Endotracheal tube biofilm in critically ill patients during the COVID-19 pandemic : description of an underestimated microbiological compartment.

Date publication

décembre 2022

Journal

Scientific reports

Auteurs

Membres identifiés du Cancéropôle Est :
Dr FOURNEL Isabelle

Tous les auteurs :
Maldiney T, Pineau V, Neuwirth C, Ouzen L, Eberl I, Jeudy G, Dalac S, Piroth L, Blot M, Sautour M, Dalle F, Abdulmalak C, Ter Schiphorst R, Pugliesi PS, Poussant T, Ogier-Desserrey A, Fournel I, de Giraud d'Agay M, Jacquier M, Labruyère M, Aptel F, Roudaut JB, Vieille T, Andreu P, Prin S, Charles PE, Hamet M, Quenot JP

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/36575298

Résumé

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.

Mots clés

Humans, Critical Illness, Pandemics, COVID-19, epidemiology, Intubation, Intratracheal, methods, Pneumonia, Ventilator-Associated, epidemiology, Biofilms, Enterobacter

Référence

Sci Rep. 2022 12 27;12(1):22389