학술논문
Endotracheal tube biofilm in critically ill patients during the COVID-19 pandemic : description of an underestimated microbiological compartment.
Document Type
Article
Author
Maldiney, Thomas; Pineau, Valentin; Neuwirth, Catherine; Ouzen, Linda; Eberl, Isabelle; Jeudy, Géraldine; Dalac, Sophie; Piroth, Lionel; Blot, Mathieu; Sautour, Marc; Dalle, Frédéric; Abdulmalak, Caroline; Ter Schiphorst, Romain; Pugliesi, Paul-Simon; Poussant, Thomas; Ogier-Desserrey, Agathe; Fournel, Isabelle; de Giraud d'Agay, Melchior; Jacquier, Marine; Labruyère, Marie
Source
Subject
*ENDOTRACHEAL tubes
*COVID-19 pandemic
*CRITICALLY ill
*STREPTOCOCCUS pneumoniae
*BIOFILMS
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Language
ISSN
2045-2322
Abstract
Biofilm (BF) growth is believed to play a major role in the development of ventilator-associated pneumonia (VAP) in the intensive care unit. Despite concerted efforts to understand the potential implication of endotracheal tube (ETT)-BF dispersal, clinically relevant data are lacking to better characterize the impact of its mesostructure and microbiological singularity on the occurrence of VAP. We conducted a multicenter, retrospective observational study during the third wave of the COVID-19 pandemic, between March and May 2021. In total, 64 ETTs collected from 61 patients were included in the present BIOPAVIR study. Confocal microscopy acquisitions revealed two main morphological aspects of ETT-deposited BF: (1) a thin, continuous ribbon-shaped aspect, less likely monobacterial and predominantly associated with Enterobacter spp., Streptococcus pneumoniae or Viridans streptococci, and (2) a thicker, discontinuous, mushroom-shaped appearance, more likely characterized by the association of bacterial and fungal species in respiratory samples. The microbiological characterization of ETT-deposited BF found higher acquired resistance in more than 80% of analyzed BF phenotypes, compared to other colonization sites from the patient's environment. These findings reveal BF as a singular microbiological compartment, and are of added clinical value, with a view to future ETT-deposited BF-based antimicrobial stewardship in critically ill patients. Trial registration NCT04926493. Retrospectively registered 15 June 2021. [ABSTRACT FROM AUTHOR]