae</i> (10%). <i>Mycoplasma</i> and <i>Ureaplasma</i> were also identified as dominant organisms in several subjects.In mechanically ventilated children, changes over time in microbial factors were marginally associated with VAP risk, although these changes were not suitable for predicting VAP in individual patients. These findings suggest that focusing exclusively on pathogen burden may not adequately inform VAP diagnosis."],"journal":["The European respiratory journal"],"pubmed_title":["Temporal airway microbiome changes related to ventilator-associated pneumonia in children."],"pmcid":["PMC7979474"],"funding_grant_id":["RL1 HD107773","UG1HD083171","1R01HL124103","UG1HD083170","UG1 HD083170","UG1 HD083171","K23 HL138461","UG01HD049934","UG1HD050096","UG1 HD063108","UG1HD63108","UG1 HD050096","U10 HD049983","UG1 HD049981","UG1HD083166","UG1HD049983","UG1 HD083166","R01 HL124103","UG1HD049981","U01 HD049934","K23 HD096018","UG1 HD049983","UG1HD083116"],"pubmed_authors":["Robertson CE","Williamson KM","Simoes EAF","Meert K","Kamm J","Ambroggio L","Zuppa AF","Fink EL","Wagner BD","Holubkov R","Berger JT","Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN)","Wessel DL","Burd R","McQuillen P","Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) members are as follows:","Mourani PM","Ziegler K","Meert KL","Reeder RW","VanBuren J","Berg RA","Pollack MM","Dean JM","DeRisi JL","Locandro C","Osborne CM","Harris JK","Maddux AB","Heidemann SM","Notterman DA","Yates AR","Sapru A","Sontag MK","Reeder R","Leroue MK","Bell M","Langelier C","Carpenter TC","Carcillo J","Carcillo JA","Sward K","Hall MW"],"additional_accession":[]},"is_claimable":false,"name":"Temporal airway microbiome changes related to ventilator-associated pneumonia in children.","description":"We sought to determine whether temporal changes in the lower airway microbiome are associated with ventilator-associated pneumonia (VAP) in children.Using a multicentre prospective study of children aged 31 days to 18 years requiring mechanical ventilation support for >72 h, daily tracheal aspirates were collected and analysed by sequencing of the 16S rRNA gene. VAP was assessed using 2008 Centers for Disease Control and Prevention paediatric criteria. The association between microbial factors and VAP was evaluated using joint longitudinal time-to-event modelling, matched case-control comparisons and unsupervised clustering.Out of 366 eligible subjects, 66 (15%) developed VAP at a median of 5 (interquartile range 3-5) days post intubation. At intubation, there was no difference in total bacterial load (TBL), but Shannon diversity and the relative abundance of <i>Streptococcus</i>, Lactobacillales and <i>Prevotella</i> were lower for VAP subjects <i>versus</i> non-VAP subjects. However, higher TBL on each sequential day was associated with a lower hazard (hazard ratio 0.39, 95% CI 0.23-0.64) for developing VAP, but sequential values of diversity were not associated with VAP. Similar findings were observed from the matched analysis and unsupervised clustering. The most common dominant VAP pathogens included <i>Prevotella</i> species (19%), <i>Pseudomonas aeruginosa</i> (14%) and <i>Streptococcus mitis</i>/<i>pneumoniae</i> (10%). <i>Mycoplasma</i> and <i>Ureaplasma</i> were also identified as dominant organisms in several subjects.In mechanically ventilated children, changes over time in microbial factors were marginally associated with VAP risk, although these changes were not suitable for predicting VAP in individual patients. These findings suggest that focusing exclusively on pathogen burden may not adequately inform VAP diagnosis.","dates":{"release":"2021-01-01T00:00:00Z","publication":"2021 Mar","modification":"2025-04-22T08:16:38.578Z","creation":"2025-04-05T22:28:57.456Z"},"accession":"S-EPMC7979474","cross_references":{"pubmed":["33008935"],"doi":["10.1183/13993003.01829-2020"]}}