title: Amoeba-resisting bacteria and ventilator-associated pneumonia.
abstract: To evaluate the role of amoeba-associated bacteria as agents of ventilator-associated pneumonia (VAP), we tested the water from an intensive care unit (ICU) every week for 6 months for such bacteria isolates; serum samples and bronchoalveolar lavage samples (BAL) were also obtained from 30 ICU patients. BAL samples were examined for amoeba-associated bacteria DNA by suicide-polymerase chain reaction, and serum samples were tested against ICU amoeba-associated bacteria. A total of 310 amoeba-associated bacteria from 10 species were isolated. Twelve of 30 serum samples seroconverted to one amoeba-associated bacterium isolated in the ICU, mainly Legionella anisa and Bosea massiliensis, the most common isolates from water (p=0.021). Amoeba-associated bacteria DNA was detected in BAL samples from two patients whose samples later seroconverted. Seroconversion was significantly associated with VAP and systemic inflammatory response syndrome, especially in patients for whom no etiologic agent was found by usual microbiologic investigations. Amoeba-associated bacteria might be a cause of VAP in ICUs, especially when microbiologic investigations are negative.
authors.affiliation: Unité des Rickettsies, Marseille, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: La Scola
authors.forename: Ioanna
authors.initials: I
authors.lastname: Boyadjiev
authors.forename: Gilbert
authors.initials: G
authors.lastname: Greub
authors.forename: Atieh
authors.initials: A
authors.lastname: Khamis
authors.forename: Claude
authors.initials: C
authors.lastname: Martin
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
mesh_terms: D000328:Adult; D000656:Amoeba / Q000302:isolation & purification* / Q000382:microbiology*; D000818:Animals; D001419:Bacteria / Q000145:classification* / Q000302:isolation & purification*; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology / Q000469:parasitology; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D011014:Pneumonia / Q000382:microbiology* / Q000469:parasitology; D012122:Ventilators, Mechanical / Q000009:adverse effects / Q000382:microbiology* / Q000469:parasitology; D014871:Water Microbiology