Abstract
Purpose of review Discovery of a normal lung microbiome requires reassessment of our concepts of HAP/VAP pathogenesis and has important implications for clinical diagnosis and management. Recent findings Changes in the microbiome of dental plaque are associated with increased risk of HAP/VAP. A transition to a lung microbiome enriched with gut flora is found in ARDS with an increased inflammatory response in patients with this change in microbial flora. A characteristic microbiome pattern of higher amounts of bacterial DNA, lower community diversity, and greater relative abundance of a single species characterize pneumonia and occasionally identify bacteria not found in culture. The influence of the microbiome makes probiotics a logical strategy to prevent or ameliorate HAP/VAP but so far clinical support is unclear. Summary The presence of a normal lung microbiome and the interaction of that microbiome with other microbiota have an important but previously overlooked impact on the pathogenesis of HAP/VAP. Deep sequencing suggests that the repertoire of microorganisms and the pattern of bacterial communities associated with HAP/VAP remains incompletely understood but recent studies are adding greater clarity.
Original language | English (US) |
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Pages (from-to) | 208-213 |
Number of pages | 6 |
Journal | Current Opinion in Infectious Diseases |
Volume | 30 |
Issue number | 2 |
DOIs | |
State | Published - Jan 1 2017 |
Keywords
- Deep sequencing
- Microbiome
- Pneumonia
- Probiotics
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases