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Could daily changes in respiratory microbiota help predicting early Staphylococcus aureus ventilator-associated pneumonia?. Les changements quotidiens du microbiote respiratoire peuvent-ils aider à prédire la pneumonie précoce associée à la ventilation assistée à Staphylococcus aureus ?

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Meyer, Sylvain | Gaïa, Nadia | Lazarevic, Vladimir | Schrenzel, Jacques | François, Bruno | Barraud, Olivier | Daix, Thomas | Chainier, Delphine | Ploy, Marie-Cécile | Vignon, Philippe

Edité par CCSD ; Springer -

International audience. Ventilator-associated pneumonia (VAP) remains the most frequent healthcare-associatedinfection in Intensive Care Units (ICUs) with a prevalence of 9–27% [1]. Factorsdriving the progression from colonization to infection during VAP development are notfully elucidated. Metataxonomics [16S rRNA gene next-generation sequencing (NGS)]has emerged as an efficient tool to investigate pulmonary microbiota. When comparedto conventional aerobic culture, metataxonomics provides additional information whichallows assessing exhaustively the local bacterial community, including anaerobes, thatare fastidious and yet-unculturable organisms. This culture-free approach provides newinsights into respiratory microbiota dynamics and potential mechanisms of VAP development[2–5]. No study has yet sequentially explored respiratory microbiota dysbiosison a daily basis and its potential relationship with the development of early VAP. Wehypothesized post hoc that patients who develop Staphylococcus aureus VAP mightexhibit modified respiratory microbiota during mechanical ventilation (MV) when comparedto patients without VAP. In this pilot study (IRB #464-2021-120), we analyzed thedaily changes of respiratory microbiota in a homogeneous population of patients underMV without prior exposure to antibiotics or antibiotic treatment during the study perioduntil potential VAP diagnosis.Eligible patients were adults admitted to the ICU for an acute brain injury requiringat least 48 h of MV, with no chronic or acute respiratory disease, and who did notreceive antibiotics in the previous 15 days. If antibiotics were administered during thestudy period, patients were secondarily excluded. Endotracheal aspirates (ETA) werecollected every morning from the day of tracheal intubation (day 1) to either the dayof VAP suspicion, the day of extubation or until day 7 whichever occurred first. AllVAP events were blindly adjudicated by two independent ICU physicians

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